자궁경부암 선별진단에 있어서 자궁경부확대촬영술의 보조적 역할

Abstract

Despite widespread clinical acceptance and use of Papanicolaou (Pap) test, cervical cancer remains a disease of prime importance in Korea. The purpose of this study was to investigate the supportive role of cervicography in screening test for uterine cervical cancer. Pap test and cervigram data were obtained from 220 patients who visited the cancer detection center of the department of obstetrics and gynecology, Yonsei University College of Medicine from Jul.1997 to Feb.1998. Histologic specimens were obtained from patients in whom abnormalities were detected by either Pap test or cervigram. Histologic confirmation were taken either by colposcopically directed biopsy (CDB) or large loop excision of the transformation zone (LLETZ). The results were as follows: 1. Pap test (209 cases) outcomes were WNL in 119 cases (57.0%), ASCUS in 12 cases (5.7%), LSIL in 11 cases (5.3%), HSIL in 48 cases (22.9%), and SCC in 19 cases (9.1%). 2. Cervicography (209 cases) outcomes were negative cervigram (N1, N2) in 53 cases (25.7%), benign atypia (B1, B2) in 61 cases (29.6%), suspicious atypia (S1, S2) in 59 cases (28.6%), and positive (PL, PH, PC) in 33 cases (16.1%). Technically defect (TD) in 3 cases were exclusive in analysis. 3. When cervicography and Pap test were used together, the sensi- tivity (P ＜0.01) and negative predictive value (P ＜0.01) were increased than for cervicography alone. 4. When cervicography and Pap test were used together, the sensitivity (P ＜0.01) and negative predictive value (P ＜0.05) were increased than for Pap test alone. Our study revealed that cervicography combined with Pap test improved the sensitivity and negative predictive value (NPV) in the screening of uterine cervical cancer. In conclusion, cervicography may play a supportive role in the screening of uterine cervical cancer.