Clinical analysis of histopathology diagnosis of micro endometrial tissues obtained by endometrial cell collector

Abstract

Objective To evaluate the feasibility and application of histopathology diagnosis of endometrial tissues obtained by endometrial cell collector (Jingyou, SAP- 1). Methods One hundred and ninety-three patients whose endometrial lesions should be excluded were selected. First, endometrial tissue were obtained from the patients by Jingyou, then they underwent comprehensive curettage under hysteroscopy. The histopathology diagnosis was performed respectively. The specimen satisfaction rate and diagnostic accuracy was analyzed and compared. Results The specimen satisfaction rate of curettage under hysteroscopy was 95.85% (185/193). The specimens of 8 cases were not satisfied because the tissues were not enough. The specimen satisfaction rate of Jingyou was 82.38% (159/193). The specimens of 34 cases were not satisfied, among whom in 10 cases scratches did not throughout the whole palace antrum, and in 24 cases tissues quality were poor. The endometrial thickness in unsatisfactory specimen by Jinyou was significantly thinner than that in satisfactory specimen: (0.64 ± 0.18) cm vs. (0.97±0.43) cm, and there was statistical difference (P <0.05). The diagnostic accordance rate between Jingyou and curettage under hysteroscopy was 79.87% (127/159). The sensitivity of Jingyou from high to low was 94.19% (81/86) in normal menstrual endometrial, 7/10 in endometrial carcinoma/ atypical hyperplasia, 67.86% (38/56) in endometrial hyperplasia and 1/7 in endometrial polyps. Missed diagnosis of jingyou inluded 2 cases of endometrial carcinoma and 4 cases of endometrial atypical hyperplasia. The misdiagnosed rate of high grade endometrial lesions was 6/16, and the patients were misdiagnosed because the tissues were not enough. Four cases of endometrial atypical hyperplasia had underwent conservative treatment of repeated curettage. Conclusions Application of Jingyou can obtain micro endometrial tissues, and the accordance rate of histopathology diagnosis is high with curettage under hysteroscopy. When the collector makes a comprehensive collection to the uterine cavity specimen, it can accurately screen endometrial carcinoma and atypical hyperplasia. The patients who have endometrial atypical hyperplasia and receive conservative treatment and curettage repeatedly curettage, thin endometrium and ultrasonic highly suspected endometrial polyps, are not recommend to use Jingyou to obtain specimen. When the specimen is not satisfied using the collector, additional hysteroscopy should be performed to avoid misdiagnosis of high grade endometrial lesions. Key words: Biopsy; Pathology; Endometrial cell collector; Screening