Pandey Deeksha, Kunamneni Srividya, Inukollu Pranadeep Reddy, Su Hsuan
Department of Obstetrics and Gynaecology, KMC Manipal, Manipal University, Manipal, Karnataka, 576104, India.
Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital at Linkou, Chang Gung University School of Medicine, Tao-Yuan, Taiwan.
Gynecol Minim Invasive Ther. 2017 Oct-Dec;6(4):178-182. doi: 10.1016/j.gmit.2017.08.001. Epub 2017 Aug 26.
Pattern recognition of various phases of normal endometrium and endometrial pathologies during hysteroscopy has many advantages. It would help to triage women with AUB, so as to be selective with biopsies and curettages. Recognition of normal variant or benign lesion would reduce burden to the pathologist by decreasing the number of unnecessary sampling. It will also decreases anxiety of the patient as the report/prognostication can be instant in many cases.
This prospective, double blind, correlation study was carried out in the teaching hospital with a sample population of 70 women presenting with AUB who underwent hysteroscopy and endometrial sampling. We identified patterns of endometrium which can used to predict six endometrial pathologies which were later correlated with the final histological diagnosis.
There was good correlation between hysteroscopic patterns and histopathology report, 33% of starry sky appearance correlated with atrophic endometrium, 87% of tongue shaped projections correlated with endometrial polyp, 44.4% of pebble stone appearance correlated with myomatous polyp, 50% of polypoidal pattern correlated with endometrial hyperplasia. 100% correlation was seen in strawberry appearance, pattern for secretory endometrium and cerebroid appearance which was pattern designated to endometrial carcinoma.
Hysteroscopic pattern recognition is a useful concept to triage women who require sampling for histopathological diagnosis.
宫腔镜检查时对正常子宫内膜各阶段及子宫内膜病变进行模式识别有诸多优势。这有助于对异常子宫出血（AUB）女性进行分类，从而有选择地进行活检和刮宫。识别正常变异或良性病变可减少不必要的采样数量，减轻病理学家的负担。在许多情况下，报告/预后结果可即时得出，这也能减轻患者的焦虑。
本前瞻性、双盲、相关性研究在教学医院开展，样本为70例因AUB接受宫腔镜检查和子宫内膜采样的女性。我们识别出可用于预测六种子宫内膜病变的子宫内膜模式，随后将这些模式与最终的组织学诊断结果进行相关性分析。
宫腔镜检查模式与组织病理学报告之间存在良好的相关性，33%的星空样外观与萎缩性子宫内膜相关，87%的舌状突起与子宫内膜息肉相关，44.4%的卵石样外观与肌瘤性息肉相关，50%的息肉样模式与子宫内膜增生相关。在草莓样外观、分泌期子宫内膜模式和脑样外观（指定为子宫内膜癌的模式）方面观察到100%的相关性。
宫腔镜检查模式识别是一种有用的概念，可用于对需要进行组织病理学诊断采样的女性进行分类。
