Elsandabesee D, Greenwood P
Department of Obstetrics and Gynaecology, James Paget Hospital, Gorleston, Norfolk NR31 6LA, UK.
J Obstet Gynaecol. 2005 Jan;25(1):32-4. doi: 10.1080/01443610400025390.
Endometrial sampling using the Pipelle device is widely used in the UK especially in the investigation of postmenopausal bleeding. This study was aimed at evaluating the clinical benefit and diagnostic accuracy of the procedure in the setting of a dedicated one-stop clinic for women with postmenopausal bleeding. The study also examined the factors that would affect the adequacy of endometrial samples in terms of their suitability for histopathalogical examination. Data from 97 consecutive patients attending the clinic were collected and analysed. All the patients had a transvaginal ultrasound scan and an endometrial Pipelle sample was attempted unless refused by the patient. The analysis revealed that the procedure avoided the need for hysteroscopy in 61.5% of cases with an endometrial thickness of > 4mm. No cases of endometrial cancer were missed after successful Pipelle sampling. The ability to obtain an adequate endometrial sample was primarily affected by the endometrial thickness. There is only a 27% probability of getting an adequate endometrial sample in the group of women with an endometrial thickness of < 5 mm. The study recommends this procedure for the group of women with an endometrial thickness of > 4 mm. However, when the endometrial thickness is < or = 4 mm, little can be gained from endometrial sampling as malignancy is rare and the chance of getting an adequate sample is small.
在英国，使用 Pipelle 装置进行子宫内膜取样被广泛应用，尤其是在对绝经后出血的调查中。本研究旨在评估在为绝经后出血女性设立的专门一站式诊所中该程序的临床益处和诊断准确性。该研究还探讨了就子宫内膜样本对组织病理学检查的适用性而言，会影响样本充分性的因素。收集并分析了连续 97 例到该诊所就诊患者的数据。所有患者均接受了经阴道超声扫描，除非患者拒绝，否则均尝试进行子宫内膜 Pipelle 取样。分析显示，在子宫内膜厚度 > 4mm 的病例中，该程序避免了 61.5% 的患者需要进行宫腔镜检查。成功进行 Pipelle 取样后，没有漏诊子宫内膜癌的病例。获取足够子宫内膜样本的能力主要受子宫内膜厚度影响。在子宫内膜厚度 < 5mm 的女性群体中，获得足够子宫内膜样本的概率仅为 27%。该研究建议对子宫内膜厚度 > 4mm 的女性群体采用此程序。然而，当子宫内膜厚度 ≤ 4mm 时，由于恶性肿瘤罕见且获得足够样本的机会很小，子宫内膜取样几乎没有收获。
