TY  - JOUR
T1  - DIAGNOSTIC ACCURACY OF ENDOMETRIAL SAMPLING AND COLPOSCOPY GUIDED CERVICAL BIOPSY IN WOMEN UNDERGOING HYSTERECTOMY: A SINGLE-CENTER EXPERIENCE
TT  - HİSTEREKTOMİ YAPILAN KADINLARDA ENDOMETRİYAL BİYOPSİ VE KOLPOSKOPİ DESTEKLİ SERVİKAL BİYOPSİNİN TANI DOĞRULUĞU: TEK MERKEZ DENEYİMİ
AU  - Paltacı, Şeyma İlayda
AU  - Garibova, Sudaba
AU  - Dur, Rıza
AU  - Kanat Pektaş, Mine
PY  - 2025
DA  - April
Y2  - 2024
DO  - 10.18229/kocatepetip.1522212
JF  - Kocatepe Tıp Dergisi
JO  - KTD
PB  - Afyonkarahisar Sağlık Bilimleri Üniversitesi
WT  - DergiPark
SN  - 3061-9904
SP  - 122
EP  - 127
VL  - 26
IS  - 2
LA  - en
AB  - OBJECTIVE: This study aims to compare the results of the preoperatively obtained endometrial and cervical biopsies to the histopathological characteristics of the related hysterectomy specimens and, thus in vestigate their consistency.MATERIAL AND METHODS: This is a retrospective review of 390 hysterectomies performed for both benign and malignant indications as verified by cervical and endometrial biopsies at the study center between 1 January 2017 and 1 January 2023.RESULTS: Seventy-four hysterectomies (19.0%) had preoperative cervical biopsy results, while 316 had preoperative endometrial biopsy results (81.0%). Only 55.6% agreement (κ=0.011) and no significant correlation between endometrial biopsy results and related hysterectomy specimens for benign lesions (χ2=4.500, p=0.343). There were 85.1% agreement (κ=0.462) and a significant correlation between cervical biopsy results and related hysterectomy specimens for pre-invasive and malignant lesions (χ2=106.349, p=0.001). Endometrial biopsy results presenting polyps had the lowest diagnostic accuracy of 59.3% and endometrial cancer was identified in 52.2% of the patients whose biopsy results revealed complex hyperplasia with atypia.CONCLUSIONS: The relatively lower diagnostic accuracy of endometrial biopsy suggests that it is not required for definitive diagnosis in patients who are scheduled to have a hysterectomy for benign indications. The relatively higher rate of complex atypical hyperplasia and endometrial cancer co-existence also indicates that hysteroscopy can be performed to visualize the uterine cavity before a hysterectomy is planned for patients with biopsy-based hyperplasia. The relatively higher concordance rate between cervical biopsy results and related hysterectomy specimens supports the significance and validity of colposcopy in the management of pre-invasive and malignant lesions of the cervix.
KW  - Biopsy
KW  - Diagnosis
KW  - Hysterectomy
KW  - Pathology
N2  - AMAÇ: Bu çalışmanın amacı, ameliyat öncesi alınan endometriyal ve servikal biyopsi sonuçlarını, ilgili histerektomi örneklerinin histopatolojik özellikleriyle karşılaştırmak ve böylece tutarlılıklarını araştırmaktır.GEREÇ VE YÖNTEM: Bu çalışma, 1 Ocak 2017 ile 1 Ocak 2023 tarihleri arasında çalışma merkezinde servikal ve endometriyal biyopsilerle doğrulanan, benign ve malign endikasyonlarla gerçekleştirilen 390 histerektominin retrospektif bir incelemesidir.BULGULAR: Yetmiş dört histerektominin (%19,0) preoperatif servikal biyopsi sonucu, 316 histerektominin ise preoperatif endometriyal biyopsi sonucu (%81,0) vardı. Benign lezyonlar için endometriyal biyopsi sonuçları ile ilgili histerektomi örnekleri arasında yalnızca %55,6 uyum (κ=0,011) vardı ve anlamlı korelasyon yoktu (χ2=4,500, p=0,343). Preinvaziv ve malign lezyonlar için servikal biyopsi sonuçları ile ilgili histerektomi örnekleri arasında %85,1 uyum (κ=0,462) ve anlamlı korelasyon vardı (χ2=106,349, p=0,001). Polipleri ortaya koyan endometriyal biyopsi sonuçları 59,3 ile en düşük tanısal doğruluğa sahipti. Biyopsi sonuçlarında atipili kompleks hiperplazi saptanan hastaların %52,2'sinde endometriyal kanser tespit edildi.SONUÇ: Endometriyal biyopsinin göreceli olarak daha düşük tanısal doğruluğu, benign endikasyonlarla histerektomi planlanan hastalarda kesin tanı için gerekli olmadığını düşündürmektedir. Kompleks atipik hiperplazi ve endometriyal kanserin birlikte görülme oranının göreceli olarak daha yüksek olması, biyopsi bazlı hiperplazisi olan hastalarda histerektomi planlanmadan önce rahim boşluğunun görüntülenmesi için histeroskopi yapılabileceğini de göstermektedir. Servikal biyopsi sonuçları ile ilgili histerektomi örnekleri arasındaki uyum oranının nispeten yüksek olması serviksin pre-invaziv ve malign lezyonlarının tedavisinde kolposkopinin önemini ve geçerliliğini desteklemektedir.
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UR  - https://doi.org/10.18229/kocatepetip.1522212
L1  - https://dergipark.org.tr/tr/download/article-file/4097038
ER  -