CONSISTENCY OF ENDOMETRIAL SAMPLING WITH SUBSEQUENT HYSTERECTOMY FINDINGS IN DUHOK- IRAQ
DOI:
https://doi.org/10.61841/y2a2ab47Keywords:
Endometrium, carcinoma, hyperplasia, upgrading, downgrading, hysterectomyAbstract
Endometrial sampling is one of the commonest diagnostic procedures and upon its results various actions will be set. This study aimed to compare the results of endometrial biopsy and proceeding hysterectomy and to determine the value of endometrial biopsy in the diagnosis of various pathologies. This study is a comparative one between the results of endometrial sampling and hysterectomy and included 200 patients from 1-1-2012 until 1-1-2018 in Duhok City-Iraq. Pregnancy related disorders were excluded. Histological reports and slides were retrieved from the bank of data in the central laboratory of Duhok City. Results of both procedures were put in three categories; the non-significant differences, the significant and consistent findings and the significant and inconsistent results. The reliability of endometrial biopsy was determined for carcinoma and hyperplasia. In addition, upgrading and downgrading of certain disorders was calculated. For the significant and inconsistent category, intra and inter-observer variability were estimated. The age of the included patients ranged from 27-80 years with a mean of 53.5 years ± (26.5). There were non-significant differences in (53%) of cases, significant and consistent results in 9% of cases and significant but inconsistent results in 38% of cases. In the latter group the intra-observer and inter-observer variabilities were (22.4%) and (77.6%) respectively. For carcinoma cases, endometrial sampling was reliable in (100%) of cases but for hyperplasia, correct diagnosis was given in only 30.8% of cases. Significant and inconsistent results of endometrial biopsy when compared to hysterectomy were found in (38%) cases a finding should make the gynecologists deal with awareness when making a proceeding decision to utilize other investigations modalities in conjunction. Regarding endometrial carcinoma, endometrial sampling is a reliable diagnostic procedure but this reliability is diminished for other pathologies.
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1. Landrum LM, Zuna RE, Walker JL. The Endometrial Hyperplasia, Estrogen Therapy, and the Prevention of Endometrial Cancer. In PHILIP J WTRSDSMDG. Clinical Gynecologic Oncology. 9th ed. Philadelphia: Elsevier; 2018. p. 104-120.
2. Longacre TA, Atkins KA, Kempson RL, Hendrickson MR. The uterine corpus. In MILLS SE. Sternberg's Diagnostic Surgical Pathology. 5th ed. Philadelphia: Lippincott Williams& Wilkins; 2010. p. 1208-1224.
3. Gilks B. The Uterus: Corpus. In Goldblum JR, Lamps LW, McKenney JK, Myers JL. Rosai And Ackerman’s Surgical Pathology. 11th ed. Philadelphia: Elsevier; 2017. p. 1294-1338.
4. Mills , E. S. Histology for Pathologists. 3rd ed. Mills SE, editor.: Lippincott Williams & Wilkins; 2007.
5. Gonçalves MAG, Anschau F. Adenocarcinoma of the Endometrium — The Art of Its. In Farghaly SA. Gynecologic Cancers: Basic Sciences, Clinical and Therapeutic Perspectives.: ExLi4EvA; 2016. p. 309- 330.
6. Soliman PT, Lu KH. Neoplastic Diseases of the Uterus. In Lobo RA, Gershenson DM, Lentz GM, Valea FA. Comprehensive Gynecology. 7th ed. Philadelphia: ELSEVIER; 2017. p. 714-732.
7. Stovall TG. Hystrectomy. In Berek JS. Berek & Novak's Gynecology. 14th ed. Philadelphia: Lippincott Williams& Wilkins; 2007. p. 804-842.
8. Barber MD. Hysterectomy. In Sokol AI, Sokol ER. General Gynecology: The Requisites In Obstertics & Gynecology. Philadelphia: Elsevier; 2007. p. 707-753.
9. Querleu D, Plante M, Sonoda Y, Gotlieb W, Leblanc E. Minimally Invasive Surgery in Gynecologic Cancer. In Barakat RR, Berchuck A, Markman M, Randall ME. Principles And Practice Of Gynecologic Oncology. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2013. p. 210-238.
10. French CA, Curtis SG. Manual Of Surgical Pathology. 3rd ed. Lester SC, editor. Philadelphia: Elsevier; 2010.
11. Cibula D. Radical Hysterectomy With En Bloc Vaginectomy Or Pelvic Lymphadenectomy. In Bristow RE, Chi DS. Radical And Reconstructive Gynecologic Cancer Surgery. New Yourk: McGraw-Hill Education; 2015. p. 62-82.
12. Wieslander CK, Wong KS. Therapeutic gynecologic procedures. In DeCherney AH, Nathan L, Laufer N, Roman AS. Current Diagnosis & Treatment Obstetrics & Gynecology. 11th ed.: McGraw-Hill Companies, Inc.; 2013.
13. Sinha P, ReKha PR, KonaPuR PG, Selvi RT, SuBRamaniam Pm. Pearls and pitfalls of endometrial curettage with that of hysterectomy in DUB. Journal of Clinical and Diagnostic Research for doctors. 2011 May; 6(1199-202).
14. Huang GS, Gebb JS, Einstein MH, Shahabi S, Novetsky AP, Goldberg GL. Accuracy of preoperative endometrial sampling for the detection of high-grade endometrial tumors. American journal of obstetrics and gynecology. 2007 Mar; 196(3)(243-e1).
15. Wang X, Huang Z, Di W, Lin Q. Comparison of D&C and hysterectomy pathologic findings in endometrial cancer patients. Archives of gynecology and obstetrics. 2005 August; 272(2)(136-41).
16. Barut A, Barut F, Arikan I, Harma M, Harma MI, Ozmen BU. Comparison of the histopathological diagnoses of preoperative dilatation and curettage and hysterectomy specimens. Journal of Obstetrics and Gynaecology Research. 2012; 38.1(16-22).
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