Endometri̇al Örnekleme Sonuçlarimiz :744 Olgunun Anali̇zi̇ (Evaluation of Endometrial Biopsy Results in Our Clinic; Analysis of 744 Cases)

Abstract

Amaç: Kliniğimizde endometrial örnekleme yapı-lan olgularda, endikasyon ile histopatolojik sonuçlar arasındaki ilişkinin araştırılması. Gereç ve Yöntem:Kliniğimize Ocak 2013-Ocak 2014 tarihleri arasında başvuran ve gebelik dışı herhangibir endikasyonla endometrial örnekleme yapılan 744 olgu retrospektif olarak değerlendirildi. Veriler hastanemiz kadın hastalıkları ve doğum kliniği ve patoloji kliniği arşivinden alındı. İstatistiksel analiz için SPSS 13 programı kullanıldı. Bulgular:Olguların ortalama yaşları 43.6 +/-8.3 idi. Endometrial örnekleme endikasyonları sırasıy-la menometroraji/menoraji (%87), postmenopozal kanama (%9.5), servikal polip (%1.9), myom uteri (%1.6) idi. Histopatolojik sonuçlar ise sırayla proliferatif/sekretuar endometrium (%72.8), endometrial polip (%9.5), basit atipisiz hiperplazi (%7.9), atrofik endometrium (%3.5), endometrit (%3.2), yetersiz materyal (%0.9), endometrium kanseri (%0.8), basit atipili hiperplazi (%0.7), komplex atipili hiperplazi (%0.3), komplex atipisiz hiperplazi (%0.3) idi. Endometrium kanseri görülme oranı postmenapozal kanaması olan hasta grubunda %5.6 ile diğer gruplara oranla anlamlı derecede yüksek bulundu.Sonuç: En sık endometrial örnekleme endikasyonu menoraji/menometroraji iken endometrium kanseri açısından riskli grubun postmenopozal kanamalı olgular olduğu gösterilmiştir. Bu nedenle postmenapozal kanamalı hastalarda ciddi endometrial değerlendirme ve örnekleme yapılmasi gerekir. Ayrıca servikal polip olgularında endometriumunun değer-lendirilmesinin gerektiği sonucuna varılmıştır.Anahtar kelimeler: endometrial örnekleme, anormal uterin kanama, endometrium kanseri ABSTRACT Aims: To evaluate indications and histopathological diagnoses of endometrial samplings in our clinic. Materials-Methods:Seven hundred and fourty four subjects who required endometrial biopsy to be taken for any indication other than pregnancy between January 2013 and January 2014 were included in the study. Data collected retrospectively from Dumlupinar University Evliya Celebi Training and Research Hospital obstetrics and gynecology clinic database and pathology clinic. Statistical analysis of data was performed using SPSS for Windows 13 package programme.Results: Mean age of the subjects was 43.6 ± 8.3. Indications of endometrial sampling were menorrhagia/menometrorrhagia (87%), myoma uteri (1.6%), postmenopausal bleeding (9.5%), cervical polyp (1.9%). Histopathologic diagnoses were as follows: secretory/proliferative endometrium in 72.8%, atrophic endometrium in 3.5%, simple atypical endometrial hyperplasia in 0.7%, simple typical endometrial hyperplasia in 7.9%, complex atypical endometrial hyperplasia in 0.3%, complex typical endometrial hyperplasia in 0.3%, atrophic endometrium in 3.5%, endometrium cancer in 0.8%, and endometrial polyp in 9.5%. Insufficient sampling material was reported in 0.9%. Endometrium cancer was detected in 5.6% of postmenopausal group. Conclusion:The most common endometrial sampling indication was menorrhagia/menometrorrhagia, while endometrium cancer was detec...

Assessment of Endometrial Sampling and Histopathological Results: Analysis of 4,247 Cases

“…Routine endometrial sampling is not recommended before hysterectomy for exclusion of endometrial pathology in patients presenting with myoma uteri; however, it is still widely performed by many clinicians [5,11]. In our study, EC was not determined in samples obtained due to myoma uteri, similar to the studies in the literature [6,11].…”

“…The endometrial hyperplasia rate was reported as 9%-10% in endometrial samples obtained due to abnormal uterine bleeding in the studies of Kucur et al [6] and Tuncer et al [7]. Endometrial hyperplasia was found in 411 (9.68%) cases in our study.…”

“…Although the most common indication for endometrial biopsy was menometrorrhagia/ menorrhagia (70.66%) in our study, this rate may vary between 57% and 89% [1,4,6]. Routine endometrial sampling is not recommended before hysterectomy for exclusion of endometrial pathology in patients presenting with myoma uteri; however, it is still widely performed by many clinicians [5,11].…”

“…Jetley et al [12] determined proliferative-secretory endometrium in 63% of the patients who had undergone endometrial biopsy due to abnormal uterine bleeding, and Kucur et al [6] was reported as 1%-3% in hyperplasia without atypia and 8%-29% in hyperplasia with atypia [13]. The endometrial hyperplasia rate was reported as 9%-10% in endometrial samples obtained due to abnormal uterine bleeding in the studies of Kucur et al [6] and Tuncer et al [7].…”

“…D/C and office biopsy methods enable the complete evaluation of the endometrium as only one-third of the endometrium can be evaluated with these methods [5]. Hysteroscopy is accepted as the gold standard for evaluating endometrial pathologies as the endometrial cavity may be directly observed with hysteroscopy, which also enables concurrent treatment [3,6]. Recent studies report that routine endometrial sampling is controversial as they are associated with high costly, high morbidity, and anxiety in patients [5][6][7].…”