Published August 30, 2023 | Version https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue8,Article274.pdf

To Compare Pipelle Biopsy Report with Hysterectomy/ D&C Histopathology for Endometrial Pathologies

  • 1. MS, Senior Resident, Department of Obstetrics & Gynecology, G.R. Medical College & J.A. Group of Hospitals, Gwalior, MP
  • 2. MS, Consultant Gynecologist, District Hospital, Jashpur, Chattisgarh
  • 3. MD, Senior Resident, Department of Medicine, G.R. Medical College & J.A. Group of Hospitals, Gwalior, MP

Description

Introduction: Endometrial pathologies refer to abnormalities affecting the uterine lining, and various sampling techniques are used to diagnose these conditions. Pipelle biopsy is a minimally invasive procedure, while hysterectomy and dilatation and curettage (D&C) are more invasive approaches. Comparing the findings of pipelle biopsy with histopathology from hysterectomy or D&C can provide valuable information for managing endometrial pathologies. Objective: The objective of this study was to compare pipelle biopsy reports with hysterectomy/D&C histopathology reports and determine the sensitivity and specificity of pipelle curette for endometrial pathologies. Material and Methods: The study was a prospective interventional study conducted at the Department of Obstetrics and Gynecology, Kamla Raja Hospital, Gwalior. The sample size included 100 women above 30 years or women presenting with postmenopausal bleeding. Pipelle biopsy was performed, and the samples were sent for histopathology. Statistical analysis was done using SPSS software. Results: The study compared the findings of pipelle biopsy with hysterectomy/D&C and found that the frequency of secretory endometrium was similar in both procedures. However, approximately 15% of pipelle biopsy samples were inadequate. False positive findings with pipelle biopsy included squamous metaplasia, squamous cell carcinoma (SCC), and non-keratinizing squamous cell carcinoma (NKSCC). False negative findings included adenocarcinoma, senile endometrium, and endometritis. Conclusion: The study highlights the limitations and potential pitfalls of pipelle biopsy compared to hysterectomy/D&C. While pipelle biopsy can provide valuable information for certain conditions, it may miss or misdiagnose others. Clinicians should be aware of the potential for false negative and false positive results when interpreting pipelle biopsy findings and may need to use additional diagnostic tools or procedures for a more comprehensive evaluation of uterine pathology.

 

 

Abstract (English)

Introduction: Endometrial pathologies refer to abnormalities affecting the uterine lining, and various sampling techniques are used to diagnose these conditions. Pipelle biopsy is a minimally invasive procedure, while hysterectomy and dilatation and curettage (D&C) are more invasive approaches. Comparing the findings of pipelle biopsy with histopathology from hysterectomy or D&C can provide valuable information for managing endometrial pathologies. Objective: The objective of this study was to compare pipelle biopsy reports with hysterectomy/D&C histopathology reports and determine the sensitivity and specificity of pipelle curette for endometrial pathologies. Material and Methods: The study was a prospective interventional study conducted at the Department of Obstetrics and Gynecology, Kamla Raja Hospital, Gwalior. The sample size included 100 women above 30 years or women presenting with postmenopausal bleeding. Pipelle biopsy was performed, and the samples were sent for histopathology. Statistical analysis was done using SPSS software. Results: The study compared the findings of pipelle biopsy with hysterectomy/D&C and found that the frequency of secretory endometrium was similar in both procedures. However, approximately 15% of pipelle biopsy samples were inadequate. False positive findings with pipelle biopsy included squamous metaplasia, squamous cell carcinoma (SCC), and non-keratinizing squamous cell carcinoma (NKSCC). False negative findings included adenocarcinoma, senile endometrium, and endometritis. Conclusion: The study highlights the limitations and potential pitfalls of pipelle biopsy compared to hysterectomy/D&C. While pipelle biopsy can provide valuable information for certain conditions, it may miss or misdiagnose others. Clinicians should be aware of the potential for false negative and false positive results when interpreting pipelle biopsy findings and may need to use additional diagnostic tools or procedures for a more comprehensive evaluation of uterine pathology.

 

 

Files

IJPCR,Vol15,Issue8,Article274.pdf

Files (362.3 kB)

Name Size Download all
md5:1c75bd668efe58062dd99044e2a8a336
362.3 kB Preview Download

Additional details

Dates

Accepted
2023-07-30

References

  • 1. Stovall T.G.: "Solomon SK. Ling FW. Endometrial sampling prior to hysterectomy". Obstet. Gynecol., 1989, 73, 405. 2. Oehler M.K.: "Rees MC. Menorrhagia: an update". Acta Obtet. Gynecol. Scand., 2003, 82, 405. 3. Kazandi M., Okmen F., Ergenoglu A.M., Yeniel A.O., Zeybek B., Zekioglu O.: £Comparison of the success of histopathological diagnosis with dilatationcurettage and Pipelle endometrial sampling. J.Obstet. Gynaecol., 2012, 32, 790. 4. Epstein E., Ramirez A., Skoog L., Valentin L.: "Dilatation and curettage fails to detect most focal lesions in the uterine cavity in women with postmenopausal bleeding". Acta Obstet. Gynecol. Scand., 2001, 80, 1131. 5. Hwang WY, Suh DH, Kim K, No JH, Kim YB. Aspiration biopsy versus dilatation and curettage for endometrial hyperplasia prior to hysterectomy. Diagnostic pathology. 2021 Dec; 16:1-6. 6. Ilavarasi CR, Jyothi GS, Alva NK. Study of the efficacy of pipelle biopsy technique to diagnose endometrial diseases in abnormal uterine bleeding. Journal of Mid-Life Health. 2019 Apr; 10(2):75. 7. Sanam M, Majid MM. Comparison the diagnostic value of dilatation and curettage versus endometrial biopsy by pipelle-a clinical trial. Asian Pacific Journal of Cancer Prevention. 2015; 16(12):4971-5. 8. Abdelazim IA, Aboelezz A, AbdulKareem AF. Pipelle endometrial sampling versus conventional dilatation & curettage in patients with abnormal uterine bleeding. Journal of the Turkish German Gynecological Association. 2013; 14(1):1.