Incidence and risk factors for insufficient endometrial tissue from endometrial sampling

Aue-aungkul, Apiwat; Kleebkaow, Pilaiwan; Kietpeerakool, Chumnan

doi:10.2147/ijwh.s172696

Cited by 18 publications

(28 citation statements)

References 17 publications

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“…Consistent with our findings, several authors reported that the chance of getting an adequate sample was increased in postmenopausal women with an endometrial thickness of >12 mm, and they also suggested that nulliparity and advanced age were independent factors affecting unsuccessful Pipelle sampling (15). A recent study reported that an endometrial thickness of less than 8 mm and menopausal status were associated with an increased risk of insufficient endometrial sampling (19).…”

Section: Discussionsupporting

confidence: 90%

Factors Associated with Insufficient Endometrial Sampling in Postmenopausal Women

Ateş¹,

Karasu²,

Çalı³

et al. 2020

Haseki

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Aim:To assess the risk factors associated with high rate of insufficient endometrial sampling on endometrial biopsy in postmenopausal women.Methods: Data were retrieved from the records of 522 consecutive patients who underwent endometrial sampling. Logistic regression analyses were performed to determine various factors associated with scanty endometrial biopsy. The exclusion criteria included patient refusal, uncertain menopausal status, cervical carcinoma detected after sampling and unavailable records. Results:The sample was insufficient for a definitive diagnosis in 143 (25.9%) patients. Out of these, 53 cases were investigated with invasive procedures. Further histopathological examination revealed that five (9.4%) patients had uterine malignancy. Based on the multivariate analysis, time since the onset of menopause [Odds ratio (OR)=1.044, 95% confidence interval (CI)=1.000-1.090, p=0.049] was significantly associated with insufficient endometrial biopsy in cases with a endometrial thickness of >12 mm on ultrasonography (OR=0.624, 95% CI=0.472-0.824, p=0.001). The use of dilation and curettage technique (OR=0.662, 95% CI=0.522-0.841, p=0.001) decreased the risk of insufficient sampling on endometrial biopsy. Conclusion:Time since the onset of menopause and the thickness of endometrium were significant independent factors associated with insufficient sample. Using Karman cannula for endometrial aspiration may not be a reliable method in the evaluation of postmenopausal women. An insufficient endometrial sample does not rule out endometrial carcinoma, therefore, a further histopathological examination is recommended.Amaç: Postmenopozal kadınlarda endometrial biyopsi patoloji sonucunun yetersiz doku olarak saptanması ile ilişkili risk faktörlerini değerlendirmektir.Yöntemler: Endometrial örnekleme yapılan ardışık 552 hastanın kayıtları incelenerek veriler toplandı. Endometrial örneklemenin yetersizliğine ilişkin faktörleri belirlemek için lojistik regresyon analizleri yapıldı. Hastanın onayının olmaması, belirsiz menapozal durum, örnekleme sonrası serviks kanseri saptanması ve hastanın kayıtlarına ulaşamama dışlanma kriterleri olarak kabul edildi.Bulgular: Endometrial örneklem 143 (%25,9) hastada kesin tanı için yeterli değildi. Bu vakaların 53'üne invaziv işlem uygulandı. Ek histopatolojik inceleme sonucunda beş (%9,4) hastada uterus malignitesi saptandı. Multivariate analiz sonucunda, yetersiz endometrial biyopsi sonuçları ile menopoz başlangıcından itibaren geçen süre (OR=1,044, % 95 CI=1,000-1,090, p=0,049) arasında anlamlı ilişki saptandı. Ultrasonografide endometrial kalınlığın >12 mm olması (OR=0,624, %95 CI=0,472-0,824, p=0,001), dilatasyon ve kürtaj tekniğinin uygulanması (OR=0,662, %95 CI=0,522-0.841, p=0,001) endometrial biyopside yetersiz örnek saptanma riskini azalttığı gösterildi.Sonuç: Menopoz başlangıcından bu yana geçen süre ve endometrium kalınlığı, yetersiz örneklem ile ilişkili önemli bağımsız faktörlerdir. Endometrial aspirasyon için Karman kanülünün kullanımı, postmenapozal kadınların değ...

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Section: Discussionsupporting

confidence: 90%

Factors Associated with Insufficient Endometrial Sampling in Postmenopausal Women

Ateş¹,

Karasu²,

Çalı³

et al. 2020

Haseki

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“…Combining both inadequate and inconclusive reports in our study sample inadequacy was higher in the current study compared to all other publications which might be because of less endometrial assessment by transvaginal ultrasound. Retrospective review at the Khon Kaen University’s Srinagarind Hospital showed menopausal status and endometrial thickness of less than 8 mm were independent predictors for insufficient endometrial tissue after endometrial sampling(21). In our study patients ≥ 50 years of age were eight times more likely to have inadequate sample compared to those 20-29 years of age but TVUS was not done to assess endometrium in almost all cases (97.74%) and there is no association with parity and level of health professional who did the procedure.…”

Section: Discussionmentioning

confidence: 99%

Review of histopathologic findings of endometrial biopsy done at a tertiary referral hospital in urban Ethiopia

Tolu

Kebtamu

Abedella

et al. 2020

Preprint

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23 Background: An endometrial sampling procedure is a gold standard for the diagnostic 24 evaluation of women with abnormal uterine bleeding (AUB) with primary aim to identify 25 the cause, especially to determine whether carcinoma or premalignant lesions are 26 present. The objective of the study is therefore to review endometrial biopsy specimen 27 histopathological findings and associated factors at a tertiary referral hospital in urban 28 Ethiopia.29 Methodology: This is a two years retrospective analysis of cases of patients for whom 30 endometrial biopsy was taken at a territory referral hospital in urban Ethiopia. Odd's ratios, 31 95% confidence interval and p-value set at 0.05 were used to determine the statistical 32 significance of the associations.33 Results: A total of 277 patient records were analyzed and mean and the median age of 34 the study patients were 41.89 and 40.00 years respectively. The commonest 35 histopathologic finding was endometrial polyp 66 (23.83%), followed by proliferative 36 endometrium 47 (16.97%) and secretory endometrium 25(9.03%). Endometrial 37 hyperplasia, endometrial malignancy, and pregnancy complications were reported in 938 (3.25%), 13 (4.69%), and 25 (9.03%) of cases respectively. Endometritis was detected in 39 20(7.22%), while Tuberculous (TB) endometritis was reported in 3(1.08%) of cases only. 40 Inconclusive and inadequate sample was reported in 30 (10.83%) and 34 (12.27%) of 41 cases respectively. Endometrial polyp was associated with 40-49 years of age (OR= 42 12.56, 95% CI: 2.58-61.23). 43 Conclusions: Endometrial polyp was the commonest histopathologic finding followed by 44 proliferative and secretory endometrium respectively. Rate of sample inadequacy is 3 | P a g e 45 higher than most of the study reports which mandates to improve sampling technique to 46 increase sample adequacy and routine transvaginal ultrasound for endometrial evaluation 47 especially for those postmenopausal women to decide the necessity of endometrial 48 sampling. 49 Key Words: Endometrial biopsy, Histopathological findings, Ethiopia 50 Background. 51 An endometrial biopsy is the removal of a small piece of tissue from the endometrium, 52 which is the lining of the uterus (1-3). This tissue sample can show cell changes due to 53 abnormal tissues or variations in hormone levels. The preferred method is an outpatient 54 office-based endometrial biopsy, usually without anesthesia or cervical dilation. For the 55 office procedure, a 2-4 mm diameter plastic cannula, with a plunger within, is used and 56 is reliable and is well accepted by the patient (1-7). 57 Sharp curettage (D& C) alone or in combination with hysteroscope might also be required 58 in case simple office sampling techniques failed to provide sufficient diagnostic 59 information or if abnormal bleeding persists after normal histopathologic findings (2, 3). 60 An endometrial sampling procedure is a gold standard for the diagnostic evaluation of 61 women with abnormal uterine bleeding (AUB) with primary aim to identify the c...

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“…U literaturi jako varira postotak nezado voljavajućih uzoraka: od 6 pa do 44,5% za histološku dijagnozu asimptomatskih žena. 21 Ovdje izloženi re zultati za citološke i histološke uzorke spadaju u sku pinu istraživanja s manjim postotkom nezadovoljava jućih uzoraka, vjerojatno zato što su istraživanje pro veli iskusni patolozi i citolozi iz iste institucije i prema standardiziranim kriterijima za procjenu prikladnosti uzoraka.…”

Section: Raspravaunclassified

“…Slične probleme navode i drugi autori. 21,24,28,29 Jedno stavna hiperplazija endometrija točno je dijagnostici rana kod 11 od 13 bolesnica (84,6%), a kompleksna hiperplazija samo u njih 50% (2/4) (slika 3.). Katkad se degenerativne promjene endometrijskih stanica poput, npr., povećanja jezgara mogu interpretirati kao atipija.…”

Section: Raspravaunclassified

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Efficacy of Uterobrush in Endometrial Sample Collection for the Cytology and Diagnosis of Endometrial Lesions

Bolanča

Simon

Bota

et al. 2019

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1 Zavod za kliničku citologiju i citogenetiku, Klinička bolnica Merkur, Zagreb 2 Odjel za patologiju i kliničku citologiju Opće bolnice Virovitica, Virovitica 3 Odjel za patologiju i citologiju Opće bolnice Bjelovar, Bjelovar Pregled | Review Deskriptori ENDOMETRIJ -patologija; TUMORI ENDOMETRIJA -dijagnoza, patologija; HIPERPLAZIJA ENDOMETRIJA -dijagnoza, patologija; CITODIJAGNOSTIKA -instrumenti, metode; UZIMANJE UZORKA -instrumentiSAŽETAK. Endometrijski karcinom najčešća je invazivna neoplazma ženskoga genitalnog trakta s rastućom incidencijom u posljednjim desetljećima. Cilj je ovog rada upozoriti na učinkovitost metode materničnog četkanja (uterobrush) pri dobivanju uzoraka materništa i postavljanju citološke dijagnoze endometrijskih lezija. Materijal i metode: Tijekom godine dana četkicom su uzeti uzorci materništa od 162 simptomatske bolesnice u perimenopauzi i postmenopauzi koje su došle u Kliniku za ženske bolesti i porode KB-a Merkur. Patohistološke dijagnoze, dobivene nakon frakcionirane kiretaže (n = 36 ) ili nakon kirurškog zahvata (n = 16), usporedilo se s postavljenim citološkim dijagnozama, a 97 bolesnica pratilo se godišnjim ultrazvučnim pregledima. Iz istraživanja su isključeni uzorci neadekvatni za analizu. Rezultati: Citološka dijagnoza postavljena s pomoću metode materničnog četkanja bila je u skladu s patohistološkom dijagnozom u 69,2% (36/52) bolesnica. Citološki i histološki potvrđeni su: sedam karcinoma, ukupno 13 hiperplazija endometrija, jedan polip te 14 nalaza s benignim promjenama. Pacijentice praćene ultrazvukom nisu više imale ginekoloških simptoma. Zaključak: Uporaba maternične četkice omogućuje dobivanje prikladnog i reprezentativnog uzorka materništa za prepoznavanje lezija endometrija i sudjeluje u postupniku obrade simptomatskih bolesnica. SUMMARY.Objective: Endometrial carcinoma is the most common invasive neoplasm of the female genital tract, with a rising incidence over the past few decades. The aim of the study was to evaluate the efficacy of endometrial cytology using uterobrush in the collection of samples and diagnosis of endometrial lesions. Methods and examinees: During the 12-month period direct endometrial samples by uterobrush were collected from 162 perimenopausal or postmenopausal symptomatic patients at Gynaecology Department at Merkur University Hospital. Results were compared with histology of the endometrium obtained by dilatation and curettage (n= 36), or hysterectomy (n=16), or the patients follow -up mainly by ultrasonography (n=97). Inadequate samples were excluded from the study. Results: Cytological findings were confirmed by histology in 69.2% (36/52) of cases. Seven cancers, 13 hyperplasias, one polyp and 14 benign disorders were diagnosed and confirmed by histology. After using uterobrush device, patients who were followed-up by ultrasonography showed no gynaecological symptoms. Conclusion: Endometrial cytology by using uterobrush method can provide direct, adequate and representative endometrial sample. Cytology can recognise endometrial lesions and...

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Incidence and risk factors for insufficient endometrial tissue from endometrial sampling

Cited by 18 publications

References 17 publications

Factors Associated with Insufficient Endometrial Sampling in Postmenopausal Women

Factors Associated with Insufficient Endometrial Sampling in Postmenopausal Women

Review of histopathologic findings of endometrial biopsy done at a tertiary referral hospital in urban Ethiopia

Efficacy of Uterobrush in Endometrial Sample Collection for the Cytology and Diagnosis of Endometrial Lesions

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