Aksoy Hüseyin, Çopuroğlu Mehmet, Genco Mehmet, Genco Merve, Korkmaz Baştürk Mürüvet
Department of Obstetrics and Gynaecology, Kayseri City Hospital, 38070 Kayseri, Turkey.
Department of Obstetrics and Gynaecology, Kayseri State Hospital, 38070 Kayseri, Turkey.
Diagnostics (Basel). 2025 Jul 7;15(13):1725. doi: 10.3390/diagnostics15131725.
This retrospective study aims to evaluate the effect of copper intrauterine device (Cu-IUD) use on the adequacy and diagnostic quality of endometrial biopsy specimens in women with abnormal uterine bleeding (AUB). Patients with levonorgestrel-releasing intrauterine systems (LNG-IUS, e.g., Mirena) were excluded from the study. The study compares the histopathological adequacy of endometrial samples between Cu-IUD users and non-users, highlighting potential interpretation challenges in routine pathological assessment. The study was conducted on 409 women aged 25-55 who presented with abnormal uterine bleeding (AUB) to the Gynecology and Obstetrics Outpatient Clinic at Kayseri City Hospital between 1 April 2021 and 1 April 2023. The patients were divided into two groups: copper IUD (Cu-IUD) users ( = 215) and non-IUD users ( = 194). Patients using levonorgestrel-releasing intrauterine systems (LNG-IUS, e.g., Mirena) were excluded from the study. Endometrial biopsies were obtained using the Pipelle curette technique without anesthesia, preserved in 10% formalin, and assessed for pathological classification and diagnostic adequacy. The proportion of unclassifiable pathological categories was significantly higher in copper IUD users (63.93%) compared to non-IUD users (36.05%) ( = 0.013). Additionally, a negative correlation was observed between pathological category and endometrial thickness (r = -0.3147, < 0.001), suggesting that thinner endometrial lining may reflect atrophic or diagnostically ambiguous tissue patterns. However, no significant association was found between IUD use and endometrial thickness ( = 0.073). The findings indicate that copper IUD use may affect the diagnostic adequacy of endometrial biopsy specimens, likely due to inflammatory or structural changes in the endometrium. These results underline the importance of considering IUD-related alterations when interpreting biopsy findings. Further research is needed to refine diagnostic approaches and better understand the clinical implications of these effects.
这项回顾性研究旨在评估使用铜宫内节育器（Cu-IUD）对异常子宫出血（AUB）女性子宫内膜活检标本的充分性和诊断质量的影响。使用左炔诺孕酮宫内节育系统（LNG-IUS，如曼月乐）的患者被排除在本研究之外。该研究比较了Cu-IUD使用者和非使用者子宫内膜样本的组织病理学充分性，突出了常规病理评估中潜在的解读挑战。该研究对2021年4月1日至2023年4月1日期间到开塞利市医院妇产科门诊就诊的409名25 - 55岁出现异常子宫出血（AUB）的女性进行。患者被分为两组：铜宫内节育器（Cu-IUD）使用者（n = 215）和非宫内节育器使用者（n = 194）。使用左炔诺孕酮宫内节育系统（LNG-IUS，如曼月乐）的患者被排除在本研究之外。采用Pipelle刮匙技术在无麻醉情况下获取子宫内膜活检标本，保存在10%福尔马林中，并进行病理分类和诊断充分性评估。与非宫内节育器使用者（36.05%）相比，铜宫内节育器使用者中无法分类的病理类别比例显著更高（63.93%）（P = 0.013）。此外，观察到病理类别与子宫内膜厚度之间存在负相关（r = -0.3147，P < 0.001），这表明较薄的子宫内膜可能反映萎缩或诊断不明确的组织模式。然而，未发现使用宫内节育器与子宫内膜厚度之间存在显著关联（P = 0.073）。研究结果表明，使用铜宫内节育器可能会影响子宫内膜活检标本的诊断充分性，这可能是由于子宫内膜的炎症或结构变化所致。这些结果强调了在解读活检结果时考虑与宫内节育器相关改变的重要性。需要进一步研究以完善诊断方法并更好地理解这些影响的临床意义。
