title: Comparison of the histopathological diagnoses of preoperative dilatation and curettage and hysterectomy specimens.
abstract: OBJECTIVE
  A biopsy is often taken as part of the preoperative workup, regardless of the indication for hysterectomy. Some authors believe that dilatation and curettage is a poor diagnostic procedure for intrauterine pathologies, but dilatation and curettage has been the method of choice for obtaining an endometrial sample. The aim of this study was to investigate the concordance between endometrial histopathological diagnoses from preoperative dilatation and curettage and hysterectomy specimens. The differences between premenopausal and postmenopausal women were also investigated.
  
  
  METHODS
  Histopathological results for dilatation and curettage specimens from 645 women (401 premenopausal and 244 postmenopausal) who underwent a hysterectomy between 2003 and 2009 were analyzed retrospectively.
  
  
  RESULTS
  High sensitivity (87.8%), specificity (100%), positive (100%) and negative (98.7%) predictive values, and accuracy (98.8%) were observed for all malignant endometrial pathologies obtained at dilatation and curettage. In postmenopausal women, eight malignancies were missed when the preoperative diagnosis from the dilatation and curettage sample indicated inadequate tissue or premalignant lesions. For premenopausal women, we found only two missed malignancies. The accuracy was 99.5% and 96.8% for malignant pathologies diagnosed from curettage material for pre- and postmenopausal women, respectively.
  
  
  CONCLUSIONS
  Dilatation and curettage remains the 'gold standard' for diagnosing endometrial pathologies, especially malignancies.
authors.affiliation: Departments of Gynecology and Obstetrics Pathology, Faculty of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey. aykbar@yahoo.com
authors.forename: Aykut
authors.initials: A
authors.lastname: Barut
authors.forename: Figen
authors.initials: F
authors.lastname: Barut
authors.forename: Ilker
authors.initials: I
authors.lastname: Arikan
authors.forename: Muge
authors.initials: M
authors.lastname: Harma
authors.forename: Mehmet Ibrahim
authors.initials: MI
authors.lastname: Harma
authors.forename: Ulku
authors.initials: U
authors.lastname: Ozmen Bayar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004107:Dilatation and Curettage; D004717:Endometrium / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014591:Uterine Diseases / Q000473:pathology* / Q000601:surgery