PubMed1980
Diagnosis of extension of cervical cancer still depends mostly on subjective inspection and palpation and there is only a few objective methods to know the extent of invasion and metastasis of the cancer and the difficulty of surgical operation. To develop a new method, a combination of 67Ga-computer scintigraphy, I.V.P. and lymphography was evaluated in the diagnosis of parametrial infiltration and lymph metastasis in 84 cases of cervical cancer at the stage one to four. 67Ga-citrate is now the most efficient of oncotropic radioisotopes with a short half life. It was revealed that this isotope bounds to the protein with a molecular weight of about 70,000 daltons or more in the 105,000g supernatant of the cytoplasm of tumor cells. The 67Ga accumulation on scintigram was classified into five types according to the shape, extent and concentration, and in each type tissue specimens obtained by surgical operation were examined histologically. I.V.P. with reference to renogram was also used to know the extent of parametrial invasions of cancer in which cases the ureter was extremely distended. Lymphography was done by Kinmonth method. The extent of parametrial invasion was judged from findings of both 67Ga-scintigram and I.V.P., and metastasis was estimated by abnormal features of both 67Ga-scintigram and lymphogram. As a result of the above study on the combination of the three methods, the rate of correct diagnosis for parametrial infiltration was increased to 70.8% by combining the findings of I.V.P. to scintigram, and the rate for lymph metastasis was improved to 89.6% by combining lymphogram to scintigram. At the same time the rate of false negative diagnosis for each extension of the cancer could also be decreased. It might be concluded that this combined method has a large diagnostic significance.