A comparison of malignant histopathological diagnoses on uterine curettings and hysterectomy specimens

• Published in: South African journal of obstetrics and gynaecology (1999) Vol. 28; no. 1; pp. 10 - 15
• Main Authors: Ismail, A, Wadee, R
• Format: Journal Article
• Language: English; Portuguese
• Published: South African Medical Association NPC 01.06.2022; Health & Medical Publishing Group; South African Medical Association
• Subjects: Comparative analysis; Development and progression; Health aspects; Hysterectomy; Medical research; Medicine, Experimental; Obstetrics & Gynecology; Postmenopausal women; Surgery; Tumors; Women
• ISSN: 0038-2329; 2305-8862; 2078-5135; 2305-8862
• DOI: 10.7196/SAJOG.2022.v28i1.2078

Background Endometrial carcinoma (EC) is a common gynaecological malignancy in postmenopausal females. Diagnosis is made on endometrial biopsy, where histological subtype and tumour grade are used to predict disease progression and to plan surgical management.Objectives To determine the accuracy of preoperative biopsies compared with the final diagnosis on hysterectomy specimens.Methods This was a retrospective, cross-sectional study in which 126 biopsies and corresponding hysterectomy specimens, collected over a 3-year period, were reviewed. Patient demographics and histological features were recorded and statistically analysed.Results The most prevalent tumours were endometrioid endometrial carcinoma (EEC) (48.5%), serous carcinomas (25.4%) and carcinosarcomas (16.7%). The majority (66.7%) of tumours were high-grade tumours on biopsy and hysterectomy specimens (58.7%). EECs had a poor sensitivity level (65.1%) compared with other subtypes but had a high specificity rate (90%). There was moderate agreement between biopsy and excision specimen diagnoses. High-grade tumours had a high sensitivity level (94.3%).Conclusions Our study showed moderate agreement between histopathological diagnoses on biopsy and excision specimens. There was a high sensitivity level for biopsies of high-grade tumours, concordant with other studies. Accurate preoperative tumour subtyping and grading are needed to guide surgical management. It is envisaged that use of a combined histological and molecular tumour classification will better guide patient treatment and allow for reproducible results.