title: Accuracy of preoperative endometrial sampling for the detection of high-grade endometrial tumors.
abstract: OBJECTIVE
  This study was undertaken to evaluate the ability of preoperative endometrial sampling to accurately diagnose high-grade endometrial tumors.
  
  
  METHODS
  Three hundred sixty endometrial cancer patients had preoperative endometrial sampling and hysterectomy specimens that underwent pathologic review at a single institution from 1995 to 2005. The sensitivity of Pipelle and curettage to diagnose high-grade endometrial tumors (grade 3 endometrioid adenocarcinoma, serous carcinoma, carcinosarcoma, clear cell carcinoma) was determined. Agreement between preoperative and hysterectomy diagnoses was measured by the Kappa statistic.
  
  
  RESULTS
  Sensitivity of Pipelle and curettage was 93.8% and 97% in patients with low-grade cancer and 99.2% and 100% in patients with high-grade cancer. Good agreement was observed between the preoperative and the hysterectomy histologic diagnoses (Kappa = 0.69), and between the preoperative and hysterectomy tumor grade (Kappa=0.78).
  
  
  CONCLUSIONS
  Preoperative endometrial sampling with Pipelle or curettage is sensitive and accurate for the diagnosis of high-grade endometrial tumors, including tumors with nonendometrioid histology.
authors.affiliation: Department of Obstetrics and Gynecology and Women's Health, Division of Gynecologic Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA. ghuang@montefiore.org
authors.forename: Gloria S
authors.initials: GS
authors.lastname: Huang
authors.forename: Juliana S
authors.initials: JS
authors.lastname: Gebb
authors.forename: Mark H
authors.initials: MH
authors.lastname: Einstein
authors.forename: Shohreh
authors.initials: S
authors.lastname: Shahabi
authors.forename: Akiva P
authors.initials: AP
authors.lastname: Novetsky
authors.forename: Gary L
authors.initials: GL
authors.lastname: Goldberg
mesh_terms: D003475:Curettage; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D005629:Frozen Sections; D006801:Humans; D007044:Hysterectomy; D011300:Preoperative Care; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity