Polena Viola, Mergui Jean-Luc, Zerat Laurent, Sananes Serge
Service de Gynécologie-Obstétrique, Hôpital Tenon, 4 rue de la Chine, 75020 Paris, France.
Eur J Obstet Gynecol Reprod Biol. 2007 Oct;134(2):233-7. doi: 10.1016/j.ejogrb.2006.07.026. Epub 2006 Oct 9.
To evaluate the feasibility and accuracy of Pipelle Mark II sampling (designed for combined cytology and histology testing) in the diagnosis of endometrial disease.
A 97 women with abnormal uterine bleeding or intrauterine lesions on ultrasound examination underwent Pipelle Mark II endometrial sampling, followed by diagnostic hysteroscopy. The adequacy of endometrial samples obtained for cytological and histological analysis was assessed. A correlation was established between endometrial cytology, histology and diagnostic hysteroscopy results. Where discrepancies were found, they were compared with the histological results obtained from operative hysteroscopy.
The tissue samples obtained for cytological and histological diagnoses were insufficient in 14.4% and 11.3% of patients, respectively. The opposite was found in the group of postmenopausal women (N=52): the tissue samples for cytological and histological diagnoses were insufficient in only 3.8% and 15.4% of cases, respectively. The cytological results corroborated diagnostic hysteroscopy findings and histological results in all cases but 3 (3.6%). Only two cases of endometrial carcinoma were reported in this group of patients, and they were both detected by all three methods. The rate of false positives with endometrial cytological sampling was 3.6%. There were no false negatives.
Pipelle Mark II endometrial sampling is feasible. It provides adequate samples for histological and/or cytological analysis and reliable results. It reduces the rate of false negative results for endometrial cancer. Pipelle Mark II sampling is particularly useful in postmenopausal women and in women with endometrial atrophy. Other larger studies are necessary to evaluate the efficiency of Pipelle Mark II.
评估用于联合细胞学和组织学检测的 Pipelle Mark II 采样法在诊断子宫内膜疾病中的可行性和准确性。
97 例超声检查显示子宫异常出血或宫内病变的女性接受 Pipelle Mark II 子宫内膜采样，随后进行诊断性宫腔镜检查。评估获取的用于细胞学和组织学分析的子宫内膜样本的充足性。建立子宫内膜细胞学、组织学与诊断性宫腔镜检查结果之间的相关性。发现差异时，将其与手术宫腔镜检查获得的组织学结果进行比较。
分别有 14.4%和 11.3%的患者获取的用于细胞学和组织学诊断的组织样本不足。在绝经后女性组（n = 52）中情况相反：用于细胞学和组织学诊断的组织样本不足的病例分别仅为 3.8%和 15.4%。除 3 例（3.6%）外，细胞学结果在所有病例中均与诊断性宫腔镜检查结果及组织学结果相符。该组患者仅报告了 2 例子宫内膜癌，且三种方法均检测到了这两例。子宫内膜细胞学采样的假阳性率为 3.6%。无假阴性。
Pipelle Mark II 子宫内膜采样是可行的。它能为组织学和/或细胞学分析提供充足样本及可靠结果。它降低了子宫内膜癌的假阴性结果率。Pipelle Mark II 采样法在绝经后女性及子宫内膜萎缩的女性中尤其有用。需要其他更大规模的研究来评估 Pipelle Mark II 的有效性。
