Dongre Trupti A, Maimoon Sabiha A
Pathology, N.K.P. Salve Institute of Medical Sciences and Research Centre and Lata Mangeshkar Hospital, Nagpur, IND.
Cureus. 2023 Jul 11;15(7):e41699. doi: 10.7759/cureus.41699. eCollection 2023 Jul.
Introduction Endometrial aspiration cytology (EAC) is a noninvasive, rapid, and cost-effective procedure for diagnosing gynecological disorders. This study aimed to validate endometrial aspiration as a routine, safe, and efficient outpatient diagnostic procedure, correlating its findings with histopathology evaluations to facilitate early surgical planning for patients with abnormal uterine bleeding. Materials and methods This cross-sectional study involved patients of reproductive, menopausal, and postmenopausal age groups who presented with diverse gynecological concerns that required dilatation and curettage. Endometrial aspiration was performed using a Karman cannula (Angiplast Pvt. Ltd., Vatva, India), and the obtained material was prepared into smears and stained for evaluation. Sampling adequacy, the nature of glandular and stromal cells, phasing of the endometrium, and other abnormalities were assessed and correlated with histology to examine the diagnostic utility of endometrial cytology. Results EAC showed 90.66% sampling adequacy with the Karman cannula. The sensitivity of EAC for diagnosing benign and malignant conditions was 88.7% and 100%, respectively. Conditions including secretory endometrium, proliferative phase, tuberculous endometritis, and glandular hyperplasia were diagnosed using EAC and confirmed by histopathology. Six malignancies were successfully diagnosed on cytology smears, while challenges in differentiation and sampling errors were recognized as limitations of the technique. Conclusions This study established EAC as a highly sensitive, minimally invasive preliminary diagnostic tool for gynecological disorders, particularly effective in diagnosing malignancy. Despite certain limitations, the procedure's ease, cost-effectiveness, and safety underscore its potential for routine use by surgeons.
引言 子宫内膜抽吸细胞学检查(EAC)是一种用于诊断妇科疾病的非侵入性、快速且经济高效的方法。本研究旨在验证子宫内膜抽吸作为一种常规、安全且高效的门诊诊断程序,将其检查结果与组织病理学评估相关联,以便为异常子宫出血患者制定早期手术计划。材料与方法 这项横断面研究纳入了生殖期、围绝经期和绝经后期的患者,这些患者存在各种需要刮宫的妇科问题。使用卡尔曼套管(印度瓦德瓦的Angiplast Pvt. Ltd.公司生产)进行子宫内膜抽吸,将获取的材料制成涂片并染色以供评估。评估取样充分性、腺细胞和基质细胞的性质、子宫内膜的分期以及其他异常情况,并与组织学进行关联,以检验子宫内膜细胞学的诊断效用。结果 使用卡尔曼套管时,EAC的取样充分率为90.66%。EAC诊断良性和恶性疾病的敏感性分别为88.7%和100%。通过EAC诊断出包括分泌期子宫内膜、增殖期、结核性子宫内膜炎和腺体增生等情况,并经组织病理学证实。在细胞学涂片上成功诊断出6例恶性肿瘤,同时认识到鉴别诊断方面的挑战和取样误差是该技术的局限性。结论 本研究确立了EAC作为一种对妇科疾病高度敏感、微创的初步诊断工具,在诊断恶性肿瘤方面尤其有效。尽管存在某些局限性,但该程序的简便性、成本效益和安全性突出了其被外科医生常规使用的潜力。