Diagnostic test of endometrial cytobrush in cases of perimenopausal and postmenopausal hemorrhage
Perimenopausal menopausal hemorrhage can be due to by a variety of causative factors. One of its dangerous causes is atypicalÂ hyperplasia and endometrial carcinoma. There are a number of risk factors for the occurrence of endometrial carcinoma. The groupÂ that has this risk belongs to high-risk group. In this high-risk group, it is necessary to have a method to identify the changes inÂ endometrial abnormality. One of the alternatives is the examination of endometrial cytology. The objective of this study was toÂ evaluate the sensitivity, specificity and correlation test between endometrial cytology and endometrial histology. This study was aÂ diagnostic test of cytological examination of the endometrium as compared with endometrial histology. Endometrial cytology wasÂ performed with a modification of cytubrush and IUD shell. Specimen was dissolved into the centrifuged NaCl, and its depositsÂ were then processed for cytological examination with Papanicolaou and Giemsa staining. After the taking of cytology, the processÂ was continued with curettage of the endometrium, and the specimens were processed for cytological examination. Both of them wereÂ examined by anatomic pathologist. Statistical analysis used diagnostic test using histological examination of curetage specimens asÂ gold standard. During the period of study 45 study samples were collected, among which 12 (26.66%) were endometrialÂ adenocarcinoma, 6 (13.33%) with atypical hyperplasia, 11 (24.44%) with non-atypical hyperplasia, 15 (33.33%) were samplesÂ without abnormality, and one sample with endometritis. Actual correlation value was 57.8%, correlation because of possibility 3.38%,Â and correlation not because of possibility 54.42%, potential correlation not because of possibility 96.62%, and Kappa value 0.56. ItÂ was concluded that cytological examination of the endometriurn with cytobrush could be employed as a screening method in theÂ abnormalities of endometrial thickness, with sensitivity of 62.5% and specificity of 62.2%. (Med J Indones 2005; 14: 87-91)
Keywords: Endometrial cencer, endometrial cytology
Copyright (c) 2005 Andrijono Andrijono, Gunawan D. Prayitno, Chairil Hamdani
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