A RETROSPECTIVE EVALUATION OF NEOPLASTIC AND NON-NEOPLASTIC PATHOLOGIES IN NON-PREGNANCY ENDOMETRIAL TISSUE SAMPLES AND A LITERATURE REVIEW

Abstract

Objective: This study retrospectively examined patients presenting with abnormal uterine bleeding. Based on the histopathological and clinical characteristics of the obtained data, we sought a statistical answer to the question “Do age, material type, clinical findings, clinical preliminary, and histopathological diagnosis parameters differ from the literature findings?” Material and Methods: A total of 2,000 endometrial samples were reviewed and filtered according to the appropriate parameters collected within 5 years (2017-2022). The statistical significance of the data was measured using the ch-square test. Results: The study included 1,815 patients aged 19 to 86 years. In dications for endometrial sampling were classified as menometrorrhagia/menorrhagia (49.2%), endometrial polyp (19.5%), post-menopausal bleeding (18%), endometrial hyperplasia (14.6%), and leiomyoma (2.8%). Patients were grouped by menstrual status: premenopausal (51.6%, under 45 years), perimenopausal (25.39%, aged 45-51), and postmenopausal (22.97%, aged 51 and above). Histopathological findings showed benign pathologies including endometrial polyp (61.9%), proliferative/secretory endometrium (12%), atrophic endometrium (6.6%), and chronic endometritis (0.2%). The premalignant findings were endometrial hyperplasia without atypia (9%) and atypical hyperplasia of the endometrium (0.6%). Malignant findings included adenocarcinoma (1.2%). Conclusion: An in-depth answer was challenging due to insuffi cient data documentation in the current practice. Nevertheless, we have presented the concordance for the four major pathologies and their distribution in the patient population. Our study has shown that endometrial polyps are the pathology most frequently diagnosed correctly. Our study detected endometrial cancer predominantly in the postmenopausal group, emphasising the importance of endometrial sampling in this group. This aligns with the existing literature.

Keywords

• Endometrium
• histopathology
• diagnosis

GEBELİK DIŞI ENDOMETRİAL DOKU ÖRNEKLERİNDE NEOPLAZİK VE NONNEOPLAZİK PATOLOJİLERİN; LİTERATÜR EŞLİĞİNDE RETROSPEKTİF OLARAK İNCELENMESİ

Abstract

Amaç: Bu çalışmada anormal uterin kanama şikayetiyle gelen hastalar retrospektif olarak olarak incelenmiştir. Elde edilen verilerin histopatolojik ve klinik özelliklerinden yola çıkarak “yaş, materyal tipi, klinik bulgular, klinik ön tanı ve histopatolojik tanı parametreleri literatür bulguları ile farklılık gösteriyor mu?” sorusuna istatiksel olarak cevap aramak amaçlanmıştır. Gereç ve Yöntemler: Son 5 yılda (2017-2022) gönderilen 2000 adet endometrial örnek taranmıştır ve uygun parametrelere göre filtrelenmiştir. Verilerin istatistiksel anlamlılığı Ki-Kare ile ölçülmüştür. Bulgular: Çalışmadaki 1815 hastanın yaşları 19-86 aralığındadır. Endometrial örnekleme endikasyon sınıflandırması: menometroraji/menoraji (%49,2), endometrial polip (%19,5) postmenopozal kanama (%18), endometrial hiperplazi (%14,6) ve leiomyom (%2,8) şeklindedir. Menstrüel durumlarına göre; 45 yaş altındaki hastalar premenopoz (%51,6), 45-51 yaş arası hastalar perimenopoz (%25,39), ve 51 yaş ve üstü hastalar postmenopoz (%22,97) şeklinde üç gruba ayrılmıştır. Histopatolojik olarak, benign histopatolojik bulgular arasında endometrial polip (%61,9), proliferatif/sekretuar endometrium (%12), atrofik endometrium (%6,6) ve kronik endometrit (%0,2) bulunmuştur. Pre-malign bulgularda, atipisiz endometrial hiperplazi (%9), ve atipik endometrial hiperplazi (%0,6), malign bulgular arasında ise adenokarsinom (%1,2) saptanmıştır. Sonuç: Güncel klinik ve laboratuvar pratiğinin sebep olduğu yetersiz veri dokümantasyonu nedeniyle çalışmamızda derinlemesine bir yanıt vermek zor olmuştur. Buna rağmen çalışmamız dört ana patolojinin ön tanı-histopatolojik tanı arasındaki uyumunu ve genel popülasyondaki dağılımını sunmuştur. Endometrial poliplerin en sık doğru teşhis edilen patoloji olduğunu göstermiştir. Çalışmamızda endometrial kanserin ağırlıklı olarak postmenopozal grupta görüldüğü tespit edilmiş olup bu durum, bu grupta endometrial örnekleme yapılmasının önemini vurgulamaktadır. Bu bulgu mevcut literatürle uyumludur.

Keywords

• Endometrium
• histopatoloji
• tanı

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