Marina Dudea-Simon1, Sorin Marian Dudea2, Alexandru Burde3, Razvan Ciortea4, Andrei Malutan5, Dan Mihu6. 1. "Iuliu Hatieganu" University of Medicine and Pharmacy, 2nd Department of Obstetrics and Gynecology, 55 Bd 21 December, 400012, Cluj-Napoca, Romania. marina.dudea@gmail.com. 2. "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania. sdudea1@gmail.com. 3. "Iuliu Hatieganu" University of Medicine and Pharmacy, Department of Dental Prosthodontics & Aesthetics, 32 Clinicilor Street, 400006, Cluj-Napoca, Romania. abv.alex@yahoo.com. 4. "Iuliu Hatieganu" University of Medicine and Pharmacy, 2nd Department of Obstetrics and Gynecology, 55 Bd 21 December, 400012, Cluj-Napoca, Romania. r_ciortea@yahoo.com. 5. "Iuliu Hatieganu" University of Medicine and Pharmacy, 2nd Department of Obstetrics and Gynecology, 55 Bd 21 December, 400012, Cluj-Napoca, Romania. malutan.andrei@gmail.com. 6. "Iuliu Hatieganu" University of Medicine and Pharmacy, 2nd Department of Obstetrics and Gynecology, 55 Bd 21 December, 400012, Cluj-Napoca, Romania. dan.mihu@yahoo.com.
Abstract
AIMS: To assess the usefulness of real time elastography (RTE) strain ratio (SR) in diagnosing cervical cancer (CC) and cervical intraepithelial neoplasia (CIN), using a synthetic experimental device (ED) as reference material. MATERIAL AND METHODS: Seventy-nine participants were enrolled, divided in three groups: Group 1 - benign cervix (n=39); Group 2 - CIN (n=32); Group 3 - CC (n=8). Transvaginal RTE was performed, with SR determination, as the ratio between the ED and the cervical tissue. Mean SR values of the groups were compared; diagnostic performance was assessed by tracing the receiver operating characteristic (ROC) curve. Area under the curve (AUC) was analyzed. Cut-off values were established. Pathological results were considered as reference for data interpretation. RESULTS: SR means significantly differed in Group 1 as compared to Groups 2 and 3 (p=0.001). Excluding 2 aberrant values in Group 3, assigned to cases complicated by hemorrhagic necrosis, statistical difference was also noted between Groups 2 and 3 (p=0.02). For Groups 1 and 3, AUC was 0.966 with a 95%CI (0.914-1.000); the cut-off point of SR was 1.42, with a sensitivity of 100% and a specificity of 94.9%. AUC was 0.752 with a 95%CI (0.629-0.876) for Groups 1 and 2. For the cut-off value of 1.03, sensitivity and specificity were 75% and 74%, respectively. CONCLUSION: RTE SR, performed with a synthetic reference material, seems a reliable method for distinguishing between benign uterine cervix and malignancy, with promising results as a complementary investigation in diagnosing CIN. However, SR becomes inoperant in cases of cancer complicated with hemorrhagic necrosis.
AIMS: To assess the usefulness of real time elastography (RTE) strain ratio (SR) in diagnosing cervical cancer (CC) and cervical intraepithelial neoplasia (CIN), using a synthetic experimental device (ED) as reference material. MATERIAL AND METHODS: Seventy-nine participants were enrolled, divided in three groups: Group 1 - benign cervix (n=39); Group 2 - CIN (n=32); Group 3 - CC (n=8). Transvaginal RTE was performed, with SR determination, as the ratio between the ED and the cervical tissue. Mean SR values of the groups were compared; diagnostic performance was assessed by tracing the receiver operating characteristic (ROC) curve. Area under the curve (AUC) was analyzed. Cut-off values were established. Pathological results were considered as reference for data interpretation. RESULTS: SR means significantly differed in Group 1 as compared to Groups 2 and 3 (p=0.001). Excluding 2 aberrant values in Group 3, assigned to cases complicated by hemorrhagic necrosis, statistical difference was also noted between Groups 2 and 3 (p=0.02). For Groups 1 and 3, AUC was 0.966 with a 95%CI (0.914-1.000); the cut-off point of SR was 1.42, with a sensitivity of 100% and a specificity of 94.9%. AUC was 0.752 with a 95%CI (0.629-0.876) for Groups 1 and 2. For the cut-off value of 1.03, sensitivity and specificity were 75% and 74%, respectively. CONCLUSION: RTE SR, performed with a synthetic reference material, seems a reliable method for distinguishing between benign uterine cervix and malignancy, with promising results as a complementary investigation in diagnosing CIN. However, SR becomes inoperant in cases of cancer complicated with hemorrhagic necrosis.
Authors: Marina Dudea-Simon; Dan Mihu; Laura Ancuta Pop; Razvan Ciortea; Andrei Mihai Malutan; Doru Diculescu; Cristina Alexandra Ciocan; Roxana Maria Cojocneanu; Vasile Simon; Carmen Bucuri; Radu Mocan-Hognogi; Cornelia Braicu; Ioana Berindan-Neagoe Journal: Int J Mol Sci Date: 2022-05-27 Impact factor: 6.208