The value of hysteroscopic biopsy in the diagnosis of endometrial polyps

Abstract

Several studies have demonstrated that the combination of hysteroscopy with endometrial biopsy is more accurate in differentiating endometrial polyps from endometrial hyperplasia and cancer. However, blind biopsy not always confirms hysteroscopic findings due to high rates of inadequate or insufficient material. The objective of this clinical, prospective, and comparative study was to establish a correlation between the histological results of office-based endometrial biopsies (hysteroscopically guided and blind) with the surgical polypectomy specimens. We evaluated 82 patients with hysteroscopic diagnosis of endometrial polyp, who randomly underwent hysteroscopically guided biopsy or blind biopsy, referred for surgical resection. A total of 36 women (43.9%) underwent hysteroscopically guided biopsy and 46 women (56.1%) underwent blind biopsy. The sensitivity of hysteroscopically guided biopsy for the diagnosis of endometrial polyps ranged between 35.3 and 36.8%, when carried out at the apex and base of the lesion, compared with 29.2% for blind biopsy. Specificity was 33.3, 50, and 60%, respectively, for each biopsy. The positive predictive values were 75, 77.8, and 87.5%, and negative predictive values were 8.3, 14.3, and 8.1% respectively, compared with surgical polypectomy specimens. The office-based endometrial biopsies had low diagnostic accuracy for endometrial polyps compared with surgical polypectomy specimens.

The Holy Grail of endometriosis biomarkers in the diagnostic process – How much would it be worth and what does it look like?

“…It was designed to detect neoplastic lesions of the endometrium and any proliferation of the endometrial mucosa. 21 Indeed, the examination itself is very simple and involves the insertion of a special plastic tube, or a Pipelle (Pipelle de Cornier). In the majority of cases, the collection of an endometrial sample via this method requires no mechanical dilatation of the cervical canal.…”

Residual Disease after Operative Hysteroscopy in Patients with Endometrioid Endometrial Cancer Associated with Polyps

“…Because blind biopsies usually have a lower diagnostic accuracy, 31 32 a potential bias of our study is that, in certain cases, the biopsy was performed after a diagnostic hysteroscopy with curettage, rather than with a working instrument. Nevertheless, blind avulsion of the polyp using the appropriate materials and standardized technique leads to an adequate pathological analysis.…”

The value of hysteroscopy and transvaginal ultrasonography in the diagnosis of endometrial hyperplasia: a systematic review and meta-analysis

“…Diagnosis of endometrial hyperplasia is of great value in preventing the progression int endometrial cancer (especially type I endometrial cancer). Auxiliary examination techniques of endometrial hyperplasia include transvaginal ultrasonography ( 3 ), hysteroscopic examination or hysteroscopy guide biopsy ( 4 ), saline infusion sonography ( 5 , 6 ), magnetic resonance imaging (MRI) ( 7 , 8 ), computed tomography (CT) ( 9 ), cervical ( 10 ) and endometrial cytology ( 11 ), and diagnostic curettage ( 12 ). Among these methods, transvaginal ultrasonography and hysteroscopic examination are the two auxiliary examination methods used most commonly in clinical practice.…”