Diagnostic accuracy of dilatation and curettage for abnormal uterine bleeding.
OBJECTIVE
The objective of this study was to compare the histological findings of dilatation and curettage (D&C) with those on subsequent hysterectomy in patients with abnormal uterine bleeding.


METHODS
Between October 1998 and September 2003 a retrospective clinical study of 311 patients was conducted, including all patients who underwent D&C and within 2 months, hysterectomy because of histological findings on D&C or persistence of symptoms. The sensitivity, specificity, positive and negative predictive value and accuracy of D&C were studied.


RESULTS
The mean age of our patients was 46.6 years. In 164 of 311 patients (52.7%), D&C failed to detect intrauterine disorders subsequently found at hysterectomy. The sensitivity was 30.2%, the specificity was 72.3%, the positive predictive value was 77.1%, and the negative predictive value was 25.1%. The accuracy was 40.5% overall.


CONCLUSIONS
D&C is an inadequate diagnostic tool for uterine focal lesions, but the accuracy of D&C in the detection of endometrial hyperplasia and carcinoma is relatively high (92.1%).
Department of Gynecological Oncology, Mirza Koochak Khan Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Fariba
F
Yarandi
Narges
N
Izadi-Mood
Zahra
Z
Eftekhar
Hadi
H
Shojaei
Soheila
S
Sarmadi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004107:Dilatation and Curettage; D004714:Endometrial Hyperplasia / Q000175:diagnosis*; D016889:Endometrial Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014592:Uterine Hemorrhage / Q000175:diagnosis*; D014599:Uterus / Q000473:pathology*