Background: The abnormal uterine bleeding has many causes and consequences in women. The exact causes are described by histology of sample through D&C. Pipple biopsy samples is considered one of the least invasive, OPD setting technique, comparable to D&C. Objective: To see the adequacy of Pipelle endometrial sampling and morphological findings among women with abnormal uterine bleeding. Study Design: Cross-sectional descriptive study Place and Duration of Study: Department of Gynaecology & Histopathology, Shaikh Zayed Hospital Lahore from 1st May to 31st December 2021. Methodology: Two hundred and thirty seven adult women with AUB recommended for D&C were included. Those with endometrial thickness less than 4mm, having fibroids, with pelvic inflammatory disease, or clotting factor disorders were excluded. Pipelle endometrial sample was taken in Gyne OPD and were examined at Histopathology Department. Results: 80.0% were sampled adequately through Pipelle. Secondary endometrium was most common in 39.9% followed by proliferative endometrium in 36.2% and chronic endometritis 12.2%. There were 6 cases with carcinoma, 4 (2.1%) with adenocarcinoma and 2(1.1%) squamous cell carcinoma. Conclusion: Pipelle Endometrial sampling can be considered an effective methods for endometrial sampling. Keywords: Abnormal uterine bleeding, Pipelle endometrial biopsy, Sample adequacy, Endometrial pathology
Background: The Pipelle endometrial sample biopsy (PESB) is considered the most convenient, non - invasive method for endometrial sampling. The abnormal uterine bleeding has many causes and consequences in women. The exact causes are described by histology of sample through D&C. The accuracy of PESB is under observation in different settings and a lot of work is further required. Aim: To see the accuracy of PESBin comparison to D&C for morphological findings among women with abnormal uterine bleeding. Study design: Cross--sectional analytical study. Place and duration of study: Gyne OPD & Histopathology Departments, Shaikh Zayed Hospital, Lahore during 1st May 2019 to 8th December 2019. Methodology: Two hundred and thirty five adult women with AUB recommended for D&C and with Pipelle endometrial sample were included. Those with endometrial thickness less than 4mm, having fibroids, with pelvic inflammatory disease, or clotting factor disorders were excluded. Pipelle endometrial sample was taken in GyneOPD and were examined at Histopathology Department. Data were managed through SPSS-20. Results: 80.0% had adequate Pipelle samples and Pipelle inadequate as negative were considered for comparison the accuracy of Pipelle for proliferative endometrium and secretory endometrium were lower (90.6% vs 100.0%) and (93.6% vs 100.0%) as compared to only 188 adequate samples considered; by considering D&C as gold standard. Accuracies for Hyperplasia, and chronic endomitritis were little higher for all cases and for carcinoma the accuracy was 100.0% in either case. Conclusion: Pipelle endometrial sampling can be considered an effective method for endometrial sampling with an accuracy of more than 90.0% for each of the endometrial morphology. Keywords: Abnormal uterine bleeding, Pipelle endometrial biopsy, Diagnostic accuracy
Background: The cancer antigen 125 “CA125” and Human Epididymis protein 4 “HE4” are among some well worked out markers for recognition of malignancy in ovarian tumors. Their different cutoffs are determined and reported by various studies and mostly used recommended cutoffs are 35.0 U/mL for CA125 and 140pmol/L for HE4. They are both reported to recognize the malignancy well, but how specific they are for benign gynecological diseases is still needed to be worked out. Aim: To determine and compare the performance of CA125 and HE4 for benign gynecological pathologies. Methodology: A cross-sectional study was performed at Gajju Khan Medical College in collaboration with Armed forces Institute of pathology (AFIP). A total of 76 women of age above 18 years age, with benign ovarian pathology, confirmed through histological evaluation were enrolled. All these were examined on both markers, i.e. CA125 and HE4. Standard cutoffs of CA125 >35.0 U/mL and HE4>140 pmol/L were used to see if the case was labeled malignant, incorrectly. SPSS 20.0 was used to manage and analyze the data. Performance of the two markers were compared by using some descriptive analysis and using chi-square test. P-value ≤0.05 was considered significant. Results: The median age of these women was 40 years ranging between 18 and 71. Majority (86.8%) was premenopausal, The CA125 had no difference between pre and post-menopausal women but HE4 had a significant difference with p-value 0.029. there were 10.5% incorrect labeling of malignancy when evaluated for CA125, while only 2.6% incorrect on HE4. This difference was found statistically significant between two markers with p-value 0.05. Conclusion: HE4 is better and more specific marker for benign gynecological pathologies as compared to CA125 Keywords:Benign Ovarian Epithelial, Human epididymisprotein (HE4), Cancer Antigen 125 (CA125), Specificity
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