Comparison of D&C and office endometrial biopsy accuracy in patients with FIGO grade 1 endometrial adenocarcinoma
Comparison of D&C and office endometrial biopsy accuracy in patients with FIGO grade 1 endometrial adenocarcinoma
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DOI：
10.1016/j.ygyno.2008.12.017
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发表时间：
2009-04-01
影响因子：
4.7
通讯作者：
Abu-Rustum, Nadeern R.
中科院分区：
文献类型：
--
作者：
Leitao, Mario M., Jr.;Kehoe, Siobhan;Abu-Rustum, Nadeern R.
目标。比较术前诊断为FIGO 1级子宫内膜腺癌的患者，D&C和办公室子宫内膜活检预测子宫切除术后最终FIGO分级的准确性。我们回顾了1993年1月1日至2006年5月31日在我院连续治疗的1423例子宫内膜癌病例，并确定了术前子宫内膜活检明确显示FIGO 1级子宫内膜腺癌的病例。所有病例均经病理证实并在我院接受手术治疗。记录了子宫切除标本的FIGO分级和组织学诊断。然后将术前D&C和办公室子宫内膜取样的患者在子宫切除术标本中的发现进行比较。适当采用卡方检验和fisher精确检验。我们确定了490例术前FIGO 1级子宫内膜腺癌。482例中，71例（14.7%）FIGO分级较高；在最终的子宫切除术标本中，66例（13.7%）为2级，5例（1%）为2-3/3级。另外6例（1.2%）诊断为浆液性或透明细胞组织学。187例（38.6%）进行了子宫内膜切除术，298例（61.4%）进行了子宫内膜取样，其中5例使用的方法无法辨别。D&C诊断的16/187例（8.7%）患者最终子宫切除术后FIGO分级高于办公室子宫内膜取样诊断的52/298例（17.4%）（P=0.007）。术前FIGO 1级诊断与最终分级诊断在85%的病例中相关。虽然D&C更准确地反映了最终的FIGO分级，但在子宫切除术时，8.7%的病例会出现更高的分级。(C) 2008爱思唯尔公司版权所有。
Objective. To compare the accuracy of D&C vs office endometrial biopsy in predicting final post-hysterectomy FIGO grade in patients diagnosed with a preoperative FIGO grade 1 endometrial adenocarcinoma.Methods. We reviewed 1423 consecutive cases of endometrial cancer treated at our institution between 1/1/93 and 5/31/06 and identified cases with an unequivocal preoperative endometrial biopsy demonstrating FIGO grade 1 endometrial adenocarcinoma. All cases were pathologically confirmed and underwent surgical therapy at Our institution. FIGO grade and histology diagnosed in the hysterectomy specimen were noted. The findings in the hysterectomy specimen were then compared between those patients who had a preoperative D&C vs an office endometrial sampling. Chi-square and Fisher-exact test were used as appropriate.Results. We identified 490 cases with a preoperative FIGO grade 1 endometrial adenocarcinoma. In 482 cases, FIGO grade was determined to be greater in 71 (14.7%) cases; in the final hysterectomy specimen, 66 ( 13.7%) were found to be grade 2 and 5 (1%) were found to be grades 2-3/3. Serous or clear cell histology was diagnosed in 6 (1.2%) additional cases. D&C was performed in 187 (38.6%) cases and office endometrial sampling in 298 (61.4%): in 5 cases the method used was not discernible. The final post-hysterectomy FIGO grade was higher in 16/187 (8.7%) cases diagnosed by D&C compared to 52/298 (17.4%) diagnosed by office endometrial sampling (P=0.007).Conclusions. Preoperative FIGO grade 1 diagnosis correlates with final grade diagnosis in 85% of cases. While D&C more accurately reflects final FIGO grade, a higher grade will be found in 8.7% of the cases at the time of hysterectomy. (C) 2008 Elsevier Inc. All rights reserved.