Abstract

Dr. Nada Chettian Kandy*, Dr. Reba Philipose T., Dr. Manjunath Kamath Ammembal, Dr. Muktha R. Pai., Dr. Najah Abdul Rehman and Dr. Keerthi R. Pillai

ABSTRACT

Background: Endometrial sampling for histopathology is important in the assessment of abnormal uterine bleeding. To date, hysteroscopic biopsy & D&C is considered as the standard for endometrial sampling without its place in gynecology being challenged. Several office endometrial samplers like pipelle are available which are cost effective, which have better patient compliance and which gives comparable histological findings from tissue obtained by D&C or hysterectomy. This study seeks to place D&C in its historical perspective and to chart the development of pipelle for sampling the endometrial lining of the uterus. Objectives: 1)To compare the diagnostic ability of pipelle-endometrial biopsy comparing with hysterectomy and/or hysteroscopy specimens in abnormal uterine bleeding. 2)To assess sensitivity and specificity of pipelle in identifying focal as well as global lesions of endometrial pathology. Results: Histopathology report was available in all the 125 cases sampled by pipelle device. These reports were compared with gold standard hysterectomy specimen. Five samples were inadequate for openion. There was 22.4% of hyperplasia, 8.8% of malignancy of the endometrium and 64.8% of benign conditions of the endometrium other than hyperplasia in our study group, which were all sampled by pipelle device. In the present study specificity rate of pipelle endometrial biopsy for the detection of endometrial hyperplasia and endometrial carcinoma was 100%. Sensitivity rate of pipelle endometrial biopsy for endometrial hyperplasia was 96.4% and endometrial carcinoma was 91.6%. 99.07% was the accuracy rate for endometrial hyperplasia followed by 99.16% for endometrial carcinoma. Negative predictive value was 100% for both endometrial hyperplasia as well as carcinoma. Positive predictive value was 96.4% and 91.6% for endometrial hyperplasia and carcinoma respectively