[Analysis of pathohistological results from the uterine mucosa 1965-1998 at the gynecology department in Senta].

INTRODUCTION

It is a well known fact that there is no invasive uterine carcinoma which was not a "carcinoma in situ" in the initial stage. On the basis of this knowledge it is evident that active systematic detection of malignant uterine neoplasms is of great importance. Incidence of cervical carcinoma had been at the first place for years, but in the last 10 years the number of diagnosed cancer of corpus uteri has significantly increased. Uterine hemorrhage is a problem at any age, but at menopause and senium it is of special importance, because at this age every hemorrhage must be considered carcinomatous, unless something else is established (1). Out of all methods, histopathological analysis of the biopsy material is the most reliable, but only complete, not fractional, uterine abrasion has a full diagnostic value. Explorative curettage was performed in all cases of polypectomies and cervix biopsies (2,3,4).

MATERIAL AND METHODS

A retrospective study included all histopathological findings of curettages, polypectomies and biopsies performed due to hemorrhage in the period from 1965 to 1998. During this period 48,606 women were hospitalized at the Gynecology Department of the General Hospital in Senta. 9,475 (19.49%) underwent explorative curettage, partly for therapeutic and partly for diagnostic reasons. The biopsy material was sent for histopathological analysis, disregarding the quantity and macroscopic appearance.

RESULTS

The greatest number of explorative curettages were performed in women from 41-50 years of age (41.35%). The number of interventions decreased in the sixth and seventh decade, with sudden increase over 70 years of age. The greatest number of functional bleeding occurred in women from 21 to 50 years of age (33.59%), whereas endometrial hyperplasia was diagnosed in 22.6% of patients 41-50 years of age. Biopsies and polypectomies with explorative curettages were most frequent in patients 61-70 years of age. Uterine carcinoma was diagnosed in 470 patients: out of this number cervical carcinoma was diagnosed in 234 patients, and corpus uteri carcinoma in 236 women. Cervical carcinoma occurred most frequently in the group of patients 41-50 years of age, whereas corpus uteri carcinoma was most frequent in the group 51-70 years of age. It is important to point out the correlation between cervical carcinoma and corpus uteri carcinoma being 1:1.04.

CONCLUSION

1. In order to detect corpus uteri carcinoma, especially in women over 40 years of age, it is necessary to pay special attention to all kinds of uterine bleedings. 2. Explorative curettage of the whole uterine cavity and histopathological analysis of biopsy material are considered to be the most reliable diagnostic methods for detection of carcinoma. 3. The correlation between cervical carcinoma and corpus uteri carcinoma is 1:1.04. It points to a difference in regard to corpus uteri carcinoma established in previous studies.