자궁경부암 선별 검사에서 자궁경부 확대 촬영술의 이용

Abstract

Background Uterine cervical cancer is the most common malignant tumor of the women in Korea. This study was undertaken to evaluate the usefulness of the cervicography as a screeningg test of cervical cancer. Materials and Methods Cervicography was taken from 482 women at department of obstetrics and gymecology, at Yeungnam University Hospital from March 1, 1998 to October 31, 1999, of the 482 women, 172women were excluded from the study for various reasons, and 310 women completed the study. Three-hundred and ten women had cervical cytology(Papanicolaou smear), cervicography and colposcopy, and punch biopsy was undertaken if any of the test result was abnormal. Results The most common age group was 35-39, and 40-44, 45-49 in order and most common reason for having a screening test was regular check for cervical cancer. The mean duration from the last Pap smear was 17.1 months, and 64 women(20.4%) never had any prior screening tests. Of the 310 women, 254 women were categorized as normal or having benign disease such as cervicitis, erosion or metaplasia. Biopsy was taken from 56 patients and the results were 26 chromic cervicitis, 4 mild dysplasia, 6 moderate dysplasia, 2 severe dysplasia, 14 carcinoma in situ and 4 invasive carcinoma. The results of cytology and cervicography were well correlated(p<0.05) The sensitivity of cytology and cervicography were 86.7% and 76.9%, respectively and the sensitivity and specificity of cervicography were 56.7% and 96.2%, respectively. False negative rate of cervicography(43.3%) was much higher than those of cytology(13.3%)(p<0.05), but false positive rate of cervicography(3.8%) was much lower than that of cytology(23.1%)(p<0.05). Conclusion It seems inappropriate to use cervicography as a single scerrning test for cervival cancer, but it may be an effective complementary test for cytology to lower the false negative rate of cytology.