OBJECTIVE: To evaluate the accuracy of Pipelle endometrial sampling with and without sonographic measurement of endometrial thickness. METHODS: We studied prospectively 176 consecutive patients (23% after and 77% before menopause) scheduled for D&C. Sonographic measurement of the endometrium and endometrial biopsy with the Pipelle were performed before the curettage. RESULTS: In 159 cases (90%), the endometrial histologic results of curettage agreed with those of the Pipelle biopsy. All three cases of endometrial cancer were identified by Pipelle aspiration. In seven cases (4%), the Pipelle aspiration failed to detect hyperplasia. Sonographic endometrial thickness of more than 5 mm slightly increased the sensitivity and slightly decreased the specificity of Pipelle aspiration from 82 to 92% and from 99 to 96%, respectively. In postmenopausal patients admitted for bleeding, the sensitivity and specificity reached 100%. CONCLUSIONS: Our data suggest that normal Pipelle aspirates in premenopausal patients with abnormal uterine bleeding are highly accurate. In postmenopausal patients with sonographic endometrial thickness of 5 mm or less, the accuracy reached 100%.
OBJECTIVE: To evaluate the accuracy of Pipelle endometrial sampling with and without sonographic measurement of endometrial thickness. METHODS: We studied prospectively 176 consecutive patients (23% after and 77% before menopause) scheduled for D&C. Sonographic measurement of the endometrium and endometrial biopsy with the Pipelle were performed before the curettage. RESULTS: In 159 cases (90%), the endometrial histologic results of curettage agreed with those of the Pipelle biopsy. All three cases of endometrial cancer were identified by Pipelle aspiration. In seven cases (4%), the Pipelle aspiration failed to detect hyperplasia. Sonographic endometrial thickness of more than 5 mm slightly increased the sensitivity and slightly decreased the specificity of Pipelle aspiration from 82 to 92% and from 99 to 96%, respectively. In postmenopausal patients admitted for bleeding, the sensitivity and specificity reached 100%. CONCLUSIONS: Our data suggest that normal Pipelle aspirates in premenopausal patients with abnormal uterine bleeding are highly accurate. In postmenopausal patients with sonographic endometrial thickness of 5 mm or less, the accuracy reached 100%.
Authors: Onur Guralp; Susan M Sheridan; Josephine Harter; James Louis Hinshaw; Songwon Seo; Ellen M Hartenbach; Steven Lindheim; Sarah Stewart; David M Kushner Journal: Int J Gynecol Cancer Date: 2013-09 Impact factor: 3.437