جستجوی مقالات مرتبط با کلیدواژه « دیلاتاسیون و کورتاژ » در نشریات گروه « پزشکی »

Dilatation and curettage (D&C) has been the method of choice for obtaining endometrial sample but there is a challenge about the D&C’s accuracy and reliability compared to other diagnostic methods. The aim of this study was to investigate the concordance between endometrial histopathological diagnosis from D&C and hysterectomy samples.

In this retrospective study, histopathological results of D&C samples of 136 women who suffered from abnormal uterine bleeding between 2015 to 2018 and underwent hysterectomy were investigated and compared with pathologic reports of hysterectomy.

The mean ± standard deviation (SD) of age of patients was 52.6 ± 11.3 years in the range of 33-80 years. According to the findings of D&C in comparison with the standard method of hysterectomy, the specificity and negative predictive values were substantial in premalignant samples. Beside, D&C findings revealed the specificity and the positive predictive values as likely as 100% for diagnosing malignant samples. In the other hand, D&C revealed significant the sensitivity and the positive predictive values for diagnosing normal and benign samples. In the premalignant pathologies that were diagnosed with D&C, the risk of an undetected malignancy in the atypical hyperplasia was 16.7%.

No malignant pathology was encountered in patient with a diagnosis of normal tissue or a benign pathology on the D&C samples. In addition, both the specificity and the positive predictive values following D&C was 100% in diagnosing endometrial malignancy.

Abnormal uterine bleeding (AUB) is one common problem in perimenopausal women that should be carefully evaluated. Evaluation in terms of endometrial cancer and premalignant lesions is very important. This study was performed with aim to investigate the relationship between the findings of transvaginal sonography and pathology of endometrial curettage in women with abnormal uterine bleeding at perimenopause.

This descriptive-analytical study was conducted on 184 perimenopausal women aged 40-50 years with AUB in 2017. The patients underwent transvaginal sonography. D&C was done one week after sonography report if endometrial thickness was > 4 mm. Data collection tool was a self-made questionnaire. Demographic findings of the patients and the results of transvaginal sonography, and hystopathologic assessment of endometrium were recorded. Data were analyzed by SPSS software (version 20), and ANOVA and Kruskal-Wallis tests. P

The most common findings of transvaginal sonography was 37% normal, 30% increased thickness, and 20% endometrial polyp. About 47.3% of histopathologic findings were proliferative, then secretory and endometrial polyps and less than 5% of cases was malignant. There was only one case of adenocarcinoma with 6 mm endometrial thickness. In the estimation of the consistency of sonographic findings with D&C findings, there was significant agreement in abnormal and normal groups (P=0.004).

Major and malignant pathologies namely carcinoma and metaplasia can also be detected in cut-off levels less than 8 mm, even around 5 mm. Therefore, use of D&C along with TVUS in low cut-off levels less than 8 mm seems to be necessary.