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RISS 인기검색어
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- 저자 : 정병규(BK Jung) (검색결과 2 건)
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정병규(BK Jung),박종덕(JD Park),오병찬(BC Oh),김종덕(JD Kim) 대한산부인과학회 1989 Obstetrics & Gynecology Science Vol.32 No.4
전북대학병원 산부인과에서 1975년 1월부터 1987년 6월까지 만 12년 6개월간 자궁경암으로 수술받은 135예에 대하여 주로 수술후 합병증과 치료성적을 조사분석하여 다음과 같은 결론 은 얻었다. 1. 연도별 수술환자수는 1975년부터 1976년까지의 연평균 3.5예에서 1985년부터 1987년까지 의 26예로 현저한 증가를 보였다. 2. 연령별분포는 41-50세군에서 전체의 40.7%의 분포를 보여 가장 높은 발생빈도를 보였다. 초혼연령별 분포는 19-21세군에서 전체의 35.8%의 분포를 보여 가장 많았다. 3. 분만과의 관계는 분만회수 3-4회의 경우에 가장 높은 빈도를 보였다. 4. 자궁경암의 임상증상으로는 접촉성 출혈을 비롯한 비정상 성기출혈이 63.7%로 가장 많았 고 다음은 대하증으로 23%였다. 5. 임상기별 분포는 제 IB기가 75예(55.6%), 제 IIA기 27예(20.0%),제 0기 18예(13.3%), 제 IA기 10예(7.4%), 제 IIB기 5예(3.7%)순이었다. 6. 병리조직학적 분류는 편평상피암이 94.8%로 가장 많앗고, 이중에서 상피내암이 14.1% 미 세침윤암 7.0%, 침윤암이 78.9%였다. 7.침윤성 편평상피암중에서 세포형태에 따른 분류는 대형세포비각질화암이 62.9%로 가장 많 았고, 대형세포각질화암이 34.3%, 소형세포비각질화암이 2.8%였따. 8. 자궁경암에 병발된 질환은 빈혈이 12예(8.9%)로 가장 많았고, 자궁근종 11예(8.2%) 고혈압 및 폐질환이 각각 3예(2.2%)순이었다. 9. 근치자궁적출술을 시행한 111예에서 수술후 합병증의 빈도는 뇨로감염이 36예(32.4%)로 가장 많앗고 하지 또는 외음부부종 8예(7.2%) 수술창 감염 및 골반내 혈종이 각각 7예(6.3%) 순이었으며 수술로 인한 사망은 없었다. 10. 근치자궁적출술을 시행한 예에서 임파선전이 빈도는 제 I기 및 제II기에서 각각 13.8%, 16.1%의 전이율을 보였다. 1. The annual incindence of patients treated with surgery was increased gradually. 2. The age distribution was most commonly between 41 and 50 years. The age distribution of first marriage was most commonly between 18 and 21 years. 3. The most common parity was 3-4times 4. The most frequency clinical symptoms of cervical cancers were contact bleeding (25.2%) and vaginal spotting (24.4%). 5. Distribution of the patients by the clinical stages was as follows; stage 0; 18cases (13.3%), stage IA;10cases (7.4%), stage IB;75cases (55.6%) stage IIA ; 27cases (20.0%). stage IIB; 5cases (3.7%). 6. The results of histopathologic types were distributed as follows; squamous cell carcinoma was 94.8% adenocarcinoma was 5.2% and adenocarcinomous carcinoma was 0%. 7. The histologic subtype of invasive squamous cell carcinoma (70cases) were as follows; Large cell non-keratinizing type was 62.9% large cell keratinizing type was 34.3% and small cell non-keratinizing type was 2.8%. 8. The most frequency medical conditin in preoperative patients was anemia(8.9%). 9. The most common complications after radical hysterectomy was urinary tract infection(32.4%) 10. The incindence of lymph node metastasis was 13.8% in stage I and 16.1% in stage II, The overall incindence of regional node metastasis was 14.4%. 11. The result of 5year survival rate in confirmed patients by follow-up was 100% in stage 0. 100% in stage IA, 76.5% in stage IB and 57.1% in stage IIA. Overall 5 year survival rate was 79.4%. 12. The incindence of recurrence was 7.4% and recurrent sites were viginal stump, rectum, pelvic wall and abdominal cavity.
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오병찬,김종덕,김경옥,정병규,이동복 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.1
1.세포진검사의 정확도는 조준생검결과와 비교하여 64.8 %이었으며, 위음성율과 위양성율은 각각 23.9%, 11.3 &였다. 2. 질확대경에 의한 추정진단의 정확도는 조준생검결과와 비교하여 73.2 %이었으며, underestimated rate는 16.9 %였다. 3. 질확대경에 의한 조준생검결과와 최종 병리조직 진단과의 일치율은 77.8 %, one pathologic degree내에서의 일치율은 96.3 %이었으며, 조준생검의 underestimated rate는 14.8 %였다. 4. 자궁경관소파술 병용군에서 경관내에 이형상피증이상의 양성율은 19.4 %(6/31)이었으며, 연령분포는 6명중 5명이 40대이었다. 5. 질확대경검사시 자궁경관소파술 비병용군과 병용군간에 치료전침윤암의 오진율은 각각 3.1 %(1/32), 4.5 %(1/22)로서 비슷하였으나, 병용군에서 침윤암 13명중 2명은 자궁경관소파술에 의해 진단되었다. With the use of colposcopy to evaluate cervical lesions, the management of patients with abnormal Papanicolaou smears has become more individualized and developed. But colposcopic accuracy depends on criteria determining its limitations and examiners experience. Most important limitation of colposcopy is incomplete visualization of transformation zone extending into the endocervical canal. To improve the diagnostic accuracy of colposcopy before management, some reporters have suggested that endocervical curettage be an integral part of colposcopic examination. This suggestion has not been accepted by all authors. This study was undertaken to compare cytologic diagnosis and colposcopic impression with the histology of colposcopically directed biopsy, to determine the accuracy of colposcopy-directed biopsy, and to demonstrate whether the addition of endocervical curettage to colposcopy-directed biopsy can eliminate further diagnostic evaluation(conization) in the management of patients with satisfactory colposcopic findings. From Jan. 1, 1986 to Sep. 30, 1988, the colposcopic examination was undertaken in 71 patients with abnormal cytologic smears, excluding grossly visible carcinoma of the cervix. The results were as follows: 1. Accuracy of cytology was 64.8% and its false negative and positive rate were 23.9%, 11.3% respectively when compared to the histology of colposcopically directed biopsy. 2. Accuracy of colposcopic impression was 73.2% and its underestimated rate was 16.9% when compared to the histology of colposcopy-directed biopsy. 3. Accuracy of colposcopically directed biopsy was 77.8% and its underestimated rate was 14.8% when compared to the histology of final surgical specimen. 4. An endocervical curettage was obtained in 31 patients and was positive in 19.4% (6/31) of those sampled, including two patients with no lesion found on directed biopsy specimen. 5. There were two cases in which an invasive cancer was missed prior to therapy, one in the non-ECC group of 32 patients (incidence 3.1%), the other ECC group of 22 patients(incidence 4.5%) when comparedto the final pathologic diagnosis.
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