Department of Obstetrics and Gynecology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
J Obstet Gynaecol Res. 2022 Nov;48(11):2896-2902. doi: 10.1111/jog.15403. Epub 2022 Aug 29.
Endometrial biopsy is generally performed with a metal uterine curette sonde; however, recently, many types of vacuum aspirators are available, including the manual vacuum aspiration (MVA) system. We used the women's MVA system for endometrial sampling and evaluated its effectiveness in determining the presence of endometrial malignancy.
Forty-seven samples were examined using the following procedures after measuring endometrial thickness by transvaginal ultrasonography: fractional curettage biopsy (Bx; 20 samples), total curettage under general anesthesia (T/C; 13 samples), and MVA (14 samples). The quality of the endometrial samples was classified into four types: 1-4, where 1 denoted poor and 4, good quality.
The mean score of the MVA group was significantly higher than that of the partial curettage biopsy group (p = 0.0065). No differences were observed between the MVA and total curettage groups (p = 1.00). When patients were divided into two groups according to endometrial thickness (<10 mm or ≥10 mm) and analyzed, both the MVA and T/C groups did not show a significant difference in their scores compared to the Bx group when the endometrial thickness was <10 mm. However, when the endometrial thickness was ≥10 mm, the MVA and T/C groups had significantly better scores than the Bx group (p = 0.0225 and p = 0.0244, respectively). Vagal reflex, as an adverse event, was observed only in two patients in the Bx group (2/20, 10%).
Considering its quality and safety, Karman-type MVA for endometrial sampling could be an alternative to fractional curettage using a metallic uterine curette sonde.
子宫内膜活检通常使用金属子宫刮宫探针进行；然而，最近有多种类型的真空抽吸器可供选择，包括手动真空抽吸（MVA）系统。我们使用女性 MVA 系统进行子宫内膜取样，并评估其确定子宫内膜恶性肿瘤存在的有效性。
在经阴道超声测量子宫内膜厚度后，采用以下程序对 47 例标本进行检查：分段刮宫活检（Bx；20 例）、全身麻醉下刮宫（T/C；13 例）和 MVA（14 例）。将子宫内膜样本的质量分为 4 个等级：1-4，其中 1 表示差，4 表示好。
MVA 组的平均评分明显高于部分刮宫活检组（p=0.0065）。MVA 组与 T/C 组之间无差异（p=1.00）。当根据子宫内膜厚度（<10mm 或≥10mm）将患者分为两组进行分析时，当子宫内膜厚度<10mm 时，MVA 和 T/C 组的评分与 Bx 组相比均无显著差异。然而，当子宫内膜厚度≥10mm 时，MVA 和 T/C 组的评分明显优于 Bx 组（p=0.0225 和 p=0.0244）。迷走神经反射作为一种不良事件，仅在 Bx 组的 2 例患者中观察到（2/20，10%）。
考虑到其质量和安全性，Karman 型 MVA 用于子宫内膜取样可能是金属子宫刮宫探针分段刮宫的替代方法。
