In Women who Apply for Postmenopausal Bleeding, is Endometrial Cytology Sufficient To Diagnose?

INTRODUCTION: Endometrial cancer is the most common invasive neoplasm of the female genital tract and its incidence has increased in recent years. There is no screening test for early detection of endometrium carcinoma and its precursors. To evaluate the safety and comparability of cytologic endometrial samples obtained with Uterobrush for the diagnosis of endometrial pathologies in women with postmenopausal bleeding in our study with endometrial biopsy.
METHODS: A total of 100 patients who were admitted to the gynecological policlinics of our hospital with postmenopausal bleeding between August 1, 2015 and April 1, 2017 were included in the study. Endoscopic and endometrial sampling were performed after local anesthesia, cytologic sampling, lithotomy position, and all cases after local anesthesia. Cytological sampling of endometrium was done by Uterobrush method. The brush was then taken to the solution for a liquid-based cytological examination. Endocervical and endometrial curettage was performed after dilatation.
RESULTS: Our study also evaluated the feasibility and reliability of endometrial cytology using the Uterobrush method. Postmenopausal bleeding was observed in 63% (31), thickening in endometrium (%) and intrauterine fluid in% (6) when 100 patients were evaluated in terms of USG findings and indications before the procedure. Brush cytology showed no (94) malignant cells, (3) atrophic cells, (2) ascus cells and% (1) HGSIL cells in the brush cytology. When brush cytology and probe curettage (pc) histopathological results were compared, there were no malignant cells in brush cytology in 2 patients who had PC end result of endometrial adenocarcinoma. Brush cytology was evaluated as an inactive endometrium of pc from 2 patients from ascus. The cytology, which is the predominant endometrium, was also seen as an inactive endometrium in PC.
DISCUSSION AND CONCLUSION: Uterobrush is a technique used to obtain endometrial cytological specimens. Histological examination is still used as the gold standard for investigating endometrial pathology. In our study, endometrial cytological evaluation of Uterobrush method using endocervical brush was found to be inadequate to diagnose endometrial pathologies and it was found to be transmitted to cervical cells during sampling. In the diagnosis of postmenopausal bleeding, probe curettage uterobrush is the preferred gold standard method.