Results Of Our Endometrial Samplings: Analysis Of 655 Cases

Öz

Aim: To evaluate the relationship between endometrial sampling indications and histopathological results at a local centerMaterial and Methods: 655 patients with abnormal bleeding applied to Agrı State Hospital and had endometrial sampling between January 2014-March 2016 were included in this study. Ethics committee approval and patient records were obtained from hospital automation system.The relationship between endometrial biopsy indications and histopathological results were examined. SPSS 22 software was used for statistical analysis.Results: The mean age of patients was 47.3 ± 6.6. The indications were menorrhagia / menometroraghia 82.6% , postmenopausal bleeding %14.2 , myoma uteri %2 and cervical polyp %1.2 . The most common histopathological result was endometrial polpys %53,5 the others respectively; secretory/proliferative endometrium %26.1 , insufficient material %8.7 , atrophy %5.64 , endometrial hyperplasia %3.2 , endometritis %1.9 , endometrial cancer %0.3 , myom uteri %0.3 and other %0,15 .Conclusion: Endometrial polyp was almost most common result in all biopsy indications. Sonohysterography and diagnostic hysteroscopy can be used in addition to endometrial sampling. An endometrial sampling has to be performed if endometrial cancer risk factors exist in patients with leiomyoma planning surgery. Due to the common togethership between endometrial polyps and cervical polyps, endometrial evaluation is needed in patients with cervical polyp.

Anahtar Kelimeler

• Abnormal uterine bleeding,endometrial biopsy,menometroraghia of menorrhagia,polyp

Endometrial Örnekleme Sonuçlarımız: 655 Olgunun Analizi

Öz

Amaç: Lokal bir merkezdeki endometrial örneklemelerin histopatolojik sonuçlarının değerlendirilmesiGereç ve Yöntemler: Ağrı Devlet Hastanesi’nde Ocak 2014-Mart 2016 tarihleri arasında anormal uterin kanama nedeniyle endometrial biyopsi yapılmış 655 hastanın sonuçları retrospektif olarak incelenmiştir. Etik kurulu onayı alınmış ve hasta kayıtları hastane otomasyon sisteminden elde edilmiştir. Endometrial biyopsi endikasyonları ile histopatolojik sonuçları arasındaki ilişki araştırılmıştır. İstatistiksel analiz için SPSS 22 programı kullanılmıştır.Bulgular: Hastaların yaş ortalaması 47,3±6,6 idi. Endometrial biyopsi endikasyonları sırasıyla menoraji/metroraji %82,6 , postmenopozal kanama %14,2 , myom %2 ve servikal polipti %1.2 . Histopatolojik sonuçlar ise en sık endometrial polip %53.5 sonrasında sırasıyla sekretuar/proliferatif endometrium %26.1 , yetersiz materyal %8.7 , atrofi %5.64 , endometrial hiperplazi %3.2 , endometrit %1.9 , endometrial kanser %0.3 , myom %0.3 ve diğer %0.15 olarak raporlanmıştır.Sonuç: Tüm örnekleme endikasyonlarında hemen neredeyse en sık patoloji endometrial polip gelmiştir. Endometrial biyopsi yöntemlerine kombine olarak histerosonografi ve diagnostik histeroskopi de kullanılmaya başlanması düşünülebilir. Myoma uteri sebebi ile histerektomi veya myomektomi planlanan hastalarda eğer endometrium kanseri risk faktörleri varsa endometrial biyopsi açısından değerlendirilmelidir. Servikal polipektomi yapılan hastalarda endometrial polip birlikteliği olabileceği düşünülerek endometrial örnekleme de yapılmalıdır.

Anahtar Kelimeler

• Anormal uterin kanama,endometrial biyopsi,menometroraji,menoraji,polip

Kaynakça

1. Grimes DA. Diagnostic dilation and curettage: a reappraisal. AJOG. 1982;142:1-6.
2. Bettocchi S, Ceci O, Vicino M, Marello F, Impedovo L, Selvaggi L. Diagnostic inadequacy of dilatation and curettage. Fert. Ster. 2001;75:803-5.
3. Cote I, Jacobs P, Cumming DC. Use of health services associated with increased menstrual loss in the United States. AJOG. 2003;188:343-8.
4. Santer M, Warner P, Wyke S. A Scottish postal survey suggested that the prevailing clinical preoccupation with heavy periods does not reflect the epidemiology of reported symptoms and problems. J. Clin. Epid. 2005;58:1206-10.
5. Shapley M, Jordan K, Croft PR. An epidemiological survey of symptoms of menstrual loss in the community. The British journal of general practice: BRJ Gen. Pract. 2004;54:359-63.
6. Haynes PJ, Hodgson H, Anderson AB, Turnbull AC. Measurement of menstrual blood loss in patients complaining of menorrhagia. BJOG. 1977;84:763-8.
7. Munro MG, Critchley HO, Broder MS, Fraser IS, Disorders FWGoM. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int. J. Gynecol Obstet. 2011;11:3-13.
8. Practice bulletin no. 128: diagnosis of abnormal uterine bleeding in reproductive-aged women. Obstet. Gynecol. Clin. North Am. 2012;120:197-206.

9. Kucur SK, Şencan H, Yüksel KB, Gözükara İ, Seven A, Keskin N, et al. Endometrial Örnekleme Sonuçlarimiz: 744 Olgunun Analizi (Evaluation Of Endometrial Biopsy Results In Our Clinic; Analysis Of 744 Cases). Zeynep Kamil Tıp Bülteni. 2014;45:146-50.
10. Jetley S, Rana S, Jairajpuri ZS. Morphological spectrum of endometrial pathology in middle-aged women with atypical uterine bleeding: A study of 219 cases. J. Mid-life Health. 2013;4:216-20.
11. Dreisler E, Stampe Sorensen S, Ibsen PH, Lose G. Prevalence of endometrial polyps and abnormal uterine bleeding in a Danish population aged 20-74 years. Ultrasound Obstet Gynecol. 2009;33:102-8.
12. Bakour SH, Khan KS, Gupta JK. The risk of premalignant and malignant pathology in endometrial polyps. Acta Obstet Gynecol Scand. 2000;79:317-20.
13. Goldstein SR, Zeltser I, Horan CK, Snyder JR, Schwartz LB. Ultrasonography-based triage for perimenopausal patients with abnormal uterine bleeding. AJOG. 1997;177:102-8.
14. Aker SŞ, Yüce T, Acar D, Atabekoğlu CS. Anormal Uterin Kanaması olan Kadınlarda Endometrial Örnekleme Sonuçları: 765 Vakanın Retrospektif Analizi. Cukurova Medical Journal. 2015;40:306-10.
15. Kurman RJ, Kaminski PF, Norris HJ. The behavior of endometrial hyperplasia. A long-term study of “untreated” hyperplasia in 170 patients. Cancer. 1985;56:403-12.
16. Kimura T, Kamiura S, Yamamoto T, Seino-Noda H, Ohira H, Saji F. Abnormal uterine bleeding and prognosis of endometrial cancer. Int. J. Gynecol Obstet. 2004;85:145-50.
17. Seebacher V, Schmid M, Polterauer S, Hefler-Frischmuth K, Leipold H, Concin N, et al. The presence of postmenopausal bleeding as prognostic parameter in patients with endometrial cancer: a retrospective multi- center study. BMC cancer. 2009;9:460.
18. Bokhman Y, Tkeshelashvili VT, Vishnevsky AS, Volkova AT. Myoma uterus as a marker of oncogynecological pathology in pre- and post- menopause. Eur J. Gynaecol Oncol. 1988;9:355-9.
19. Tamay AG, Yıldırım Y, Buğday S, Koltan SO, Güvenal T, Koyuncu FM, et al. Necessity of preoperative endometrial sampling for hysterectomies with benign indications. Cumhuriyet Medical Journal. 2010;32:329-33.
20. Younis MTS, Iram S, Anwar B, Ewies AAA. Women with asymptomatic cervical polyps may not need to see a gynaecologist or have them removed: an observational retrospective study of 1126 cases. Eur. J. Obstet Gynecol Repr. Biol. 2010;150:190-4.
21. Coeman D, Van Belle Y, Vanderick G, De Muylder X, De Muylder E, Campo R. Hysteroscopic findings in patients with a cervical polyp. AJOG. 1993;169:1563-5.