Control Study Of Postmenopausal Women With Endometrial Liquid-based Cytology And Curettage Pathology

Objective:Endometrial lesions manifested as abnormal uterine bleeding, abnormalvaginal bleeding in the majority of post-menopausal. The traditional diagnosticmethod is to obtain sufficient quantities of endometrial tissue forhistopathological diagnosis by piecewise diagnostic curettage. Segmenteddiagnostic dilatation and curettage has a certain traumatic bleeding more likelyto cause infection, etc., for postmenopausal women the risk of uterineperforation, especially when tainted scraping the possibility of uterine lesionsis more limited, the data indicate that even experienced gynecologistdiagnostic curettage only when scraping the uterine area from75%to80%, themissed diagnosis of endometrial lesions was10%. Uterine cytology is a newmeans of screening for endometrial lesions developed in recent years. Manyforeign scholars have uterine cytology for asymptomatic high-risk groups (suchas tamoxifen, hormone replacement, obesity, hypertension, infertility,menopause delay, etc.) the preliminary screening of endometrial lesions, andconfirmed practical value of uterine cytology diagnosis of endometrial cancer.The purpose of this study lies in the control study to examine the value ofendometrial liquid-based cytology in the diagnosis of post-menopausal womenwith endometrial lesions in postmenopausal women with endometrialliquid-based cytology and curettage pathology.Methods:Collected between September2011to March2012,30cases of patients inthe hospital gynecology clinic because of postmenopausal irregular vaginalbleeding, vaginal ultrasound tips endometrial thickening (>4mm) or abnormal echo need further examination. Age50to75years, average61.4years old fortreatment reasons for postmenopausal bleeding in patients with23cases,vaginal ultrasound prompted endometrial thickening in seven cases,transvaginal ultrasound prompted to five cases of intrauterine abnormal echo.Results:1. Acquisition method with the endometrial cells derived smooth collectorinto the uterine cavity, without dilatation of the cervix mouth, collected cellsto the glandular epithelial cells, cell volume>5000specimens of30caseswere satisfied, drawing satisfaction rate of100%(30/30); line and paragraphcurettage method drawn specimens satisfaction,24patients, cervical atrophysignificantly curettage four cases of endometrial atrophy of the endometrialtissue can not be scraped off in sufficient quantities to send two cases ofpathological examination, drawing satisfaction rate80.0%(24/30). Notsatisfied with the specimens are able to use the uterine cytology methods toobtain a cytological diagnosis. Derived satisfaction rate difference of the twomethods was significant (P>0.05).2. Hysteroscopy results with cytology results: hysteroscopy results showgenerally normal uterine cavity22cases of uterine cytology of normalglandular epithelial cells in21cases, shaped gland epithelial cells (n=1);hysteroscopy results show the mucous membrane of endometrial polyps oruterine fibroids, cytology results for the normal glandular epithelial cells;hysteroscopy results show two cases of suspicious cancerous cytology resultsfor the two cases of adenocarcinoma epithelial cells。3. Hysteroscopy and pathology results: hysteroscopy results showgenerally normal uterine cavity16cases, pathology results for atrophicendometrium1cases of15cases of proliferative endometrium; hysteroscopyresults are shown4cases of endometrial polyps, the pathology results ofsimple hyperplasia in1case,2cases of endometrial polyps, submucous uterine fibroids; hysteroscopy results show submucous uterine fibroids two cases, thepathology results fibroids in the uterine mucosa in two cases; hysteroscopyresults show two cases of suspicious cancerous pathology results for the twocases of endometrial adenocarcinoma.4. Pathology and cytology results: the diagnosis of pathology showatrophy of the type of endometrial hyperplasia endometrial, endometrialpolyps, uterine submucosal fibroids, and cytology results were normalglandular epithelial cells; pathological diagnosis show one cases of simplehyperplasia, cytology shaped gland epithelial cells; pathological diagnosisshowed two cases of adenocarcinoma, cytology results of two cases ofadenocarcinoma epithelial cells.Conclusion:1. Endometrial cell collection method to the acquisition of endometrialcells is simple and convenient, easy to operate, less blood loss, trauma such asthe superiority of the acquisition of endometrial cells in glandular epithelialcells, cell volume>5000, drawing satisfaction, prove that the method ispractical and reliable;2. The hysteroscopy see and uterine fluid-based cytology andhistopathology were studied as controls to prove that the uterine fluid-basedcytology screening for endometrial disease much earlier, accurate, someclinical value, regarded as post-menopausal women with endometrial diseasescreening means;3. Endometrial cell collection combined liquid based cytology as a tool forscreening of endometrial lesions, especially difficult scrapings of sufficientquantities of endometrial tissue for pathology diagnosis in patients withendometrial lesions in the preoperative screening meaningful.