Objective: This study was designed to compare the diagnostic accuracy of Pipelle endometrial sampling with conventional dilatation & curettage in patients with abnormal uterine bleeding.
Material and Methods:One hundred and forty patients with abnormal uterine bleeding were included in this comparative study; where endometrial sampling was carried out before cervical dilatation by Pipelle device followed by conventional dilatation & curettage (D&C). The histopathology report of the Pipelle sample was compared with that of the dilatation & curettage sample and the dilatation & curettage reports were considered as the gold standard.Results: 100% of the samples obtained by conventional D&C, while 97.9% of the samples obtained by the Pipelle device were adequate for histopathological examination. The histolopathological examination of 140 samples obtained by conventional D&C revealed proliferative endometrium in 37 specimens, secretory endometrium in 33 specimens, endometrial hyperplasia in 49 specimens (45 without atypia & 4 with atypia), endometritis in 8 specimens, endometrial polyps in 3 specimens and malignant endometrium in 10 specimens. In this study; the Pipelle device had 100% sensitivity, 100% specificity and 100% accuracy for diagnosing endometrial hyperplasia, endometrial carcinoma, proliferative and secretory endometrium. Also, it had 88.9% sensitivity, and 99.2% negative predictive value (NPV) and 99.3% accuracy for diagnosing endometritis and it had 60% sensitivity, 89.6% NPV and 98.6% accuracy for diagnosing endometrial polyps.
Conclusion:The endometrial sampling using Pipelle is a safe, accurate, cost effective outpatient procedure, which avoids general anesthesia and has a high sensitivity and specificity for detection of endometrial hyperplasia and endometrial malignancy. Received: 06 November, 2012 Accepted: 12 December, 2012 Amaç: Bu çalışma anormal uterin kanaması olan hastalarda Pipelle endometriyal örnek alımının tanısal doğruluğunu geleneksel dilatasyon ve küretaj ile karşılaştırmak üzere tasarlandı.
Gereç ve Yöntemler:Bu karşılaştırmalı çalışmaya anormal uterin kanaması olan 140 hasta dâhil edildi; Pipelle aleti ile servikal dilatasyondan önce endometriyal örnek alınmasının ardından geleneksel dilatasyon ve küretaj (D&C) yapıldı. Pipelle örneğinin histopatoloji raporu dilatasyon ve küretaj örneğininki ile karşılaştırıldı ve dilatasyon ve küretaj raporları altın standart olarak kabul edildi.
Bulgular:Geleneksel D&C ile alınan örneklerin %100'ü, Pipelle aleti ile alınan örneklerin ise %97.9'u histopatolojik inceleme için yeterliydi. Geleneksel D&C ile alınan 140 örneğin histopatolojik incelemesi 37 örnekte proliferatif endometriyum, 33 örnekte sekretuar endometriyum, 49 örnekte endometriyal hiperplazi (45'inde atipi yok ve 4'ünde atipi var), 8 örnekte endometrit, 3 örnekte endometriyal polip ve 10 örnekte malign endometriyum gösterdi. Bu çalışmada, endometriyal hiperplazi, endometriyal karsinoma, proliferatif ve sekretuar endometriyum tanısında Pipelle aleti; %100 sensitivite, %100 spesi...