Diagnostic Hysteroscopy in Endometrial Hyperplasia (original) (raw)
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Diagnostic accuracy of hysteroscopy in endometrial hyperplasia
Maturitas, 1996
To determine the diagnostic accuracy of hysteroscopy in the diagnosis of endometrial hyperplasia in women with abnormal uterine bleeding. Methods: From 1993 through 1995, 980 women referred to our institution for abnormal uterine bleeding underwent diagnostic hysteroscopy with eye direct biopsy of the endometrium in case of macroscopic abnormalities. Hysteroscopic features were compared with pathologic findings in order to detect the reliability of the endoscopic procedure. Statistical analysis was performed with the McNemar test. Results: Positive predictive value of hysteroscopy in the diagnosis of endometrial hyperplasia accounted for 63%. In fact hysteroscopic diagnosis of endometrial hyperplasia was confirmed at pathologic examination in 81 out of 128 patients. Sensitivity and specificity of the endoscopic procedure accounted for 98% and 95X,, respectively. Negative predictive value accounted for 99(1/o, as only two cases of atypical hyperplasia were missed at hysteroscopy. Positive predictive value was higher in postmenopausal patients compared to women in the fertile age (72 vs. 58%). Conclusions: Overall, results appear encouraging, since no case of endometrial hyperplasia was missed by hysteroscopy. The high diagnostic accuracy, associated with a minimal trauma, renders hysteroscopy the ideal procedure for both diagnosis and follow-up of conservative management of endometrial hyperplasia.
HYSTEROSCOPIC VIEW OF ENDOMETRIAL HYPERPLASIA
Objective: To determine the hysteroscopic appearance of endometrial hyperplasia in women with subsequently confirmed diagnosis of endometrial hyperplasia. Methodology: This study was done in Aria Hospital in Ahwaz,Iran fromJanuary 21, 2003 to May 24 th 2005. Fifty women underwent hysteroscopy with eye direct biopsy of the endometrium. Cause of hysteroscopy was Abnormal Uterine Bleeding (AUB) in 93.5% of cases. Specimens were sent for histology assessment. From these patients five cases had pathologic diagnosis of endometrial hyperplasia. Hysteroscopic features of these five cases were reviewed. Results: In case one which was simple cystic hyperplasia, there was obvious cystic bizarre view. In case two, three and four there were minimal hysteroscopic abnormal view. In case 5 which was endometrial hyperplasia with atypia, there were obvious white endometrial elevations in the endometrial lining. Conclusions: Endometrial hyperplasia may produce obvious space occupying lesions in which diagnosis is easy with hysteroscopy, but it may be not very obvious especially in early stages of the disease. In all these 5 cases there were white areas with markedly reduced or absent vascularity.
Clinical and Experimental Obstetrics & Gynecology, 2022
Background: Endometrial hyperplasia (EH) is considered a heterogeneous pre-neoplastic clinical entity characterized by an abnormal glandular proliferation, with less than half of the tissue area occupied by the stroma. The aim of this retrospective study was to evaluate the correlation between the histological diagnosis of atypical endometrial hyperplasia (AEH) obtained through office hysteroscopy (OH) or uterine dilation and curettage (D&C) and the definitive histological evaluation after hysterectomy. Methods: Among 112 patients with atypical EH, 45 (40%) underwent hysteroscopy and 67 (60%) curettage. Results: The diagnostic accuracy of OH was very high: in particular, it showed a diagnostic coincidence in 87% of cases with the definitive histological diagnosis through hysteroscopy. The curettage, instead, had diagnostic coincidence only in 14% of cases. Conclusion: Office hysteroscopy is the ideal procedure for both diagnosis and follow-up of endometrial hyperplasia.
Morphologic hysteroscopic criteria suggestive of endometrial hyperplasia
International Journal of Gynecology & Obstetrics, 1995
Objectives: To evaluate the morphologic hysteroscopic criteria leading to a diagnosis of endometrial hyperplasia and compare their accuracy with that of histology. Met/&s: A total of 95 hysteroscopic examinations were evaluated. Of these, 37 had a histologic diagnosis of normal endometrium and the remaining 58 of simple or complex endometrial hyperplasia. We compared the morphologic hysteroscopic criteria for the two groups using Pearson's chi-squared and Fisher's exact test. Results: Only the presence of endometrial glands presenting a cystic pattern at hysteroscopy gave statistically significant results (P < 0.05), with low sensitivity (15.79%), high specificity (97.29%) and a relative risk of 6.75. With a prevalence of endometrial hyperplasia of 22.97% in a population of women with metrorrhagia, the positive predictive value was 63.53% and the negative predictive value was 79.40%. Conclusion: Additional, prospective studies are needed to determine the real value of the diagnostic morphologic parameters under consideration.
Clinical and Experimental Obstetrics & Gynecology, 2022
Background: Endometrial hyperplasia (EH) is considered a heterogeneous pre-neoplastic clinical entity characterized by an abnormal glandular proliferation, with less than half of the tissue area occupied by the stroma. The aim of this retrospective study was to evaluate the correlation between the histological diagnosis of atypical endometrial hyperplasia (AEH) obtained through office hysteroscopy (OH) or uterine dilation and curettage (D&C) and the definitive histological evaluation after hysterectomy. Methods: Among 112 patients with atypical EH, 45 (40%) underwent hysteroscopy and 67 (60%) curettage. Results: The diagnostic accuracy of OH was very high: in particular, it showed a diagnostic coincidence in 87% of cases with the definitive histological diagnosis through hysteroscopy. The curettage, instead, had diagnostic coincidence only in 14% of cases. Conclusion: Office hysteroscopy is the ideal procedure for both diagnosis and follow-up of endometrial hyperplasia.
Journal of Minimally Invasive Gynecology, 2006
To validate hysteroscopic view with histology in cases of endometrial hyperplasia and cancer in patients with abnormal uterine bleeding (AUB)Retrospective study (Canadian Task Force classification II-3).University teaching hospitals in Rio de Janeiro and São Paulo, and private office in Rio de Janeiro.Four thousand and fifty-four patients with AUB in whom hysteroscopic views were complete and the histologic result was conclusive.Four thousand and fifty-four office hysteroscopies with complete views and conclusive histologic results. The material for histologic examination was obtained through biopsy of the lesion in an outpatient unit or through the resection of the entire lesion in patients who underwent surgery. Histology was considered the “gold standard” and compared with the hysteroscopic view.In the histology of the 4054 examinations, 613 (15.2%) were endometrial hyperplasia, and 105 (2.6%) were endometrial cancer. The most frequent hysteroscopic finding was endometrial polyps (31.2%). In endometrial hyperplasia, the sensitivity of the hysteroscopic view was 56.3% (95% CI 52.2%–60.2%), specificity was 89.1% (95% CI 88.0%–90.1%), positive predictive value (PPV) was 48.0% (95% CI 44.3%–51.7%), negative predictive value (NPV) was 92.0% (95% CI 90.1%–92.9%), and accuracy was 72.7% (95% CI 70.7%–74.7%). Accuracy was defined as the proportion of correct results among the hysteroscopic examinations. In endometrial cancer, the sensitivity of the hysteroscopic view was 80.0% (95% CI 71.1%–87.2%), specificity was 99.5% (95% CI 99.2%–99.7%), PPV was 81.5% (95% CI 72.7%–88.5%), NPV was 99.5% (95% CI 99.2%–99.7%), and accuracy was 89.8% (95% CI, 85.9%–93.6%). In the 814 patients (20.0%) in whom the hysteroscopic view was normal, there were no false negatives for endometrial cancer; however, there were 37 (4.5%) false negatives for endometrial hyperplasia. In the histologic cases of endometrial cancer, 101 (96.2%) hysteroscopic views were compatible with cancer or hyperplasia (80.0% and 16.2%, respectively). Ninety-seven out of 103 hysteroscopic views with cancer findings (94.2%) had histologic diagnosis of cancer or hyperplasia (81.5% and 12.6%, respectively).It seems that even in face of good validity of hysteroscopic view for endometrial hyperplasia and cancer, histologic study is mandatory in the presence of any lesion as the hysteroscopic view cannot completely replace the histologic study in patients with AUB.
Accuracy of Hysteroscopy in Predicting Histopathology of Endometrium in 1500 Women
The Journal of the American Association of Gynecologic Laparoscopists, 2001
Endouterine view by hysteroscopy with or without endometrial sampling, can be considered the diagnostic gold standard to exclude endometrial pathology. Hysteroscopy is more effective in assessing endometrial status than blind techniques such as dilatation and curettage. 2,3 Nevertheless, the literature has scant information about the relationship between detailed features of hysteroscopic views and underlying histology. In general practice it is widely accepted that a hysteroscopy report should mainly distinguish 207 Abstract Study Objective. To estimate the accuracy of hysteroscopy in predicting endometrial histopathology.