title: Comparison of hysteroscopic and hysterectomy findings for assessing the diagnostic accuracy of office hysteroscopy.
abstract: OBJECTIVE
  To assess the diagnostic accuracy of office hysteroscopy by comparing the hysteroscopic findings with the histologic findings on the hysterectomy specimens.
  
  
  METHODS
  Retrospective clinical study.
  
  
  METHODS
  University-affiliated hospital.
  
  
  METHODS
  Review of the hospital records of 443 patients who underwent office hysteroscopy and, within 2 months, hysterectomy.
  
  
  METHODS
  We compared the hysteroscopic findings (including targeted biopsies) with the histologic findings that were obtained after hysterectomy. The results of this study were then compared with those of a previous study in which we examined the diagnostic accuracy of dilatation and curettage (D&C).
  
  
  METHODS
  We evaluated the diagnostic accuracy of office hysteroscopy.
  
  
  RESULTS
  When compared with the histologic diagnosis of the uterus, the hysteroscopic findings showed a diagnostic sensitivity of 98%, a specificity of 95%, a positive predictive value (PPV) of 96%, and a negative predictive value (NPV) of 98%. Hysteroscopy was found to have a greater diagnostic accuracy than D&C: the sensitivity and the NPV of the two diagnostic procedures were statistically different.
  
  
  CONCLUSIONS
  Office hysteroscopy is confirmed as a powerful diagnostic tool, but targeted biopsies, performed with a small diameter operative hysteroscope, must be performed in cases of suspect endometrium to confirm the image-based diagnosis.
authors.affiliation: Department of General and Specialist Surgical Sciences, Section of Obstetrics and Gynecology, University of Bari, Italy. ceci-o@libero.it
authors.forename: Oronzo
authors.initials: O
authors.lastname: Ceci
authors.forename: Stefano
authors.initials: S
authors.lastname: Bettocchi
authors.forename: Annarosa
authors.initials: A
authors.lastname: Pellegrino
authors.forename: Luigi
authors.initials: L
authors.lastname: Impedovo
authors.forename: Raffaella
authors.initials: R
authors.lastname: Di Venere
authors.forename: Nicola
authors.initials: N
authors.lastname: Pansini
mesh_terms: D004107:Dilatation and Curettage / Q000592:standards; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007044:Hysterectomy; D015907:Hysteroscopy; D008499:Medical Records; D015203:Reproducibility of Results; D012189:Retrospective Studies