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[门诊宫腔镜下子宫内膜活检与门诊手动负压吸引子宫内膜活检对绝经后子宫出血的评估。初步报告]

[Evaluation of postmenopausal uterine bleeding by endometrial biopsy in-office hysteroscopy vs endometrial biopsy with manual vacuum aspiration in the office. Preliminary report].

作者信息

Hernández José Arias, Franco María Eugenia Lozano, Mendizábal David Pablo Bulnes, Broca Yrma Bocanegra, Escoto Adrián Fores

机构信息

Departamento de Biología de la Reproducción Humana, Hospital Regional de Alta Especialidad de la Mujer de Tabasco, Villahermosa, Tabasco.

出版信息

Ginecol Obstet Mex. 2009 Nov;77(11):504-7.

PMID:20085133
Abstract

OBJECTIVE

To compare endometrial biopsy by hysteroscopy vs manual endouterine aspiration in office, in patients of Climateric Clinic from Hospital Regional de Alta Especialidad de la Mujer Tabasco, with postmenopausal uterine bleeding.

MATERIAL AND METHODS

There were included patients that come from October 30 2007 to December 20 2008 to Climateric Clinic, with abnormal uterine bleeding and without hormonal replacement therapy. There were taken biopsy by hysteroscopy and AMEU. The histopathology results were compared.

RESULTS

A total of 25 women were evaluated. The average age was 53 years (+/- 5.6). The delivery average was 3 births (+/- 1). We found polyps in 9 (37%) patients, endometrial atrophy in 3 (13%), cystic hyperplasia in 2 (8%), proliferative endometrium in 4 (17%), submucous myomas in 5 (21%) and neoplasia in 1 (4%). The correlation between endometrial biopsy by hysteroscopy and AMEU was 100% for endometrial atrophy, cystic hyperplasia, proliferativo endometrium and neoplasia. There was not correlation between manual endouterine aspiration and endometrial biopsy by hysteroscopy for polyps and submucous myomas. We didn't have complications during the procedures.

CONCLUSION

Hysteroscopic endometrial biopsy seems to have the same histopathology results than AMEU for endometrial atrophy, cystic hyperplasia, proliferative endometrium and neoplasia, not for miomas and polyps. Hysteroscopy can give us the possibility to see miomas and polyps and treat surgical pathology at the same moment almost in all cases.

摘要

目的

比较在塔巴斯科州妇女高级专科医院更年期诊所中,对有绝经后子宫出血的患者进行宫腔镜子宫内膜活检与门诊手动宫腔抽吸活检的情况。

材料与方法

纳入2007年10月30日至2008年12月20日前来更年期诊所、有异常子宫出血且未接受激素替代治疗的患者。分别通过宫腔镜和手动宫腔抽吸活检获取组织样本,并比较组织病理学结果。

结果

共评估了25名女性。平均年龄为53岁(±5.6岁)。平均分娩次数为3次(±1次)。我们发现9例(37%)患者有息肉,3例(13%)有子宫内膜萎缩,2例(8%)有囊性增生,4例(17%)有增殖期子宫内膜,5例(21%)有黏膜下肌瘤,1例(4%)有肿瘤形成。对于子宫内膜萎缩、囊性增生、增殖期子宫内膜和肿瘤形成,宫腔镜子宫内膜活检与手动宫腔抽吸活检的相关性为100%。对于息肉和黏膜下肌瘤,手动宫腔抽吸活检与宫腔镜子宫内膜活检之间无相关性。手术过程中未出现并发症。

结论

对于子宫内膜萎缩、囊性增生、增殖期子宫内膜和肿瘤形成,宫腔镜子宫内膜活检的组织病理学结果似乎与手动宫腔抽吸活检相同,但对于肌瘤和息肉则不同。宫腔镜几乎在所有情况下都能让我们看到肌瘤和息肉,并同时进行手术病理治疗。

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