The Clinicopathological Comparison of Diagnostic Curettage and Total Abdominal Hysterectomy Results in Patients with Endometrial Cancer Referred to Shahid Sadoughi Hospital, Yazd, During the Years 2019 To 2023

The Diagnostic Accuracy of Curettage in Endometrial Cancer

Abstract

Background: The use of curettage in diagnosing endometrial disorders the most common diagnostic method. The previous studies showed that curettage is an inadequate diagnostic method for focal uterine lesions but has high diagnostic accuracy in endometrial hyperplasia and carcinoma. The objective is to compare the clinicopathological results of diagnostic curettage and total abdominal hysterectomy in patients with endometrial cancer. Materials and Methods: This cross-sectional analytical study was conducted on 85 women with endometrial cancer; 19 high and 66 with low tumor grade between 21.3.2019 and 19.03.2024 who underwent diagnostic curettage and total abdominal. All reports related to pathology samples were extracted according to the inclusion and exclusion criteria of the study. All the information required for the study including the pathological result of diagnostic curettage, the pathological result of a total abdominal hysterectomy, tumor grade was extracted. Furthermore, sensitivity, specificity, positive predictive value, negative predictive value and Kappa coefficient were obtained. Results: The mean age of the studied samples was 58.825 ± 11.324 (33-90) years. The most common clinical manifestations in the participants were reported postmenopausal bleeding with a frequency of (49.4%) for 42 patients and abnormal uterine bleeding with a frequency of (41.2%) for 35 patients, respectively. The sensitivity, specificity, positive and negative predictive values calculated for curettage were 84.21%, 83.33%, 59.25% and 94.82%, respectively and the kappa coefficient was reported equal to 0.587. it can be said that the results obtained from histopathology of curettage and hysterectomy are consistent (P-value = 0.001). Conclusion: Therefore, in the present study it is concluded that the diagnostic accuracy of curettage, compared to total hysterectomy, is a relatively suitable diagnostic method for evaluating endometrial cancer; this method may be used in the timely diagnosis of this disease. However, caution is required due to the lower PPV, necessitating further evaluation before definitive management.