Postmenopozal hastalarda endometrial örnekleme sonuçlarının değerlendirilmesi; yetersiz endometrial örneklemenin önemi

Abstract

Amaç Postmenopozal hasta populasyonunda endometrial örnekleme sonuçlarının değerlendirilmesi ve yetersiz endometrial örnekleme sıklığının belirlenmesi amaçlanmıştır. Gereç ve Yöntem Bu retrospektif çalışmada Bursa Şehir Hastanesi kadın hastalıkları ve doğum bölümüne Temmuz 2019 ve Mart 2021 tarihleri arasında başvuran postmenopozal dönemdeki 825 hastadan alınan endometrial biyopsi sonuçları değerlendirilmiştir. Bulgular Postmenopozal dönemde olan 825 hastadan alınan 922 endometrial örnekleme sonucu değerlendirildi. Hastaların yaş ortalaması 56.96±7.21 olup, ortalama menopoz süresi 7.43±7.14 yıldır. Hastalardan alınan 1. endometrial örneklemenin histopatolojik değerlendirmesi yapıldığında 25.45 % yetersiz endometrial örneklemeye rastlanırken postmenopozal kanama şikayeti ile başvuran hasta grubunda ise bu oran %21.61 dir. En sık endometrial patoloji endometrial polip (22.1%) olup çalışma grubumuzda malignite sıklığı %6.18 idi. Alt grup analizlerde malignite görülme sıklığı >60 yaş grubunda daha yüksek (%18.80) iken yaş ile birlikte yetersiz endometrial örneklemenin de arttığı belirlenmiştir. Birinci endometrial örnekleme sonucu yetersiz olan hastaların sadece %20 sinden tekrar biyopsi alınabilmiştir. Bu hastalardan 3 ünde endometrium kanseri ve 1 hastada atipili endometrial hiperplazi varlığı tespit edilmiştir. Sonuç Artan yaş ile birlikte endometrium kanseri sıklığı artmasına rağmen yetersiz endometrial örneklemenin de arttığı gözlenmiştir. Özellikle bu hasta populasyonunda endometrium kanseri risk faktörlerini de göz önünde bulundurarak takiplere gelmesi konusunda yeterli bilgilendirmenin yapılması önem taşımaktadır.

Keywords

• Endometrial örnekleme
• postmenopoz
• yetersiz endometrial biyopsi.

Evaluation of endometrial sampling results in postmenopausal patients; the importance of insufficient endometrial sampling

Abstract

Aim: We aimed to evaluate the endometrial sampling results and to determine the frequency of non diagnostic endometrial sampling in the postmenopausal patient population. Materials and Method: In this retrospective study, endometrial biopsy results obtained from 825 postmenopausal women who applied to Bursa City Hospital's Obstetrics and Gynecology Department between July 2019 and March 2021 were evaluated. Results: 922 endometrial sampling results from 825 postmenopausal patients were evaluated. The mean age of the patients was 56.96±7.21 and the mean menopause time was 7.43±7.14 years. When the histopathological evaluation of the first endometrial sampling taken from the patients was performed, 25.45% of the patients had insufficient endometrial sampling, while this rate was 21.61% in the group of patients who presented with the complaint of postmenopausal bleeding. The most common endometrial pathology was endometrial polyp (22.1%), and the incidence of malignancy in our study group was 6.18%. In subgroup analyzes, the incidence of malignancy was higher (18.80%) in the age group >60 years, and it was also determined that insufficient endometrial sampling increased with age. Re-biopsy was obtained from only 20% of the patients whose first endometrial sampling result was insufficient. Endometrial cancer was detected in 3 of these patients and the presence of atypical endometrial hyperplasia in 1 patient. Conclusion: It has been observed that in addition to the increase in the incidence of endometrial cancer with advancing age, the frequency of insufficient endometrial sampling also increases. Considering the risk factors for endometrial cancer, these patients should be encouraged to continue their follow-up.

Keywords

• Endometrial sampling
• insufficient endometrial biopsy
• postmenopause

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