Online ISSN: 2515-8260

Keywords : endometrial carcinoma


Dr. M pavani, Dr. Mohd. Anwar Miya, Dr. Hemalatha. P, Dr. S. Raghu Ram Mohan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 5, Pages 447-452

Background: The most frequent presenting symptom in the gynecology outpatient department is abnormal uterine bleeding (AUB). Endometrial sampling may be effectively the initial diagnostic step in AUB, though it frequently presents a difficult interpretation for pathologists in practice. This study was done to evaluate the histopathology of endometrium for the purpose of identifying the endometrial causes of AUB. Additionally, we tried to observe the incidence of various pathologies in different age groups presenting with abnormal uterine bleeding.
Materials and methods: This is a prospective study done on cases of AUB who underwent endometrial biopsy from August 2020 to August 2021 in the department of pathology at Kakatiya Medical College, Warangal, and Telangana, India. All the biopsies were routinely processed and a histopathological diagnosis was made. A statistical analysis between age of presentation and specific endometrial causes was done using the Chi-square test.
Results: The most common age group presenting with AUB was 35–72 years old. Out of 133 cases studied, 48% of cases were found to be proliferative endometrium, 28% of cases were of secretory endometrium, 2% of cases were of atrophic endometrium, 3% were of irregular maturation, 17% were of simple hyperplasia, and 2% were of endometrial carcinoma. Endometrial causes of AUB and age pattern was statistically significant with P value<0.05.
Conclusion: Endometrial lesions are associated with particular ages. AUB is more frequently dysfunctional in perimenopausal women, so when they are in the reproductive age range, they should first rule out pregnancy-related issues. This study's significantly high incidence of aberrant proliferative patterns suggests that these patients present at an early stage.

Study of endomed sampler for endometrial biopsy, by comparing the histopathology reports as gold standard

Dr. Shibin K, Dr. Shivakumar, Dr. Sajitha AK, Dr. Nishi K, Dr. Chellamma VK

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2109-2114

Background: Abnormal uterine bleeding (AUB) is a major clinical problem in women of peri and post-menopausal age group. It accounts for 30%of outpatient population coming to a gynaecologist. Evaluation of AUB is important for ruling out endometrial carcinoma and its precursors. Endomed biopsy is an ideal method for obtaining endometrial sample with ease, low cost and without anaesthesia. To determine sensitivity, specificity, positive predictive value and negative predictive value of Endomed sampler, by comparing the histopathology reports of endometrial samplings with that of hysterectomy specimen, taken as gold standard. Methods: This study is carried out in 76 patients with abnormal uterine bleeding posted for hysterectomy. Endometrial sampling was done with Endomed in all patients. The histopathology report of endomed sample is compared with that of hysterectomy sample. Results: The mean age of study population in our study was 45.75 ± 7.19 years. The most common complaint was menorrhagia (39.5%), followed by polymenorrhagia (17.1%), dysmenorrhea and lower abdominal pain (14.5% each). Endomed sample was found to be adequate for 94.7% of the study population. Among the adequate samples, proliferative endometrium contributed to a 28.9%, followed by secretory endometrium (22.4%) and the least was hyperplasia with atypia (3.9%). Among the study population, 8 (10.5%) of them were found to have carcinoma endometrium with histopathology (HPR) report of hysterectomy specimen whereas 6 (7.9%) using Endomed sampling. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy was found to be 100%, 88.2%, 96.97%, 100% and 97.22% respectively for Carcinoma Endometrium. Conclusion: Endometrial sampling by endomed method is safe, easy to perform, highly sensitive and specific for diagnosis of endometrial carcinoma and its precursors. Endomed sampling can be used as an alternative to D&C for sampling of endometrium.