The agreement of histopathological findings of endometrial hyperplasia between curettage and hysterectomy at Srinagarind Hospital
Department of Obstetrics and Gynecology, Srinagarind Hospital
Faculty of Medicine, Khon Kaen University, THAILAND
Objective :To determine the agreement of histopathological findings of endometrial hyperplasia between curettage and hysterectomy at Srinagarind Hospital
Material and method : Retrospective study of endometrium from 86 patients with endometrial hyperplasia detected by endometrial curettage were done and subsequently ubsequently performed hysterectomy without hormonal treatment within 1 year from diagnosis during January 1995 through December 2005 at Srinagarind Hospital. The results were processed by program Stata, Kappa analysis regarding p value higher than 0.05 as normal distribution. The agreement of variation was assessed by using Kappa Analysis, Chi square test was also used to compared the data, a p-value of lower than 0.05 was regarded as significant.
Result : The 86 women, were grouped into pre- and perimenopause 78(81.4%) and postmenopause 8(9.3%). The average age was 35-76. BMI mean was 25.85 . The number of patients with no underlying disease was 62 (72%), with diabetes mellitus 3 (3.5%), with hypertension 7 (8.1%), and other 14(16.2 %). Comparing curettage and hysterectomy specimens among the 51 patients with simple hyperplasia without atypia we found that 20 out of 51 were the same, 28 out of 51 were improved, 2 out of 51 were worse and 1 out of 51 had endometrial cancer. Among the 4 patients with simple hyperplasia with atypia 1 out of 4 were the same, 3 out of 4 were improved. Among the 17 patients with complex hyperplasia without atypia we discover that 1 out of 17 were the same, 15 out of 17 were improved, 1 out of 17 was worse. Among the 14 patients with complex hyperplasia with atypia we found that 3 out of 14 were the same, 10 out of 14 were improved, 1 out of 14 had endometrial cancer.
Conclusion :The histopathology of hysterectomy specimens was found to be different from curettage specimens because of the difficulty to obtain correct diagnosis of endometrial hyperplasia by curettage due to variability of the morphological change of endometrium through endometrial cycle and there were many factors influencing the endometrium such as age, hormonal effects and the morphology which could vary in area of endometrium from curettage and technic of samplings the tissue from hysterectomy specimens .
Keywords : Endometrial hyperplasia, curettage, hysterectomy
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