2017, Number 11
<< Back Next >>
Ginecol Obstet Mex 2017; 85 (11)
Correlation between hysteroscopic and histopathological reports in patients with abnormal uterine bleeding
Valenzuela-Islas HA, Frías-Mendívil M, Luis-Zárate H
Language: Spanish
References: 23
Page: 748-754
PDF size: 340.64 Kb.
ABSTRACT
Objetive: To determine the sensitivity and specificity, predictive
value positive and negative and estimate the correlation coefficient
between hysteroscopy and endometrial histopathological outcomes
in patients with abnormal uterine bleeding.
Materials and Methods:Descriptive, observational, a series of
consecutive cases was performed at the Hysteroscopy Clinic of the
"Hospital Integral de la Mujer del Estado de Sonora” were included
with abnormal uterine bleeding. The hysteroscopy and histopathological
findings of the endometrial alterations were classified. In order to
calculate the sensitivity and specificity of the hysteroscopy, the patients
were grouped into two categories: normal endometrium (healthy
women) and abnormal endometrium (patients with endometrial
polyp, submucous myoma, adenomyosis, endometrial hyperplasia,
endometrial cancer, among other alterations). Statistical analysis was
performed using the SPSS program V. 22, for Windows 10.0; the sensitivity
and specificity was calculated with 95% confidence intervals,
the correlation coefficient was estimated by Pearson method.
Results: We registered 400 patients; the average age was 45.2
(±11.04). The most frequent diagnosis by hysteroscopy and histopathological
was endometrial polyp. The sensitivity was 0.95 (95%CI
= 0.93-0.97) and specificity of 0.85 (95%CI = 0.82-0.89) as cause of
abnormal uterine bleeding by hysteroscopy, the positive predictive
value was 0.97 95%CI = 95-98) and negative predictive value of
0.79%. (CI95% = 0.75-0.83). The Pearson correlation coefficient was
77.8% (p = 0.000) between hysteroscopy impression and histopathology
diagnosis, when the result was classified as normal or abnormal.
Results: Hysteroscopy is a high sensitivity and specificity
technique to diagnosis of benign and malignant endometrial alterations;
in addition, an excellent correlation was observed between the
hysteroscopy findings and the histopathological findings.
REFERENCES
Munro MG. Abnormal uterine bleeding. Cambridge: Cambridge University Press; 2010.
Fraser IS, Critchley HO, Munro MG. Abnormal uterine bleeding: getting our terminology straight. Curr Opin Obstet Gynecol 2007;19:591-5.
Van Dongen H, de Kroon C, Jacobi C, Trimbos B, Jansen F. Diagnostic hysteroscopy in abnormal uterine bleeding: a systematic review and meta-analysis. BJOG 2007;114:664- 675.
Procopé B. Aetiology of postmenopausal bleeding. Acta Obstet Gynecol Scand 1971;50:311-3.
Cepni I, Ocal P, Erkan S, et al. Comparison of transvaginal sonography, saline infusion sonography and hysteroscopy in the evaluation of uterine cavity pathologies. Aust N Z J Obstet Gynaecol 2005;45:30-5.
Bingol B, Gunenc MZ, Gedikbasi A, Guner H, Tasdemir S, Tiras B. Comparison of diagnostic accuracy of saline infusion sonohysterography, transvaginal sonography and hysteroscopy in postmenopausal bleeding. Arch Gynecol Obstet 2011;284:111-7.
Ragni G, Diaferia D, Vegetti W, Colombo M, Arnoldi M, Crosignani PG. Effectiveness of sonohysterography in infertile patient work-up: a comparison with transvaginal ultrasonography and hysteroscopy. Gynecol Obstet Invest 2005;59:184-8.
Clark T, Voit D, Gupta JK, Hyde C, Song F, Khan KS. Accuracy of hysteroscopy in the diagnosis of endometrial cancer and hyperplasia: a systematic quantitative review. JAMA 2002;288:1610-21.
Lasmar RB, Barrozo PRM, Oliveira MAP, Coutinho ESF, Dias R. Validation of hysteroscopic view in cases of endometrial hyperplasia and cancer in patients with abnormal uterine bleeding. J Min Inv Gynecol 2006;13:409-12.
Bedner R, Rzepka-Gorska I. Diagnostic hysteroscopy after D&C in women with perimenopausal bleeding. Ginekol Pol 2002;73:577-82.
Pato-Mosquera M, Vázquez- Rodríguez M, Pérez-Adán M, García-García MJ, Blanco-Pérez S. Indicaciones y resultados de la histeroscopia diagnóstica ambulatoria en el complexo Hospitalario Universitario de Ourense. Ginecol Obstet Mex 2013;81:382-388.
Bettocchi S, Nappi L, Oronzo C, Selvaggi L. What does diagnostic hysteroscopy mean today? The role of the new techniques. Curr Opin Obstet Gyencol 2003;15:303-308.
Nagele F, O‘Connor H, Davies A, Badawy A, Mohamed H, Magos A. Outpatient diagnostic hysteroscopies. Obstet Gynecol 1996;88(1):87-92.
Pierre F, Lansac J, Soutoul JH. Air embolism and exploratory hysteroscopy: myths or realities? Preliminary results. J Gynecol Obstet et Biol Reprod 1995;24:19-23.
Alanís FJ, Martínez GM, Mata MP. Hallazgos histeroscópicos en pacientes con sangrado genital posmenopáusico. Ginecol Obstet Mex 2007;75:253-8.
Alanís FJ. Polipectomía histeroscópica en consultorio: análisis de ocho años. Ginecol Obstet Mex 2007;75:341- 6.
Alexopaoulos ED, Simonis CD, Kidsley S, Fay Toby N. The value of outpatient hysteroscopy in the management of postmenopausal bleeding: a review of 862 cases. Gynaecol Endosc 2000;9:107-12.
De Wit AC, Vleugels MP, De Kruif JH. Diagnostic hysteroscopy: a valu- able diagnostic tool in the diagnosis of structural intra-cavital pathology and endometrial hyperplasia or carcinoma? Six years of experience with non-clinical diagnostic hysteroscopy. Eur J Obstet Gynecol Reprod Biol (Ireland) 2003;110:79-82.
Pellicer A, Diamond MP. Distending media for hysteroscopy. Obstet Gynecol Clin North Am 1998;15:23-8.
Oguz S, Sargin A, Kelekci S, et al. The role of hormone replacement therapy in endometrial polyp formation. Maturitas 2005;50(3):231.
Onalan R, Onalan G, Tonguc E, et al. Body mass index is an independent risk factor for the development of endometrial polyps in patients undergoing in vitro fertilization. Fertil Steril 2009; 91:1056.
Reslová T, Tosner J, Resl M, et al. Endometrial polyps. A clinical study of 245 cases. Arch Gynecol Obstet 1999; 262:133.
Gran DE, Jawan RA, Moy FM. Concordance between hysteroscopic impression and endometrial histopathological diagnosis. Preventive Medicine 2013;57(Suppl 1):S21-S23.