Narrow-band imaging in diagnosis of endometrial cancer and hyperplasia: a new option?
OBJECTIVE
To estimate whether the use of narrow-band imaging (NBI) hysteroscopy increases concordance between visual identification and a histologic diagnosis of endometrial cancer and hyperplasia.


METHODS
Prospective study (Canadian Task Force classification: II-2).


METHODS
Department of obstetrics and gynecology, University of Eastern Piedmont, Novara, Italy.


METHODS
209 consecutive patients with abnormal uterine bleeding.


METHODS
White-light hysteroscopy and NBI hysteroscopy followed by direct biopsy.


RESULTS
The sensitivity and specificity of conventional hysteroscopy in predicting a diagnosis of cancer and hyperplasia were, respectively, 84.21% (95% confidence interval [CI], 79.27-89.15) and 99.47% (95% CI, 98.49-100.0), and 64.86% (95% CI, 58.39-71.34) and 98.77% (95% CI, 97.27-100.0), and of NBI hysteroscopy were 94.74% (95% CI, 91.71-97.76) and 97.89% (95% CI, 95.95-99.84), and 78.38% (95% CI, 72.8-83.96) and 97.67% (95% CI, 96.63-99.72). The concordance of conventional and NBI hysteroscopy with the histopathologic findings (measured using the Cohen kappa) was, respectively, 88.80% (95% CI, 86.2%-96.3%) and 91.78% (95% CI, 89.6%-98.2%), a difference of 2.98% (95% CI, 0-9) in favor of NBI.


CONCLUSIONS
Narrow-band imaging hysteroscopy can accurately predict a histologic diagnosis of endometrial cancer or hyperplasia.
Surico
Daniela
D
Advanced Gynecological Oncology Centre, Department of Obstetrics, Novara, Italy. daniela.surico@med.unipmn.it
Vigone
Alessandro
A
Bonvini
Daniele
D
Tinelli
Raffaele
R
Leo
Livio
L
Surico
Nicola
N
D000368:Aged; D004714:Endometrial Hyperplasia / Q000175:diagnosis* / Q000473:pathology; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity