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Category: Volume 08 Issue 01 January 2020
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Title: Study of Endometrial Aspiration Cytology and Its Correlation with HPE in Cases of Dub

Authors: Dr PS. Shangreihow, Dr Nameirakpam Somananda, Dr Soreingam Kasar, Dr Th. Digel Singh, Dr Ng. Indrakumar Singh

 DOI: https://dx.doi.org/10.18535/jmscr/v8i1.146

Abstract

Background: Endometrial aspiration cytology has long been undermined, but has now emerged as a powerful yet cost effective tool for diagnosing DUB in resource limited settings.                   

Purpose: The current study compares the accuracy of EAC with HPE as gold standard in diagnosis of   DUB in women. It also determines the various morphologic patterns of endometrium in DUB.

Methods: 70 women diagnosed as DUB were subjected to endometrial aspiration with 4mm Karman’s cannula and MR syringe prior to D&C and HPE sampling. Data was compiled & analysed with SPSS 18 package. Patients were analysed based on socioeconomic, clinical parameters; cytological diagnosis was compared against HPE diagnosis based on sensitivity, specificity, diagnostic accuracy. 

Result: EAC showed a sampling adequacy of 90%. The commonest lesion detected was proliferative endometrium followed by secretory endometrium and hyperplasia without atypia. Sensitivity for detecting proliferative endometrium was 100%, specificity 89.2% and accuracy of 89.2% against gold standard HPE. Sensitivity for detecting secretory endometrium was 100%, specificity 92.8% and accuracy was 88.5%. Sensitivity and specificity of detecting hyperplasia by aspiration cytology was 64% and 100% respectively. Accuracy was 90%. Sensitivity of aspiration cytology in detecting adenocarcinoma was 50% and specificity was 100% in this study with Accuracy of detection being 97% in this study.

Conclusion: Endometrial aspiration is an effective, useful and a minimally invasive procedure comparing with gold standard HPE.

References

  1. Patil P, Venigalla S, Kumar MLH, Raju K. A Comparative Evaluation of the Three Different Methods of Endometrial Sampling in the Diagnosis of Perimenopausal Bleeding. J clin Gynae & obstet 2014:3(4):133-7.
  2. Liza SR, Rameshkumar K, Lilian. Value of endometrial aspiration cytology in assessing endometrial status in symptomatic peri and postmenopausal women. Indian J of Cancer 1999;36:57-61.
  3. Devi LS, Singh MR, Singh LR, Debnath The histological and histochemical study of endometrium in dysfunctional uterine bleeding. J Med Soc 2012;26:167-70.
  4. Rao SS, SavithriC, Lalithakumari B, Venkataratnam Endometrial aspiration cytology in dysfunctional uterine bleeding. J of Obst & Gyn of India 1986;36(3):334-7.
  5. Tripathy SN, Mahan Place of aspiration cytology in dysfunction uterine bleeding. J Indian Med Assoc 1990 Sep;88(9):247-8.
  6. Hemalatha AN, Pai MR, Raghuveer CV. Endometrial aspiration cytology in dysfunctional uterine bleeding. Indian J 2006;49(2):214-7.
  7. Morse AR, Ellice RM, Anderson MC. Aspiration cytology versus histology in the assessment of the endometrium of women attending a menopause clinic. Br J of Obstet & Gynaecol 1981;88:421-5.
  8. Noyes RW, Hertig AT, Rock J. Dating the endometrial biopsy. Fertil Steril 1950;1:3-25.
  9. Kaur NT, Chahal JS, Bandlish U, Kaul R, Mardi K, Kaur H. Correlation between cytological and histopathological examination of the endometrium in abnormal uterine J cytol 2014;31(3):144- 9.
  10. Handa U, Bansal C, Aggarwal P, Huria A, Mohan H. Diagnostic Utility of Endometrial Aspiration Cytology in Women with Abnormal Uterine Bleeding.J Midlife Health 2018 Jul-Sep;9(3):140–4.
  11. Baxi SN, Panchal NS. Histopathology-like categories based on endometrial imprint cytology in dysfunctional uterine bleeding. J Cytol 2015 Apr-Jun;32(2):96–101.
  12. Byrne AJ. Endocyte endometrial smears in the cytodiagnosis of endometrial carcinoma. ActaCytol 1990;34:373-81.
  13. Garcia F, Barker B, Davis J. Shelton T, Harrigill K, Schalk N et al. Thin- Layer cytology and histopathology in the evaluation of abnormal uterine bleeding. J Reprod Med 2003;48(11):882-88.
  14. Robert R. Endometrial aspiration smears in diagnosis of malignancy of uterine corpus. Am J Obstet Gynecol 1963 Dec 1;87(1):921-5.
  15. Anderson MG, Eaton CJ, Galinkim LJ, Newton CW, Haines JP. Miller NF. The cytologic diagnosis of endometrial adenocarcinoma. Am J Obstet Gynecol 1976;125:376-83.
  16. Sagar S, Prakash P, Goyal A histo-cytologic study of endometrium by aspiration technique. J of Obst & Gyn of India 1980;26(1):626-9.
  17. Chakravarthy A. Diagnostic efficacy of endometrial cytology. Obstet Gynecol 1986;134:147-51.
  18. Polson DW, Morse A, Beard RW. An alternative to the diagnostic dilatation and curettage- endometrial cytology. Br Med J 1984 Mar;288(6422):981-3.

Corresponding Author

Dr PS. Shangreihow

Post Graduate Trainee, Dept. of Obs. & Gynae, JNIMS, Imphal Manipur