Comparison of endometrial biopsy and postoperative hysterectomy specimen findings in patients with abnormal uterine bleeding (AUB)

Abstract

Abnormal uterine bleeding is one of the common complaints of gynecology clinic patients, which disrupts the normal performance of patients and wastes useful working hours, and as a result, imposes a heavy burden on the health system and the economy of society. Given that in most cases, the diagnosis and treatment of this complication is done empirically based on clinical findings and sampling, and hysterectomy, which is considered one of the major surgeries in women, is done with confidence in pre-operative examinations, and with Note that there are still no reliable findings regarding the compatibility between preoperative endometrial sampling and microscopic examination of hysterectomy samples in patients undergoing surgery, so this study aims to compare the histological results of hysterectomy samples with the results of endometrial sampling as a standard. Talai was performed in patients with abnormal uterine bleeding. Materials and methods: This research was applied, descriptive, analytical, cross-sectional and prospective in May 2022. In this study, all women who were between 30 and 88 years old (in reproductive age, premenopause, and menopause) and complained of abnormal uterine bleeding (AUB) unresponsive to treatment at Alzahra Clinic of Tabriz University of Medical Sciences were evaluated. were taken and entered into the study. The number of samples was determined by using Cochran's formula of 94 people, and including 10 additional people, the number of samples was considered to be 104 people. All demographic, sonographic, histopathological and clinical information were completed. Before hysterectomy, endometrial sampling (Pipell or D&C) was performed. Sensitivity, specificity, negative and positive predictive value, and accuracy of tubal biopsy in diagnosing different endometrial pathologies were analyzed. Results: There were 60 discordant cases in the comparison of endometrial pathology reports regarding papillary biopsy and D&C and hysterectomy with a discordance rate of 57.7%. Several diseases in endometrial sampling are related to endometrial proliferative disorder (23%), simple hyperplasia (17.3%) and adenocarcinoma (14.4%). Several viral diseases in histopathological findings are endometrial proliferative disorder (32.6%), adenocarcinoma (15.3%) and inactive endometrium (9.6%), leiomyoma (9.6%) and atrophic endometrium (8.6%). %)) was related. The highest histopathological rate between endometrial sampling and hysterectomy is observed in patients with endometrial atrophy and adenocarcinoma and endometrium without ovulation and drug use. In patients with endometrial proliferative disorder, inactive endometrium (inactive endometrium), simple hyperplasia and leiomyoma were observed.