Möglichkeiten und Grenzen eines zytologischen Früherkennungsprogramms beim Endometriumkarzinom

Abstract

In a review of the most important examination methods for diagnosis of endometrial carcinoma so far published the efficacy of each of the individual methods is assessed according to uniform criteria. Only the specimens diagnosed as positive were taken as a basis for the rate of correct diagnosis, in order to facilitate comparison of the efficacy of the methods with one another. The validity of the methods is briefly outlined. Cytological diagnosis of endometrial carcinoma is appreciably less reliable than that of cervical carcinoma, regardless of the method used. The cytodiagnostic problems are different, depending whether exfoliative cytology or endouterine biopsy techniques have been used. Cancers of highly differentiated tumor cells are most seldom identified by the conventional smear techniques. Taking the endometrial carcinoma and endometrial hyperplasia patients at Erlangen University Gynecological Clinic between 1963 and 1981 as a basis, and limiting the scope of the study to high-risk adipose patients aged over 45, one-fifth of the carcinomas and one-fourth of the precancerous patients would not be included in a program based on risk factors. Of the Erlangen patients, a 5-year survival probability of 95% and more was calculated for women with tumors from cytologically highly differentiated cancer cells in histological stage I. It is particularly difficult to identify these patients cytologically, and the prognosis for them can hardly be improved further. Cytological nucleus grading proved a reliable prognosis factor, in particular for histologically undifferentiated tumors.(ABSTRACT TRUNCATED AT 250 WORDS)

Stellenwert der fraktionierten Abrasio und der Portio-, Endozervikalzytologie in der Diagnostik des Endometriumkarzinoms

“…Endoze rvika l-un d Vaginalzytologie versagen ihre Dienst e in der siche re n Erkenn ung de r Uterusmalignome. Die TrefTerrat e wird na ch literaturangabe n mit 62 % für das hin tere Sch eid en gew ölbe und m it nur 52 % für den Portio-End ozer vix-Ber eich angege be n (14). Insbesondere hochdifTeren zierte Karzin om e entge he n der Exfoliativzytologie am häufigsten und sind außerdem sehr oft a uch na ch sorg fältigster h istologisch er Untersuchung nicht eindeutig von gutartiger Zerv ixschleimhaut zu trenn en (14) .…”