Comparison of Two Sampling Procedures for Diagnosing Endometrial Carcinoma and Hyperplasia: Outpatient Tissue Biopsy Versus Cytologic Examination

Abstract

Background: We compared the sensitivity of 2 diagnostic procedures—tissue biopsy and cytologic examination— for detecting endometrial carcinoma and hyperplasia in outpatients. The patients’ degree of acceptance of these methods was also evaluated. Methods: The study included 124 women who had been diagnosed with carcinoma and hyperplasia by histological examination in private clinics or were suspected to have endometrial carcinoma and hyperplasia—for example, those presenting with uterine bleeding and/or abnormal endometrial morphology on cytologic examination—at Jikei University Hospital, University of Yamanashi Hospital and National Hospital Organization Kure Medical Center from January 28, 1999, to August 28, 2006. Both cytologic examination (using Endocyte ® ) and tissue biopsy (using Suresample ™ ) of the endometrium were performed before complete curettage and/or hysterectomy. The diagnosis made using these two outpatient procedures was compared to the final diagnosis made using curettage and/or hysterectomy. McNemar’s chi-square test was used to evaluate the statistical significance. Results: The sensitivity of tissue biopsy for detecting endometrial carcinoma and hyperplasia was 84% and 91%, respectively, and that of cytologic examination was 78% and 55%, respectively. There was a significant difference in the sensitivity of the 2 methods for detecting hyperplasia (p =0.045). No patients complained of severe pain, and no other complication occurred during both methods. Both methods were well tolerated by the patients. Conclusion: Our data indicate a certain diagnostic superiority of tissue biopsy over cytologic examination.