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IN WOMEN WHO APPLY FOR POSTMENOPAUSAL BLEEDING, IS ENDOMETRIAL CYTOLOGY SUFFICIENT TO DIAGNOSE ?

Year 2018, Volume: 49 Issue: 2, 188 - 191, 27.06.2018
https://doi.org/10.16948/zktipb.416733

Abstract

IN WOMEN WHO APPLY
FOR POSTMENOPAUSAL BLEEDING, IS ENDOMETRIAL CYTOLOGY SUFFICIENT TO DIAGNOSE ?

SUMMARY

 

OBJECTIVE:
Endometrial cancer is the most common invasive neoplasm of the female genital
tract and its incidence has increased in recent years. There is no screening
test for early detection of endometrium carcinoma and its precursors. To
evaluate the safety and comparability of cytologic endometrial samples obtained
with Uterobrush for the diagnosis of endometrial pathologies in women with
postmenopausal bleeding in our study with endometrial biopsy.

METHODS: A total
of 100 patients who were admitted to the gynecological policlinics of our
hospital with postmenopausal bleeding between August 1, 2015 and April 1, 2017
were included in the study. Endoscopic and endometrial sampling were performed
after local anesthesia, cytologic sampling, lithotomy position, and all cases
after local anesthesia. Cytological sampling of endometrium was done by
Uterobrush method. The brush was then taken to the solution for a liquid-based
cytological examination. Endocervical and endometrial curettage was performed
after dilatation.

RESULTS: Our
study also evaluated the feasibility and reliability of endometrial cytology
using the Uterobrush method. Postmenopausal bleeding was observed in 63% (31),
thickening in endometrium (%) and intrauterine fluid in% (6) when 100 patients
were evaluated in terms of USG findings and indications before the procedure.
Brush cytology showed no (94) malignant cells, (3) atrophic cells, (2) ascus
cells and% (1) HGSIL cells in the brush cytology. When brush cytology and probe
curettage (pc) histopathological results were compared, there were no malignant
cells in brush cytology in 2 patients who had PC end result of endometrial
adenocarcinoma. Brush cytology was evaluated as an inactive endometrium of pc
from 2 patients from ascus. The cytology, which is the predominant endometrium,
was also seen as an inactive endometrium in PC.













CONCLUSION:
Uterobrush is a technique used to obtain endometrial cytological specimens. Histological
examination is still used as the gold standard for investigating endometrial
pathology. In our study, endometrial cytological evaluation of Uterobrush
method using endocervical brush was found to be inadequate to diagnose
endometrial pathologies and it was found to be transmitted to cervical cells
during sampling. In the diagnosis of postmenopausal bleeding, probe curettage
uterobrush is the preferred gold standard method.

References

  • 1.Maksem J, Sager F and Bender R: Endometrial collection and interpretation using the Tao Brush and the CytoRich Fixative System: a feasibility study. Diagn Cytopathol 17: 339-346, 1997.
  • 2. Jordan MJ, Bader GM and Nemazie AS: Comparative accuracy of preoperative cytologic and histologic diagnosis in endometrial lesions. Obstet Gynecol 7: 646-653, 1956.
  • 3. Johnson JE and Storm by NG: Cytological brush technique in malignant disease of the endometrium. Acta Obstet Gynecol Scand 47: 38-51, 1968.
  • 4.Vuopala S, Klemi PJ, Maenpaa J, Salmi T and Makarainen L: Endobrush sampling for endometrial cancer. Acta Obstet Gynecol Scand 68: 345-350, 1989.
  • 5.Sato S, Yaegashi N, Shikano K, Hayakawa S and Yajima A:Endometrial cytodiagnosis with the Uterobrush and Endocyte. Acta Cytol 40(5): 907-910, 1996.
  • 6. Tao LC. Direct intrauterine sampling: the IUMC Endometrial Sampler. Diagn Cytopathol. 1997;17(2):153–159.
  • 7. Kipp BR, Medeiros F, Campion MB, Distad TJ, Peterson LM, Keeney GL, Halling KC, Clayton AC. Direct uterine sampling with the Tao brush samplerusing a liquid-based preparation method for the detection of endometrial cancer and atypical hyperplasia: a feasibility study. Cancer. 2008;114(4):228–235.
  • 8.Papaefthimiou M, Symiakaki H, Mentzelopoulou P, Tsiveleka A,Kyroudes A, Voulgaris Z, Tzonou A and Karakitsos P: Study on the morphology and reproducibility of the diagnosis ofendometrial lesions utilizing liquid based cytology. Cancer105:56-64, 2005.
  • 9.Koss LG, Schreiber K, Oberlander SG, Moussouris HF andLesser M: Detection of endometrial carcinoma and hyperplasia in asymptomatic women. Obstet Gynecol 64: 1-11, 1984.
  • 10. Tao L-C: Cytomorphologic appearances of normal endometrial cells during different phases of the menstrual cycle: A cytologic approach to endometrial dating. Diagn Cytopathol 13: 95-102,1995.
  • 11.Dijkhuizen FP, Brolmann HA, Potters AE, Bongers MY and Heinz AP: The accuracy of transvaginal ultrasonography in the diagnosis of endometrial abnormalities. Obstet Gynecol 87: 345-349, 1996.
  • 12. Yang GCH, Wan LS. Endometrial biopsy using the Tao Brush (R) method—a study of 50 women in a general gynecologic practice. J Reprod Med. 2000;45(2):109–114.
  • 13. Del Priore G, Williams R, Harbatkin CB, Wan LS, Mittal K, Yang GC. Endometrial brush biopsy for the diagnosis of endometrial cancer. J Reprod Med. 2001;46(5):439–443.
  • 14. Wu HH, Harshbarger KE, Berner HW, Elsheikh TM. Endometrial brush biopsy (Tao brush). Histologic diagnosis of 200 cases with complementary cytology: an accurate sampling technique for the detection of endometrial abnormalities. Am J Clin Pathol. 2000;114(3):412–418.
  • 15. Williams AR, Brechin S, Porter AJ, Warner P, Critchley HO. Factor saffecting adequacy of Pipelle and Tao Brush endometrial sampling. BJOG. 2008;115(8):1028–1036.

POSTMENOPOZAL KANAMA İLE BAŞVURAN KADINLARDA ENDOMETRİAL SİTOLOJİ TANI KOYMADA YETERLİ MİDİR?

Year 2018, Volume: 49 Issue: 2, 188 - 191, 27.06.2018
https://doi.org/10.16948/zktipb.416733

Abstract

POSTMENOPOZAL
KANAMA İLE BAŞVURAN KADINLARDA ENDOMETRİAL SİTOLOJİ TANI KOYMADA YETERLİ MİDİR?

 

ÖZET

 

AMAÇ: Endometrial
kanser kadın genital sisteminin en yaygın invaziv neoplazmı olup insidansı son
yıllarda artmaktadır . Endometrium karsinomasının ve öncüllerinin erken tespiti
için tarama testi yoktur.  Çalışmamızda postmenopozal
kanaması olan kadınlarda endometrial patolojilerin tanısi için Uterobrush kullanılarak
alınan sitolojik endometriyal örneklerin endometrial biopsi ile
karşılaştırılması ve güvenilirliğini değerlendirmektir.

YÖNTEM:Çalışmaya
1 ağustos 2015 ile 1 nisan 2017 tarihleri arasında hastanemizin kadın doğum
polkliniklerine postmenopozal  kanama ile
başvuran 100 hasta dahil edildi. Tüm hastalara lokal anestezi altında, litotomi
pozisyonunda  önce sitolojik örnekleme
ardından endoservikal ve endometrial örnekleme yapıldı. Endometriyumun sitolojik
örneklemesi  Uterobrush yöntemi  ile yapılmıştır. Fırça daha sonra sıvı bazlı
bir sitolojik inceleme için  solüsyona 
alınmıştır. Ardından dilatasyon sonrası endoservikal ve endometrial küretaj
yapılmıştır.

 

BULGULAR:Çalışmamız
da Uterobrush yöntemi kullanılarak endometrial sitolojinin fizibilite ve
güvenilirliği değerlendirilmiştir. 100 hastanın işlem öncesi usg bulguları ve
endikasyonları açısından değerlendirildiğinde 
%(63) postmenopozal kanama,  %(31)
endometriumda kalınlaşma,  %(6) intrauterin
sıvı izlenmiştir. Fırça sitolojisinde %(94)malignite hücresi izlenmemiş,  %(3) atrofik hücreler,   %(2) ascus hücreleri, %(1) hgsıl
hücreleri  izlenmiştir. Fırça sitolojisi
ile probe küretaj (pc) histopatolojik sonuçları karşılaştırıldığında pc sonucu
endometroid adenokarsinom sonucu gelen 2 hastada fırça sitolojisinde malign
hücreler izlenmemiştir. Fırça sitolojisi ascus gelen 2 hastanın pc sonucu
inaktif endometrium olarak değerlendirilmiştir. Hsıl olan sitoloji sonucu pc de
inaktif endometrium olarak görülmüştür.

SONUÇ:Uterobrush,
endometrial sitolojik numune elde etmek için kullanılan  bir  tekniktir. Histolojik muayene endometrial
patolojiyi araştırmak için halen altın standart olarak kullanılmaktadır. Çalışmamızda
endoservikal fırça kullanılarak yapılan Uterobrush yönteminde  endometrial sitolojik değerlendirmenin
endometrial patolojilerin tanısını koymada yetersiz olduğu ve örnekleme esnasında
servikal hücrelerle de bulaş olduğu saptanmıştır. Postmenopozal kanaması
olanlarda tanı koymada probe küretaj uterobrusha tercih edilecek altın standart
yöntemdir.

 





















Anahtar sözcükler: Uterobrush, Endometrial örnekleme, Endometrium
kanseri

References

  • 1.Maksem J, Sager F and Bender R: Endometrial collection and interpretation using the Tao Brush and the CytoRich Fixative System: a feasibility study. Diagn Cytopathol 17: 339-346, 1997.
  • 2. Jordan MJ, Bader GM and Nemazie AS: Comparative accuracy of preoperative cytologic and histologic diagnosis in endometrial lesions. Obstet Gynecol 7: 646-653, 1956.
  • 3. Johnson JE and Storm by NG: Cytological brush technique in malignant disease of the endometrium. Acta Obstet Gynecol Scand 47: 38-51, 1968.
  • 4.Vuopala S, Klemi PJ, Maenpaa J, Salmi T and Makarainen L: Endobrush sampling for endometrial cancer. Acta Obstet Gynecol Scand 68: 345-350, 1989.
  • 5.Sato S, Yaegashi N, Shikano K, Hayakawa S and Yajima A:Endometrial cytodiagnosis with the Uterobrush and Endocyte. Acta Cytol 40(5): 907-910, 1996.
  • 6. Tao LC. Direct intrauterine sampling: the IUMC Endometrial Sampler. Diagn Cytopathol. 1997;17(2):153–159.
  • 7. Kipp BR, Medeiros F, Campion MB, Distad TJ, Peterson LM, Keeney GL, Halling KC, Clayton AC. Direct uterine sampling with the Tao brush samplerusing a liquid-based preparation method for the detection of endometrial cancer and atypical hyperplasia: a feasibility study. Cancer. 2008;114(4):228–235.
  • 8.Papaefthimiou M, Symiakaki H, Mentzelopoulou P, Tsiveleka A,Kyroudes A, Voulgaris Z, Tzonou A and Karakitsos P: Study on the morphology and reproducibility of the diagnosis ofendometrial lesions utilizing liquid based cytology. Cancer105:56-64, 2005.
  • 9.Koss LG, Schreiber K, Oberlander SG, Moussouris HF andLesser M: Detection of endometrial carcinoma and hyperplasia in asymptomatic women. Obstet Gynecol 64: 1-11, 1984.
  • 10. Tao L-C: Cytomorphologic appearances of normal endometrial cells during different phases of the menstrual cycle: A cytologic approach to endometrial dating. Diagn Cytopathol 13: 95-102,1995.
  • 11.Dijkhuizen FP, Brolmann HA, Potters AE, Bongers MY and Heinz AP: The accuracy of transvaginal ultrasonography in the diagnosis of endometrial abnormalities. Obstet Gynecol 87: 345-349, 1996.
  • 12. Yang GCH, Wan LS. Endometrial biopsy using the Tao Brush (R) method—a study of 50 women in a general gynecologic practice. J Reprod Med. 2000;45(2):109–114.
  • 13. Del Priore G, Williams R, Harbatkin CB, Wan LS, Mittal K, Yang GC. Endometrial brush biopsy for the diagnosis of endometrial cancer. J Reprod Med. 2001;46(5):439–443.
  • 14. Wu HH, Harshbarger KE, Berner HW, Elsheikh TM. Endometrial brush biopsy (Tao brush). Histologic diagnosis of 200 cases with complementary cytology: an accurate sampling technique for the detection of endometrial abnormalities. Am J Clin Pathol. 2000;114(3):412–418.
  • 15. Williams AR, Brechin S, Porter AJ, Warner P, Critchley HO. Factor saffecting adequacy of Pipelle and Tao Brush endometrial sampling. BJOG. 2008;115(8):1028–1036.
There are 15 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original Research
Authors

Dilşad Herkiloğlu

Mustafa Eroğlu

Sadik Şahin

Ahter Tayyar

Publication Date June 27, 2018
Published in Issue Year 2018 Volume: 49 Issue: 2

Cite

APA Herkiloğlu, D., Eroğlu, M., Şahin, S., Tayyar, A. (2018). POSTMENOPOZAL KANAMA İLE BAŞVURAN KADINLARDA ENDOMETRİAL SİTOLOJİ TANI KOYMADA YETERLİ MİDİR?. Zeynep Kamil Tıp Bülteni, 49(2), 188-191. https://doi.org/10.16948/zktipb.416733
AMA Herkiloğlu D, Eroğlu M, Şahin S, Tayyar A. POSTMENOPOZAL KANAMA İLE BAŞVURAN KADINLARDA ENDOMETRİAL SİTOLOJİ TANI KOYMADA YETERLİ MİDİR?. Zeynep Kamil Tıp Bülteni. June 2018;49(2):188-191. doi:10.16948/zktipb.416733
Chicago Herkiloğlu, Dilşad, Mustafa Eroğlu, Sadik Şahin, and Ahter Tayyar. “POSTMENOPOZAL KANAMA İLE BAŞVURAN KADINLARDA ENDOMETRİAL SİTOLOJİ TANI KOYMADA YETERLİ MİDİR?”. Zeynep Kamil Tıp Bülteni 49, no. 2 (June 2018): 188-91. https://doi.org/10.16948/zktipb.416733.
EndNote Herkiloğlu D, Eroğlu M, Şahin S, Tayyar A (June 1, 2018) POSTMENOPOZAL KANAMA İLE BAŞVURAN KADINLARDA ENDOMETRİAL SİTOLOJİ TANI KOYMADA YETERLİ MİDİR?. Zeynep Kamil Tıp Bülteni 49 2 188–191.
IEEE D. Herkiloğlu, M. Eroğlu, S. Şahin, and A. Tayyar, “POSTMENOPOZAL KANAMA İLE BAŞVURAN KADINLARDA ENDOMETRİAL SİTOLOJİ TANI KOYMADA YETERLİ MİDİR?”, Zeynep Kamil Tıp Bülteni, vol. 49, no. 2, pp. 188–191, 2018, doi: 10.16948/zktipb.416733.
ISNAD Herkiloğlu, Dilşad et al. “POSTMENOPOZAL KANAMA İLE BAŞVURAN KADINLARDA ENDOMETRİAL SİTOLOJİ TANI KOYMADA YETERLİ MİDİR?”. Zeynep Kamil Tıp Bülteni 49/2 (June 2018), 188-191. https://doi.org/10.16948/zktipb.416733.
JAMA Herkiloğlu D, Eroğlu M, Şahin S, Tayyar A. POSTMENOPOZAL KANAMA İLE BAŞVURAN KADINLARDA ENDOMETRİAL SİTOLOJİ TANI KOYMADA YETERLİ MİDİR?. Zeynep Kamil Tıp Bülteni. 2018;49:188–191.
MLA Herkiloğlu, Dilşad et al. “POSTMENOPOZAL KANAMA İLE BAŞVURAN KADINLARDA ENDOMETRİAL SİTOLOJİ TANI KOYMADA YETERLİ MİDİR?”. Zeynep Kamil Tıp Bülteni, vol. 49, no. 2, 2018, pp. 188-91, doi:10.16948/zktipb.416733.
Vancouver Herkiloğlu D, Eroğlu M, Şahin S, Tayyar A. POSTMENOPOZAL KANAMA İLE BAŞVURAN KADINLARDA ENDOMETRİAL SİTOLOJİ TANI KOYMADA YETERLİ MİDİR?. Zeynep Kamil Tıp Bülteni. 2018;49(2):188-91.