Evaluation of frozen section biopsy for fast track diagnosis of endometrial pathology in high-risk women with abnormal uterine bleeding

OBJECTIVE: Abnormal uterine bleeding which is the most frequent complaint among pre- and postmenopausal women should be investigated to rule out endometrial cancer. An intra-operative frozen section can be taken to examine the suspicious of the malignancy. The study aims to investigate the accuracy of frozen section in suspicious of endometrial malignancy.STUDY DESIGN: Fifty patients with pre-malign endometrial pathology and malignant ultrasound characteristics were included in this study and their preoperative biopsy, frozen and postoperative pathological results were examined. RESULTS: The kappa coefficient between postoperative pathology and frozen section was 0.88 (p<0.05) and 95% confidence interval was (0.63-1.12). This indicates that the amount of agreement between the two tests was strong, thus the frozen section would be considered as a valid indicator of postoperative pathology results.CONCLUSIONS: Frozen section is a valuable method to investigate the suspicious of malignancy in endometrial pre-malign lesions.

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Etiological structure and diagnosis of abnormal uterine bleeding

GYNECOLOGY ◽

10.26442/2079-5696_2018.2.14-18 ◽

2018 ◽

Vol 20 (2) ◽

pp. 14-17

Author(s):

G E Chernukha ◽

I A Ivanov ◽

Z N Efendieva ◽

M R Dumanovskaya ◽

A V Asaturova

Keyword(s):

Diagnostic Accuracy ◽

Endometrial Hyperplasia ◽

Ultrasound Examination ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Histological Diagnosis ◽

Reproductive Age ◽

Endometrial Polyps ◽

Chronic Endometritis ◽

Endometrial Pathology

Abnormal uterine bleeding (AUB) is one of the most common indications for hysteroscopy. Most of the AUB cases occur due to endometrial or myometrium pathology. Among it, endometrial polyps (EP) and chronic endometritis (CE) prevalent in reproductive age, while endometrial hyperplasia (EH) and EP dominate in perimenopause. It was determined that EP and CE are characterized with menorrhagia and metrorrhagia approximately equally, whereas EH reveals AUB with oligomenorrhoea. Verification of exact endometrial pathology by ultrasound examination is hindered, that results in deviations of ultrasound and histological diagnosis. The usage of ultrasound data and AUB’s characteristics may improve the diagnostic accuracy on preadmission period.

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Study of Endometrial Pathology in Abnormal Uterine Bleeding Patients Visited in Hospital: An Retrospective Study

Asian Journal of Medical Research ◽

10.21276/ajmr.2019.8.4.og1 ◽

2019 ◽

Vol 8 (4) ◽

pp. OG01-OG02

Author(s):

Kheta Ram Soni ◽

◽

Sudesh Agarwal ◽

Keyword(s):

Retrospective Study ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Endometrial Pathology

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Prediction of Endometrial Hyperplasia and Cancer among Premenopausal Women with Abnormal Uterine Bleeding

BioMed Research International ◽

10.1155/2019/8598152 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 7

Author(s):

Luca Giannella ◽

Lillo Bruno Cerami ◽

Tiziano Setti ◽

Ezio Bergamini ◽

Fausto Boselli

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Prediction Model ◽

Endometrial Hyperplasia ◽

Premenopausal Women ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Stepwise Logistic Regression ◽

Simultaneous Presence ◽

Endometrial Pathology

Objective. To create a prediction model including clinical variables for the prediction of premalignant/malignant endometrial pathology in premenopausal women with abnormal uterine bleeding (AUB). Methods. This is an observational retrospective study including 240 premenopausal women with AUB referred to diagnostic hysteroscopy. Based on the presence of endometrial hyperplasia (EH) or cancer (EC), the women were divided into cases (EH/EC) and controls (no EH/EC). Univariate, stepwise logistic regression and ROC curve analysis were performed. Results. 12 women had EH/EC (5%). Stepwise logistic regression analysis showed that EH/EC associated significantly with BMI ≥ 30 (OR=7.70, 95% CI 1.90 to 31.17), diabetes (OR=9.71, 95% CI 1.63 to 57.81), and a thickened endometrium (OR=1.20, 95% CI 1.08 to 1.34, criterion > 11 mm). The AUC was 0.854 (95% confidence intervals 0.803 to 0.896, p<0.0001). Considering the pretest probability for EH/EC of 5%, the prediction model with a positive likelihood ratio of 8.14 showed a posttest probability of 30%. The simultaneous presence of two or three risk factors was significantly more common in women with EH/EC than controls (50% vs. 6.6 and 25% vs. 0%, respectively, p<0.0001). Conclusion. When premenopausal vaginal bleeding occurs in diabetic obese women with ET > 11 mm, the percentage of premalignant/malignant endometrial pathology increases by 25%. It is likely that the simultaneous presence of several risk factors is necessary to significantly increase the probability of endometrial pathology.

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A prospective study on the efficacy of Pipelle biopsy to diagnose endometrial pathology in patients with abnormal uterine bleeding

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20194608 ◽

2019 ◽

Vol 8 (11) ◽

pp. 4238

Author(s):

Sunitha Mary Mathew ◽

Pramod Thomas

Keyword(s):

Diagnostic Accuracy ◽

Endometrial Thickness ◽

Abnormal Uterine Bleeding ◽

Cost Effective ◽

Endometrial Biopsy ◽

Uterine Bleeding ◽

Atypical Hyperplasia ◽

Focal Lesions ◽

Endometrial Sampling ◽

Endometrial Pathology

Background: Abnormal uterine bleeding is one of the most common problem encountered in gynaecology clinics. Assessment of endometrial pathology is recommended to rule out malignancy and premalignant conditions. Endometrial sampling can be done by Pipelle biopsy in outpatient units as well as by conventional dilatation and curettage in an operation theatre setup. Our study aims to find out the efficacy of office endometrial biopsy in terms of its sample adequacy, diagnostic accuracy and patient acceptability.Methods: 120 women presenting with abnormal uterine bleeding were included. A detailed history along with clinical examination findings are entered in the proforma. Ultrasound scan was done for all of them to identify pelvic pathology and endometrial thickness. Endometrial sampling was then done with Pipelle without anaesthesia. Histopathology reports are collected and sample adequacy and pattern were analysed. Patients are subsequently followed up for a period up to one year. Those who underwent hysterectomy are analysed for the endometrial pathology in hysterectomy specimen which is used as gold standard and compared with Pipelle endometrial sampling histopathology.Results: Sample adequacy for Pipelle biopsy was found to be 96%. Diagnostic accuracy for atypical hyperplasia and adenocarcinoma is 92.5% and 94% respectively. In hysterectomy specimens, carcinoma endometrium coexisted with atypical hyperplasia in 40% of cases with atypical hyperplasia in pipelle biopsy report.Conclusions: Thus, Pipelle endometrial biopsy is a cost-effective method for endometrial sampling except for focal lesions.

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