Obeidat Basil, Mohtaseb Alia, Matalka Ismail
Department of Obstetrics and Gynecology, Jordan University of Science and Technology, PO Box 2954, Irbid 21110, Jordan.
Arch Gynecol Obstet. 2009 Apr;279(4):489-92. doi: 10.1007/s00404-008-0749-6. Epub 2008 Aug 5.
To evaluate the consistency of preoperative and postoperative histological findings in cases of endometrial hyperplasia.
Fifty-five patients with endometrial hyperplasia detected by surgical curettage were treated by hysterectomy. The histopathological diagnoses found on curettage specimens were compared and correlated with those found on hysterectomy. Endometrial hyperplasia was classified according to the classification scheme of the International Society of Gynecological Pathologists.
Fifty-five patients were diagnosed with endometrial hyperplasia on curettage specimens performed for evaluation of various bleeding abnormalities. The average age of the patients was 51.8 years (range 35-74). Thirty patients (55%) were postmenopausal. The interval between curettage and hysterectomy was 1-33 weeks. Of the patients, 26 (47%) had simple hyperplasia, 24 (44%) complex hyperplasia and 5 patients (9%) had complex atypical hyperplasia. Histopathological evaluation of hysterectomy specimens of these patients showed a total number of 35 cases (64%) with endometrial hyperplasia, 1 case of endometrial carcinoma and 19 cases with other pathological findings. The consistency rate between curettage and hysterectomy specimens was 45% (25/55 cases). Following hysterectomy, we found that none of the 26 simple hyperplasia cases and only one of the 24 complex hyperplasia cases coexisted with endometrial carcinoma. On the other hand, three of the five cases of complex atypical carcinoma coexisted with endometrial carcinoma.
Curettage endometrial pathology tends to be more consistent with final hysterectomy pathology in simple hyperplasia. However, in cases of complex hyperplasia with atypia, curettage seems to under diagnose the real pathology.
评估子宫内膜增生病例术前和术后组织学检查结果的一致性。
55例经手术刮宫诊断为子宫内膜增生的患者接受了子宫切除术。将刮宫标本的组织病理学诊断结果与子宫切除标本的结果进行比较和关联。根据国际妇科病理学家协会的分类方案对子宫内膜增生进行分类。
55例患者因各种出血异常接受刮宫标本检查，诊断为子宫内膜增生。患者的平均年龄为51.8岁（范围35 - 74岁）。30例（55%）为绝经后患者。刮宫与子宫切除的间隔时间为1 - 33周。其中26例（47%）为单纯性增生，24例（44%）为复杂性增生，5例（9%）为复杂性不典型增生。对这些患者子宫切除标本的组织病理学评估显示，共有35例（64%）存在子宫内膜增生，1例子宫内膜癌，19例有其他病理结果。刮宫标本与子宫切除标本的一致性率为45%（25/55例）。子宫切除术后发现，26例单纯性增生病例中无一例合并子宫内膜癌，24例复杂性增生病例中只有1例合并子宫内膜癌。另一方面，5例复杂性不典型增生病例中有3例合并子宫内膜癌。
在单纯性增生中，刮宫子宫内膜病理结果与最终子宫切除病理结果的一致性更高。然而，在伴有不典型性的复杂性增生病例中，刮宫似乎对实际病理情况诊断不足。
