PT  - JOURNAL ARTICLE
AU  - Al Nemer, Areej M.
AU  - Al Bayat, Methal I.
AU  - Al Qahtani, Nourah H.
TI  - The accuracy of endometrial sampling for the diagnosis of patterns of endometrial pathology in women presenting with abnormal uterine bleeding
AID  - 10.15537/smj.2019.8.24449
DP  - 2019 Aug 01
TA  - Saudi Medical Journal
PG  - 815--819
VI  - 40
IP  - 8
4099  - http://smj.org.sa/content/40/8/815.short
4100  - http://smj.org.sa/content/40/8/815.full
SO  - Saudi Med J2019 Aug 01; 40
AB  - Objectives: Abnormal uterine bleeding (AUB) is a leading cause of hysterectomies, the cause of which is usually diagnosed with preoperative endometrial sampling. We planned this study to assess the accuracy of diagnosing the histologic patterns of endometrium in the preoperative sample in reference to the final histologic diagnosis in hysterectomy.Methods: We retrospectively reviewed medical charts between January 2011 and December 2015 at a tertiary hospital in Saudi Arabia and identified 43 cases of AUB with complete documentation. The histologic diagnoses were classified into normal and benign pathology group (N/B), or carcinoma and hyperplasia category (Ca/H). Measures of validity were used to compare endometrial sampling histological diagnoses to diagnoses following hysterectomy and Cohen’s kappa to assess for agreement between the 2 modalities.Results: The median age of all patients was 49 years. Preoperative histologic examination showed 53.8% sensitivity, 90% specificity, 70% positive predictive values and 81.8% negative predictive values, 30.1% false positive rates and 18.2% false negative rates. The agreement between preoperative and postoperative histologic diagnoses was moderate (79.1%, k=0.469).Conclusion: The accuracy of preoperative histologic examination was moderate. Our findings recommend cautious clinical decision making and limiting hysterectomy to women who do not respond to other therapeutic measures.