Agreement of histopathological findings of uterine curettage and hysterectomy specimens in women with abnormal uterine bleeding

Abstract

Objectives:To examined the diagnostic value of dilatation and curettage (D&C) in patients with abnormal uterine bleeding (AUB) by conducting a histopathological examination of endometrial tissues by D&C and hysterectomy.Methods:In this retrospective study, the medical records of 163 women who had been hospitalized in the Obstetrics and Gynecology Ward, Amir-al-Momenin Hospital, Semnan, Iran between 2010 and 2015 for diagnostic curettage due to AUB and who had undergone hysterectomy were investigated. The patients’ characteristics and histopathologic results of curettage and hysterectomy were extracted, and sensitivity and specificity and positive and negative predictive values of curettage were calculated.Results:The mean ± standard deviation age of the patients was 49.8±7.8 years. The sensitivity values of D&C in the diagnosis of endometrial pathologies was 49.1%, specificity 84.5%, positive 60.5%, and negative predictive 77.5%. The sensitivities of D&C in the diagnosis of various endometrial hyperplasia was 62.5%, disordered proliferative endometrium 36.8%, and endometrial cancer 83.3%. Of 6 patients with endometrial polyps on performing hysterectomy, no patient was diagnosed by curettage.Conclusions:Dilatation and curettage has acceptable sensitivity in the diagnosis of endometrial cancer, low sensitivity in the diagnosis of endometrial hyperplasia, and very low sensitivity in the diagnosis of disordered proliferative endometrium and endometrial polyps.

The accuracy of endometrial sampling for the diagnosis of patterns of endometrial pathology in women presenting with abnormal uterine bleeding

“…In our study, the preoperative histologic examination had a specificity of 90% and a sensitivity of 53.8%. A low sensitivity has also been reported in other research studies 5,6,9. However, the sensitivity of uterine sampling in the detection of high-grade tumors has been shown to be high 10.…”

“…Polyps can also be missed due to their focal growth pattern. In a previous study, none of the 6 polyps seen following hysterectomy were detected during preoperative sampling 5…”

Risk of More Advanced Lesions at Hysterectomy after Initial Diagnosis of Non-Atypical Endometrial Hyperplasia in Patients with Postmenopausal Bleeding and Oral Anticoagulant Treatment

“…In ordinary medical practice, the histopathological diagnosis of endometrial pathology, EH, is also established by analyzing histological samples taken by D&C. Endometrial D&C is considered appropriate for endometrial pathological diagnosis [69,70]. D&C can help detect EC preoperatively but is not accurate enough to rule out malignancy [71][72][73][74][75][76].…”

Correlación entre el diagnóstico clínico de un sangrado uterino anormal y el resultado anatomopatológico

“…4 Esto se debe a que, a mayor edad el riesgo de sangrado aumenta considerablemente, lo cual está asociado con cambios hormonales. 5 Como fue descrito en este estudio, cerca de 40% de los casos incluidos en la muestra era de mujeres nuligestas, lo cual es un factor de riesgo para el desarrollo de adenomatosis, cuyo diagnóstico está presente en un tercio de la población estudiada. 6,7 Además, la presencia de adenomatosis también ha sido asociada con el desarrollo de tejido fibroso o miomatosis uterina, que fue el principal diagnóstico anatomopatológico en nuestro estudio.…”