The accuracy of endometrial sampling in the diagnosis of patients with endometrial carcinoma and hyperplasia

Dijkhuizen, F. P. H. L. J.; Mol, Ben Willem J.; Br�lmann, Hans A. M.; Heintz, A. Peter M.

doi:10.1002/1097-0142(20001015)89:8<1765::aid-cncr17>3.0.co;2-f

Cited by 468 publications

(164 citation statements)

References 38 publications

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“…Although only a small percentage of those women will develop endometrial cancer, the prevalence of risk factors and symptoms such as irregular uterine bleeding and the greater awareness for the risk factors have created a demand by women and caregivers for screening and early detection of endometrial cancer. At present there is no simple cost-effective method to screen for endometrial cancer and suspected cases are referred for endometrial biopsy or curettage [21,23]. The present data showed that regardless of the method used for collecting specimens, namely hysterectomy curettage or endometrial touch-preps, P2X 7 immunoassays could differentiate normal/benign-hyperplastic cells from atypicalhyperplastic/cancer cells.…”

Section: Discussionmentioning

confidence: 58%

Decreased expression of P2X7 in endometrial epithelial pre-cancerous and cancer cells

Zhou

et al. 2007

Gynecologic Oncology

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Objectives-To understand the potential role of P2X 7 as biomarker of endometrial cancer, and the molecular mechanisms by which cancerous epithelial cells maintain low expression of P2X 7 .Methods-Feasibility clinical experimental study. Normal (28), simple or complex hyperplasia (7), complex hyperplasia with atypia (6) and cancer endometrial discarded tissues (40) were obtained from a total of 81 women, ages 25-75. Endpoint for P2X 7 protein was average pixel signal density of tissue immunoreactivity with anti-P2X 7 antibody. Endpoint for P2X 7 mRNA was one-step quantitative Real-Time PCR. Experiments in-vitro included normal (hEVEC) and cancerous cervical epithelial cells (HeLa) transfected with reporter plasmid containing luciferase-3′ untranslated region (3′UTR)-P2X 7 cDNA, using as endpoint steady-state luciferase mRNA levels.Results-Levels of P2X 7 protein and mRNA were significantly lower in vivo, in tissues of complex hyperplasia with atypia or endometrial adenocarcinoma, than in tissues of normal endometrium, simple hyperplasia or complex hyperplasia tissues (sensitivity and specificity of 89-100%, p<0.0001-0.01). Steady-state levels of luciferase mRNA increased over a 6 h incubation period in hEVEC cells transfected with the 3′ UTR-P2X 7 -luciferase vector, but decreased in HeLa cells transfected with the reporter plasmid.Conclusions-Tissue levels of P2X 7 protein and mRNA can differentiate effectively and accurately between normal and benign hyperplastic endometrial tissues from pre-cancerous and cancer tissues. Cancerous epithelial cells degrade P2X 7 mRNA by activation of instability domains located at the 3′UTR of the P2X 7 .

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Section: Discussionmentioning

confidence: 58%

Decreased expression of P2X7 in endometrial epithelial pre-cancerous and cancer cells

Zhou

et al. 2007

Gynecologic Oncology

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“…Our findings reaffirm the need to improve the sensitivity and specificity of AH diagnoses (Soslow, 2006) and efficiently identify the rare nonatypical EH lesions that are likely to progress. Modern outpatient biopsy techniques achieve over 90% sensitivity for detecting carcinoma (Dijkhuizen et al, 2000), but better endometrial assessment (Zaino, 2000), histopathologic classifications (Mutter, 2002), and candidate molecular markers (Mutter, 2000) deserve further study.…”

Section: Discussionmentioning

confidence: 99%

Endometrial carcinoma risk among women diagnosed with endometrial hyperplasia: the 34-year experience in a large health plan

et al. 2007

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Classifying endometrial hyperplasia (EH) according to the severity of glandular crowding (simple hyperplasia (SH) vs complex hyperplasia (CH)) and nuclear atypia (simple atypical hyperplasia (SAH) vs complex atypical hyperplasia (CAH)) should predict subsequent endometrial carcinoma risk, but data on progression are lacking. Our nested case -control study of EH progression included 138 cases, who were diagnosed with EH and then with carcinoma (1970 -2003) at least 1 year (median, 6.5 years) later, and 241 controls, who were individually matched on age, date, and follow-up duration and counter-matched on EH classification. After centralised pathology panel and medical record review, we generated rate ratios (RRs) and 95% confidence intervals (CIs), adjusted for treatment and repeat biopsies. With disordered proliferative endometrium (DPEM) as the referent, AH significantly increased carcinoma risk (RR ¼ 14, 95% CI, 5 -38). Risk was highest 1 -5 years after AH (RR ¼ 48, 95% CI, 8 -294), but remained elevated 5 or more years after AH (RR ¼ 3.5, 95% CI, 1.0 -9.6). Progression risks for SH (RR ¼ 2.0, 95% CI, 0.9 -4.5) and CH (RR ¼ 2.8, 95% CI, 1.0 -7.9) were substantially lower and only slightly higher than the progression risk for DPEM. The higher progression risks for AH could foster management guidelines based on markedly different progression risks for atypical vs non-atypical EH.

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“…The gold standard for the diagnosis of intrauterine abnormalities is diagnostic hysteroscopy combined with the histological examination of an endometrial aspiration or biopsy. However, hysteroscopy is invasive, reasonably expensive, time-consuming, and it is performed under general anaesthesia in some centres [8][9][10]. It is also associated with risks, such as uterine perforation and ascending genitourinary infection [12,19].…”

Section: Discussionmentioning

confidence: 99%

“…The reported incidence of endometrial carcinoma is 5%-17%; therefore, a thorough investigation of women with AUB is warranted [2][3][4]7,8]. Endometrial Office Biopsy (EOB) is one of the initial investigations for women with AUB who are over the age of 40 years [1,3,4,9]. However, most pathological lesions are found to be benign and are most often missed with blind sampling techniques [3,7,[10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy of Saline-Contrast Sonohysterography Guided Biopsy versus Office Biopsy in Endometrial Pathology: an Interventional Study

Al-Tannir¹

2016

Journal of Women's Health and Gynecology

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Purpose : The primary objective of this study is to evaluate the effectiveness of Saline Contrast Sonohysterography guided biopsy (SCSH GB) as compared with Endometrial Office Biopsy (EOB) in diagnosing endometrial pathologies by the adequacy of the sample and comparison of the pathologic diagnosis confirmed by hysteroscopy or hysterectomy (histological and anatomical). Methods:Unselected consecutive 250 patients aged 40 years and above with AUB and abnormal endometrium on transvaginal ultrasound presenting to ultrasound unit and outpatient department at Women Specialized Hospital, King Fahad Medical City, Riyadh, KSA were screened for eligibility in this interventional study. Fifty percent of enrolled patients were initially booked for SCSH GB then scheduled for EOB. Whereas, the remaining 50% underwent EOB first and then had SCSH GB. This method was used to control the issue of insufficient biopsy. The diagnosis was categorized as 1) physiological 2) benign polyp or sub-mucous fibroid and 3) hyperplasia/cancer. Results:Out of 113 patients 93 underwent both SCSH GB and EOB procedures and were entered into final data analysis. SCSH GB (94.6%) achieved significantly higher sample adequacy compared to 86% of EOB (p<0.001). SCSHGB significantly diagnosed all 29 (100%) polyps and sub-mucous fibroids confirmed by hysteroscopy/hysterectomy versus only 8 (27.5%) cases by EOB (p<0.001). Conclusions:The SCSH GB technique can be a reasonable alternative to EOB in pre-and post-menopausal women aged 40 and older with AUB.

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The accuracy of endometrial sampling in the diagnosis of patients with endometrial carcinoma and hyperplasia

Cited by 468 publications

References 38 publications

Decreased expression of P2X7 in endometrial epithelial pre-cancerous and cancer cells

Decreased expression of P2X7 in endometrial epithelial pre-cancerous and cancer cells

Endometrial carcinoma risk among women diagnosed with endometrial hyperplasia: the 34-year experience in a large health plan

Diagnostic Accuracy of Saline-Contrast Sonohysterography Guided Biopsy versus Office Biopsy in Endometrial Pathology: an Interventional Study

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