Pathological spectrum of endometrial biopsies in Saudi women with abnormal uterine bleeding

Abstract

To assess and age stratify the types and frequencies of endometrial pathologies in Saudi women with abnormal uterine bleeding (AUB) that underwent endometrial biopsies, at our hospital over a 13-year period. Methods: In a retrospective study, from 2006 to 2018, all endometrial biopsies from Saudi women with AUB, reported at the laboratory of King Saud University-Medical City, Riyadh, Saudi Arabia, were revisited and analyzed. The women were categorized into <40, between 40-55 and >55 years of age. Original Article Results: We analyzed 6458 biopsies. In <40 and 40-55 years' groups cyclical endometrium was most common followed by endometrial polyps and disordered proliferative endometrium. In the >55 years' group, atrophic endometrium was most common followed by endometrial polyps. The hyperplasias and malignancies together accounted for 7.2% of the study, majority in the >55 years' group. Simple hyperplasia without atypia was the most common (3.9%), followed by malignancies (1.9%), complex atypical hyperplasia (0.7%), complex hyperplasia without atypia (0.4%), and simple atypical hyperplasia (0.3%). Conclusion: Awareness of the probable spectrum of endometrial histopathologies in the various ages is useful in guiding management. Endometrial biopsies are valuable in early detection of precancerous and cancerous endometrial lesions especially in women over 40 years.

Retrospective examination of endometrial sampling results in women with abnormal uterine bleeding

“…Endometrial cancer or malignant diagnosis in AUBs increases with increasing age and is more common in the postmenopausal period [18]. When the literature is examined, it is seen that women diagnosed with malignancy are in the postmenopausal period or over 50 years of age [3,12,16,18]. This result is consistent with the literature and in our study, 11 of 20 women diagnosed with malignancy were found to be in the postmenopausal period.…”

“…Women presenting with OCD anywhere in the premenopausal or postmenopausal period should be closely evaluated for cancer incidence [6,[13][14][15]. When the literature was examined, it was seen that women who came with the complaint of AUB were diagnosed with endometrial cancer in the range of 6.2-15.2% [10,[15][16][17][18]. In the studies in our country, this rate was found to be between 0.3-5% [3,6,12].…”

“…In the studies of Çelik and Güngör involving 705 women, endometrial cancer was found in 2.4% (n=17) and other types of carcinomas in 0.4% (n=4) [12]. In the study of Sufia et al, in which 6458 Saudi women who applied to the clinic with AUB hemorrhage in the last 13 years were examined, it was observed that 1.88% (n=122) of women were diagnosed with endometrium [18]. In our study, it was observed that 3.1% (n=20) of the women who applied to the clinic with AUB were diagnosed with malignancy, and this result is consistent with the literature.…”

“…In our study, it was observed that 3.1% (n=20) of the women who applied to the clinic with AUB were diagnosed with malignancy, and this result is consistent with the literature. Endometrial cancer or malignant diagnosis in AUBs increases with increasing age and is more common in the postmenopausal period [18]. When the literature is examined, it is seen that women diagnosed with malignancy are in the postmenopausal period or over 50 years of age [3,12,16,18].…”

“…46.67% (n=7) of these cases were seen in the premenopausal period and 53.33% (n=8) in the postmenopausal period. When the literature is examined, the incidence rates of hyperplasia without simple atypia differ [3,12,15,18]. In the study of Çelik and Güngör, hyperplasia without simple atypia was 66.7% under the age of fifty, while it was 33.3% in women aged fifty and over [12].…”