Open AccessAccuracy of Preoperative Endometrial Sampling for the Detection of Endometrial Pathology: a Retrospective Study
Author(s) -
Keven P M Tali,
Lilli M T Cole
Publication year - 2017
Publication title -
indonesian journal of obstetrics and gynecology
Language(s) - English
Resource type - Journals
eISSN - 2338-7335
pISSN - 2338-6401
DOI - 10.32771/inajog.v5i1.461
Subject(s) - medicine , atypia , hysterectomy , endometrial hyperplasia , histopathology , sampling (signal processing) , gynecology , endometrial cancer , atypical hyperplasia , hyperplasia , endometrial polyp , malignancy , endometrium , radiology , pathology , cancer , obstetrics , hysteroscopy , filter (signal processing) , computer science , computer vision
Objective: To investigate the accuracy of endometrial sampling in
the diagnosis of endometrial pathology and the need of intraoperative
frozen section.
Methods: One hundred forty women who underwent endometrial
sampling followed by hysterectomy between 2011 and 2014 were
included in this study. Data were retrieved from patient files and
pathology archives in Department of Obstetrics and Gynecology,
Jose R. Reyes Memorial Medical Center, Manila, Philippines.
Results: There were 25 patients with malignancy but endometrial
sampling detected only 22 of them. The endometrial sampling
sensitivity and specificity for detecting cancer were 88% and 100%,
respectively with negative and positive predictive values of 97.5%
and 100%, respectively. In 3 patients, the endometrial sampling
failed to detect malignancy; 1 patient had a preoperative diagnosis
of complex hyperplasia with atypia, 1 patient had complex
hyperplasia without atypia and 1 patient had adenofibroma. A total
of eighty patients had benign findings. There were fifty-three cases
with finding of proliferative endometrium and twenty-seven were
secretory. Twenty-three (55.0%) and 11 (39.0%) cases were
confirmed by the hysterectomy specimen, respectively. The
sensitivity of endometrial sampling in detecting benign samples was
76.0% and the specificity reached up to 83.0%. The histopathology
result of the other fourteen cases were reported of having atrophy,
twelve cases were reported of having endometrial hyperplasia, four
with basal endometrium, four with endometrial polyp and one with
adenomyosis.
Conclusion: Outpatient endometrial biopsy has a high overall
accuracy in diagnosing endometrial cancer when the specimen
obtained is sufficient. A positive test result is more accurate for
ruling in disease than a negative test result is for ruling it out.
However, the diagnosis should be confirmed by frozen section in
patients with complex hyperplasia and adenofibroma.
[Indones J Obstet Gynecol 2017; 5-1: 23-29]
Keywords: abnormal uterine bleeding, endometrial hyperplasia,
endometrial sampling, frozen section, pipelle