Mohanlal Reena D
Department of Anatomical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
National Health Laboratory Services, Chris Hani Baragwanath Laboratory, Johannesburg, South Africa.
Afr J Lab Med. 2020 Sep 29;9(1):1038. doi: 10.4102/ajlm.v9i1.1038. eCollection 2020.
Outpatient sampling is used to investigate endometrial pathology. Little is known about practice habits and local failure rates at Chris Hani Baragwanath Academic Hospital in Johannesburg, South Africa.
This study assessed the frequency of samples that showed no or limited histological representation of endometrium, and described demographic and pathological features.
All endometrial sample histology reports from the National Health Laboratory Services at the hospital from 01 July 2013 to 31 May 2017 were retrieved by searching the laboratory's information system. Clinical variables (age, menopausal state, indication for biopsy, endometrial thickness on ultrasound) and pathological findings (macroscopic amount of tissue, histological diagnosis, microscopic presence of endometrial tissue) were extracted and statistically analysed.
A total of 1926 samples were included, 91% of which were submitted for abnormal or postmenopausal bleeding. No endometrium was observed in 25% of samples and 13% showed limited endometrium. Benign diagnoses (86%) were most common, with proliferative or secretory changes, endometrial polyps and endometritis accounting for most of these. Associations between the amount of sample received and the presence of endometrial tissue ( ≤ 0.001) and benign versus malignant diagnoses ( ≤ 0.001) were noted. The greater the endometrial thickness, the greater the likelihood of obtaining more sample (bulky vs scant < 0.001) and making a malignant versus benign diagnosis ( = 0.005).
These findings are in keeping with literature outside Africa. Histology reports should be explicit when terms such as 'inadequate' or 'insufficient' are used, in order to facilitate clinical decision-making.
门诊取样用于调查子宫内膜病变。对于南非约翰内斯堡克里斯·哈尼·巴拉格瓦纳特学术医院的实际操作习惯和局部失败率知之甚少。
本研究评估了未显示或仅显示有限子宫内膜组织学表现的样本频率，并描述了人口统计学和病理学特征。
通过检索实验室信息系统，获取了该医院2013年7月1日至2017年5月31日期间国家卫生实验室服务中心的所有子宫内膜样本组织学报告。提取临床变量（年龄、绝经状态、活检指征、超声检查时的子宫内膜厚度）和病理学结果（组织大体量、组织学诊断、子宫内膜组织的显微镜下表现）并进行统计分析。
共纳入1926个样本，其中91%因异常出血或绝经后出血送检。25%的样本未观察到子宫内膜，13%的样本显示子宫内膜有限。良性诊断（86%）最为常见，其中增殖期或分泌期改变、子宫内膜息肉和子宫内膜炎占大多数。注意到所接收样本量与子宫内膜组织存在情况（≤0.001）以及良性与恶性诊断之间的关联（≤0.001）。子宫内膜厚度越大，获取更多样本的可能性越大（大量样本与少量样本相比，<0.001），做出恶性与良性诊断的可能性也越大（=0.005）。
这些发现与非洲以外的文献一致。当使用“不充分”或“不足”等术语时，组织学报告应明确，以便于临床决策。
