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Year 2014, Volume: 45 Issue: 3, 146 - 150, 06.08.2014
https://doi.org/10.16948/zktb.68266

Abstract

Aims: To evaluate indications and histopathological diagnoses of endometrial samplings in our clinic.Materials-Methods: Seven hundred and fourty four subjects who required endometrial biopsy to be taken for any indication other than pregnancy between January 2013 and January 2014 were included in the study. Data collected retrospectively from Dumlupinar University Evliya Celebi Training and Research Hospital obstetrics and gynecology clinic database and pathology clinic. Statistical analysis of data was performed using SPSS for Windows 13 package programme.Results: Mean age of the subjects was 43.6 ± 8.3. Indications of endometrial sampling were menorrhagia/menometrorrhagia (87%), myoma uteri (1.6%), postmenopausal bleeding (9.5%), cervical polyp (1.9%). Histopathologic diagnoses were as follows: secretory/proliferative endometrium in 72.8%, atrophic endometrium in 3.5%, simple atypical endometrial hyperplasia in 0.7%, simple typical endometrial hyperplasia in 7.9%, complex atypical endometrial hyperplasia in 0.3%, complex typical endometrial hyperplasia in 0.3%, atrophic endometrium in 3.5%, endometrium cancer in 0.8%, and endometrial polyp in 9.5%. Insufficient sampling material was reported in 0.9%. Endometrium cancer was detected in 5.6% of postmenopausal group.Conclusion: The most common endometrial sampling indication was menorrhagia/menometrorrhagia, while endometrium cancer was detected most commonly in patients with postmenopausal bleeding. Our results emphasize that endometrial sampling is warranted especially in peri/postmenopausal women with abnormal uterine bleeding. Endometrial evaluation is needed in patients with cervical polyp.

References

  • Coulter A, Noone A, Goldacre M. General practitioners' referrals to specialist outpatient clinics. I. Why general practitioners refer patients to specialist outpatient clinics. BMJ. 1989 Jul 29;299(6694):304-6.
  • Brenner PF. Differential diagnosis of abnormal uterine bleeding. Am J Obstet Gynecol. 1996 Sep;175(3 Pt 2):766-9.
  • ACOG Committee on Practice Bulletins—Gynecology. Practice bulletin no. 136: management of abnormal uterine bleeding associated with ovulatory dysfunction. Obstet Gynecol. 2013 Jul;122(1):176-85.
  • Epstein E, Skoog L, Valentin L. Comparison of Endorette and dilatation and curettage for sampling of the endometrium in women with postmenopausal bleeding. Acta Obstet Gynecol Scand. 2001 Oct;80(10):959-64.
  • Mahajan N, Aggarwal M, Bagga A. Health issues of menopausal women in North India. J Midlife Health. 2012;3:84–7.
  • Munro MG, Critchley HO, Broder MS, Fraser IS. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet. 2011;113:3–13.
  • Epstein E, Ramirez A, Skoog L, Valentin L. Transvaginal sonography, saline contrast sonohysterography and hysteroscopy for the investigation of women with postmenopausal bleeding and endometrium>5 mm. Ultrasound Obstet Gynecol. 2001;18:157–62.
  • Khare A, Bansal S, Sharma P, Elhence N, et al. Morphological spectrum of Endometrium in patients presenting with Dysfunctional Uterine Bleeding. People's J Sci Res. 2012;5:13–6.
  • Burke TW, Tortolero-Luna G, Malpica A, et al. Enometrial hyperplasia and endometrial cancer. Obstet Gyneloc Clin North Am1996;23:411-56
  • Speroff L, Glass RH, Kase NG. Clinical Gynecology and Infertility.
  • th Edition Baltimore, Lippin cott Williams & Wilkins 1999;574-94.
  • Tuncer R, Uygur R, Kış S. Ankara Zübeyde Hanım Doğumevi 2000 Yılı Endometrial Biopsi Sonuçları: 676 Olgunun Analizi. MN Klinik Bilimler&Doktor 2003;9:97-9
  • Partridge EE, Shingleton HM, Menck HR. The National Cancer Data Base report on endometrial cancer. J Surg Oncol 1996; 61:111-23.
  • Jemal A, Thomas A, Murray T, et al. Cancer statistics, 2002. CA Cancer J Clin 2002; 52:23-47.
  • Paula J. Adams Hillard. Kadın üreme organları benign hastalıkları: Semptom ve bulgular. Novak Jinekoloji (Jonathans-Berek, ed) 2004;351-420.
  • Bokhman Ya, Tkeshelashvili VT, Vishnevsky AS, Volkova AT. Myoma uterus as a marker of oncogynecological pathology in pre and postmenopause. Eur J Gynaecol Oncol 1988;9(5):355-9.
  • Tamay AG, Yıldırım Y, Buğday S, Koltan OS, Güvenal T, Koyuncu FM, Altaş İ, Kandiloğlu AR. Necessity of preoperative endometrial sampling for hysterectomies with benign indications. Cumhuriyet Med J. 2010;32:329-33
  • Çelik Ö, Burak F, Atmaca R, Hasçalık Ş, Kafkaslı A. Uterin fibromyomalı kadınlarda histerektomi öncesi endometrial küretaj gerekli mi? T Klin Jinekol Obst 2001;11:365-8.
  • Stovall TG, Solomon SK, Ling FW. Endometrial sampling prior to hysterectomy. Obstet Gynecol 1989;73:405-9.
  • Tamay AG, Yıldırım Y, Buğday S, Koltan OS, Güvenal T, Koyuncu FM, Altaş İ, Kandiloğlu AR. Necessity of preoperative endometrial sampling for hysterectomies with benign indications. Cumhuriyet Med J. 2010;32:329-3
  • Younis MT, Iram S, Anwar B. Women with asymptomatic cervical polyps may not need to see a gyneacologist or have them removed: an observational retrospective study of 1126 cases. Eur J Obstet Gynecol Reprod Biol 2010;150:190-4.
  • Coeman D, Van Belle Y, Vanderick G, De Muylder X, De Muylder E. Hysteroscopic findings in patients with a cervical polyp. Am J Obstet Gynecol 1993;169(6):1563-5.
  • Vilodre L-CF, Bertat R, Petters R, Reis FM. Cervical polyp as risk factor for hysteroscopically diagnosed endometrial polyps. Gynecol Obstet Invest 1997;44(3):191-5

ENDOMETRİAL ÖRNEKLEME SONUÇLARIMIZ :744 OLGUNUN ANALİZİ (EVALUATION OF ENDOMETRIAL BIOPSY RESULTS IN OUR CLINIC; ANALYSIS OF 744 CASES)

Year 2014, Volume: 45 Issue: 3, 146 - 150, 06.08.2014
https://doi.org/10.16948/zktb.68266

Abstract

Amaç: Kliniğimizde endometrial örnekleme yapılan olgularda, endikasyon ile histopatolojik sonuçlar arasındaki ilişkinin araştırılması.

Materyal metod: Kliniğimize Ocak 2013- Ocak 2014 tarihleri arasında başvuran ve gebelik dışı herhangibir endikasyonla endometrial örnekleme yapılan 744 olgu retrospektif olarak değerlendirildi. Veriler hastanemiz arşivinden alındı. Endometrial örnekleme endikasyonları, menometroraji/menoraji, postmenapozal kanama, myom uteri ve servikal polip olarak gruplandırıldı. İstatistiksel analiz için SPSS 13   programı kullanıldı.

Bulgular: Olguların yaşları 29 ile 79 arasında idi. Hastaların ortalama yaşları 43.6 +/- 8.3 idi. Endometrial örnekleme endikasyonları sırasıyla  menometroraji/menoraji (%87), postmenopozal kanama (%9.5), servikal polip (%1.9), myom uteri (%1.6) idi. Histopatolojik sonuçlar ise sırayla proliferatif/sekretuar endometrium (%72.8), endometrial polip (%9.5), basit atipisiz hiperplazi (%7.9), atrofik endometrium (%3.5), endometrit (%3.2), yetersiz materyal (%0.9), endometrium kanseri (%0.8), basit atipili hiperplazi (%0.7), komplex atipili hiperplazi (%0.3), komplex atipisiz hiperplazi (%0.3) idi. Endometrium kanseri görülme oranı postmenapozal kanaması olan hasta grubunda %5.6 ile diğer gruplara oranla anlamlı derecede yüksek bulundu. En sık örnekleme endikasyonu menometroraji/menoraji saptanırken, bu olgularda endometrium kanseri sadece 2 (%0.3) olguda saptanmıştır. Myom uteri ve servikal polip nedeniyle yapılan endometrial örneklemelerde hiç endometrium kanseri görülmemiştir.

Sonuç: En sık endometrial örnekleme endikasyonu menoraji/menometroraji iken endometrium kanseri açısından riskli grubun postmenopozal kanamalı olguların olduğu gösterilmiştir. Postmenapozal kanamalı hastalarda ciddi endometrial değerlendirme ve örnekleme yapılmalıyken myoma uteri nedeniyle histerektomi planan hastalarda operasyon öncesi endometrial örneklemenin gerekli bulunmamıştır. Fakat servikal polip olgularında endometriumunun değerlendirilmesinin gerektiği sonucuna varılmıştır.

Anahtar kelimeler: endometrial örnekleme, anormal uterin kanama, endometrium kanseri

 

ABSTRACT

Aims: to evaluate indications and histopathological diagnoses of endometrial samplings in our clinic.

Materials-Methods: Seven hundred and fourty four subjects who required endometrial biopsy to be taken for any indication other than pregnancy between January 2013 and January 2014 were included in the study. Data collected retrospectively from Dumlupinar University Evliya Celebi Training and Research Hospital computer database and pathology clinic. Statistical analysis of data was performed using SPSS for Windows package programme.     

Results: Mean age of the subjects was 43.6 ± 8.3. Indications of endometrial sampling were menorrhagia/menometrorrhagia (87%), myoma uteri (1.6%), postmenopausal bleeding (9.5%), servical polyp (1.9%). Histopathologic diagnoses were as follows: secretory/proliferative endometrium in 72.8%, atrophic endometrium in 3.5%, simple atypical endometrial hyperplasia in 0.7%, simple typical endometrial hyperplasia in 7.9%, complex atypical endometrial hyperplasia in 0.3%, complex typical endometrial hyperplasia in 0.3%, atrophic endometrium in 3.5%, endometrium cancer in 0.8%, and endometrial polyp in 9.5%. Insufficient sampling material was reported in 0.9%. Endometrium cancer was detected in 5.6% of postmenopausal group.

Conclusions: Our results emphasize that endometrial sampling is warranted especially in peri/postmenopausal women with abnormal uterine bleeding.

Keywords: endometrial sampling, abnormal uterine bleeding, endometrial cancer

References

  • Coulter A, Noone A, Goldacre M. General practitioners' referrals to specialist outpatient clinics. I. Why general practitioners refer patients to specialist outpatient clinics. BMJ. 1989 Jul 29;299(6694):304-6.
  • Brenner PF. Differential diagnosis of abnormal uterine bleeding. Am J Obstet Gynecol. 1996 Sep;175(3 Pt 2):766-9.
  • ACOG Committee on Practice Bulletins—Gynecology. Practice bulletin no. 136: management of abnormal uterine bleeding associated with ovulatory dysfunction. Obstet Gynecol. 2013 Jul;122(1):176-85.
  • Epstein E, Skoog L, Valentin L. Comparison of Endorette and dilatation and curettage for sampling of the endometrium in women with postmenopausal bleeding. Acta Obstet Gynecol Scand. 2001 Oct;80(10):959-64.
  • Mahajan N, Aggarwal M, Bagga A. Health issues of menopausal women in North India. J Midlife Health. 2012;3:84–7.
  • Munro MG, Critchley HO, Broder MS, Fraser IS. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet. 2011;113:3–13.
  • Epstein E, Ramirez A, Skoog L, Valentin L. Transvaginal sonography, saline contrast sonohysterography and hysteroscopy for the investigation of women with postmenopausal bleeding and endometrium>5 mm. Ultrasound Obstet Gynecol. 2001;18:157–62.
  • Khare A, Bansal S, Sharma P, Elhence N, et al. Morphological spectrum of Endometrium in patients presenting with Dysfunctional Uterine Bleeding. People's J Sci Res. 2012;5:13–6.
  • Burke TW, Tortolero-Luna G, Malpica A, et al. Enometrial hyperplasia and endometrial cancer. Obstet Gyneloc Clin North Am1996;23:411-56
  • Speroff L, Glass RH, Kase NG. Clinical Gynecology and Infertility.
  • th Edition Baltimore, Lippin cott Williams & Wilkins 1999;574-94.
  • Tuncer R, Uygur R, Kış S. Ankara Zübeyde Hanım Doğumevi 2000 Yılı Endometrial Biopsi Sonuçları: 676 Olgunun Analizi. MN Klinik Bilimler&Doktor 2003;9:97-9
  • Partridge EE, Shingleton HM, Menck HR. The National Cancer Data Base report on endometrial cancer. J Surg Oncol 1996; 61:111-23.
  • Jemal A, Thomas A, Murray T, et al. Cancer statistics, 2002. CA Cancer J Clin 2002; 52:23-47.
  • Paula J. Adams Hillard. Kadın üreme organları benign hastalıkları: Semptom ve bulgular. Novak Jinekoloji (Jonathans-Berek, ed) 2004;351-420.
  • Bokhman Ya, Tkeshelashvili VT, Vishnevsky AS, Volkova AT. Myoma uterus as a marker of oncogynecological pathology in pre and postmenopause. Eur J Gynaecol Oncol 1988;9(5):355-9.
  • Tamay AG, Yıldırım Y, Buğday S, Koltan OS, Güvenal T, Koyuncu FM, Altaş İ, Kandiloğlu AR. Necessity of preoperative endometrial sampling for hysterectomies with benign indications. Cumhuriyet Med J. 2010;32:329-33
  • Çelik Ö, Burak F, Atmaca R, Hasçalık Ş, Kafkaslı A. Uterin fibromyomalı kadınlarda histerektomi öncesi endometrial küretaj gerekli mi? T Klin Jinekol Obst 2001;11:365-8.
  • Stovall TG, Solomon SK, Ling FW. Endometrial sampling prior to hysterectomy. Obstet Gynecol 1989;73:405-9.
  • Tamay AG, Yıldırım Y, Buğday S, Koltan OS, Güvenal T, Koyuncu FM, Altaş İ, Kandiloğlu AR. Necessity of preoperative endometrial sampling for hysterectomies with benign indications. Cumhuriyet Med J. 2010;32:329-3
  • Younis MT, Iram S, Anwar B. Women with asymptomatic cervical polyps may not need to see a gyneacologist or have them removed: an observational retrospective study of 1126 cases. Eur J Obstet Gynecol Reprod Biol 2010;150:190-4.
  • Coeman D, Van Belle Y, Vanderick G, De Muylder X, De Muylder E. Hysteroscopic findings in patients with a cervical polyp. Am J Obstet Gynecol 1993;169(6):1563-5.
  • Vilodre L-CF, Bertat R, Petters R, Reis FM. Cervical polyp as risk factor for hysteroscopically diagnosed endometrial polyps. Gynecol Obstet Invest 1997;44(3):191-5
There are 23 citations in total.

Details

Primary Language Turkish
Journal Section Original Research
Authors

Suna Kucur

Halime Şencan This is me

Kadriye Yüksel This is me

İlay Gözükara This is me

Ali Seven This is me

Nadi Keskin This is me

Ayşenur Değer This is me

Publication Date August 6, 2014
Published in Issue Year 2014 Volume: 45 Issue: 3

Cite

APA Kucur, S., Şencan, H., Yüksel, K., Gözükara, İ., et al. (2014). ENDOMETRİAL ÖRNEKLEME SONUÇLARIMIZ :744 OLGUNUN ANALİZİ (EVALUATION OF ENDOMETRIAL BIOPSY RESULTS IN OUR CLINIC; ANALYSIS OF 744 CASES). Zeynep Kamil Tıp Bülteni, 45(3), 146-150. https://doi.org/10.16948/zktb.68266
AMA Kucur S, Şencan H, Yüksel K, Gözükara İ, Seven A, Keskin N, Değer A. ENDOMETRİAL ÖRNEKLEME SONUÇLARIMIZ :744 OLGUNUN ANALİZİ (EVALUATION OF ENDOMETRIAL BIOPSY RESULTS IN OUR CLINIC; ANALYSIS OF 744 CASES). Zeynep Kamil Tıp Bülteni. August 2014;45(3):146-150. doi:10.16948/zktb.68266
Chicago Kucur, Suna, Halime Şencan, Kadriye Yüksel, İlay Gözükara, Ali Seven, Nadi Keskin, and Ayşenur Değer. “ENDOMETRİAL ÖRNEKLEME SONUÇLARIMIZ :744 OLGUNUN ANALİZİ (EVALUATION OF ENDOMETRIAL BIOPSY RESULTS IN OUR CLINIC; ANALYSIS OF 744 CASES)”. Zeynep Kamil Tıp Bülteni 45, no. 3 (August 2014): 146-50. https://doi.org/10.16948/zktb.68266.
EndNote Kucur S, Şencan H, Yüksel K, Gözükara İ, Seven A, Keskin N, Değer A (August 1, 2014) ENDOMETRİAL ÖRNEKLEME SONUÇLARIMIZ :744 OLGUNUN ANALİZİ (EVALUATION OF ENDOMETRIAL BIOPSY RESULTS IN OUR CLINIC; ANALYSIS OF 744 CASES). Zeynep Kamil Tıp Bülteni 45 3 146–150.
IEEE S. Kucur, H. Şencan, K. Yüksel, İ. Gözükara, A. Seven, N. Keskin, and A. Değer, “ENDOMETRİAL ÖRNEKLEME SONUÇLARIMIZ :744 OLGUNUN ANALİZİ (EVALUATION OF ENDOMETRIAL BIOPSY RESULTS IN OUR CLINIC; ANALYSIS OF 744 CASES)”, Zeynep Kamil Tıp Bülteni, vol. 45, no. 3, pp. 146–150, 2014, doi: 10.16948/zktb.68266.
ISNAD Kucur, Suna et al. “ENDOMETRİAL ÖRNEKLEME SONUÇLARIMIZ :744 OLGUNUN ANALİZİ (EVALUATION OF ENDOMETRIAL BIOPSY RESULTS IN OUR CLINIC; ANALYSIS OF 744 CASES)”. Zeynep Kamil Tıp Bülteni 45/3 (August 2014), 146-150. https://doi.org/10.16948/zktb.68266.
JAMA Kucur S, Şencan H, Yüksel K, Gözükara İ, Seven A, Keskin N, Değer A. ENDOMETRİAL ÖRNEKLEME SONUÇLARIMIZ :744 OLGUNUN ANALİZİ (EVALUATION OF ENDOMETRIAL BIOPSY RESULTS IN OUR CLINIC; ANALYSIS OF 744 CASES). Zeynep Kamil Tıp Bülteni. 2014;45:146–150.
MLA Kucur, Suna et al. “ENDOMETRİAL ÖRNEKLEME SONUÇLARIMIZ :744 OLGUNUN ANALİZİ (EVALUATION OF ENDOMETRIAL BIOPSY RESULTS IN OUR CLINIC; ANALYSIS OF 744 CASES)”. Zeynep Kamil Tıp Bülteni, vol. 45, no. 3, 2014, pp. 146-50, doi:10.16948/zktb.68266.
Vancouver Kucur S, Şencan H, Yüksel K, Gözükara İ, Seven A, Keskin N, Değer A. ENDOMETRİAL ÖRNEKLEME SONUÇLARIMIZ :744 OLGUNUN ANALİZİ (EVALUATION OF ENDOMETRIAL BIOPSY RESULTS IN OUR CLINIC; ANALYSIS OF 744 CASES). Zeynep Kamil Tıp Bülteni. 2014;45(3):146-50.