title: Endometrial histopathology in patients with laparoscopic proven salpingitis and HIV-1 infection.
abstract: OBJECTIVE
  To identify sensitive and specific histological criteria for endometritis in women with laparoscopically-confirmed acute salpingitis.
  
  
  METHODS
  Women, age 18-40 years of age presenting with complaints of lower abdominal pain ≤2 weeks and no antibiotics use in past two weeks, were enrolled. They underwent clinical examination, screening for HIV; other sexually transmitted infections plus endometrial biopsy sampling for histopathology. Diagnostic laparoscopy confirmed the diagnosis of acute salpingitis. Controls were women undergoing tubal ligation and HIV-1 infected women asymptomatic for genital tract infection.
  
  
  RESULTS
  Of 125 women with laparoscopically-confirmed salpingitis, 38% were HIV-1 seropositive. Nineteen HIV-1 negative controls were recruited. For the diagnosis of endometritis, ≥1 plasma cells (PC) and ≥3 polymorphonuclear lymphocytes (PMN) per HPF in the endometrium had a sensitivity of 74% for HIV-1-seropositive, 63% for HIV-1-seronegative women with a specificity of 75% and positive predictive value of 85% regardless of HIV-1-infection for predicting moderate to severe salpingitis. For HIV-1-seronegative women with mild salpingitis, ≥1 PC and ≥3 PMN had a sensitivity of 16% and a PPV of 57%.
  
  
  CONCLUSIONS
  Endometrial histology, did not perform well as a surrogate marker for moderate to severe salpingitis, and failed as a surrogate marker for mild salpingitis.
authors.affiliation: Department of Obstetrics and Gynecology, Kenyatta National Hospital, P.O. Box 19865-00202, Nairobi, Kenya. rwamba@csrtkenya.org
authors.forename: Nelly R
authors.initials: NR
authors.lastname: Mugo
authors.forename: Julia
authors.initials: J
authors.lastname: Kiehlbauch
authors.forename: Nancy
authors.initials: N
authors.lastname: Kiviat
authors.forename: Rosemary
authors.initials: R
authors.lastname: Nguti
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Gichuhi
authors.forename: Walter E
authors.initials: WE
authors.lastname: Stamm
authors.forename: Craig R
authors.initials: CR
authors.lastname: Cohen
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy; D016022:Case-Control Studies; D004716:Endometritis / Q000175:diagnosis / Q000473:pathology* / Q000821:virology*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006651:Histocytochemistry; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology; D010950:Plasma Cells / Q000473:pathology; D011237:Predictive Value of Tests; D012488:Salpingitis / Q000175:diagnosis / Q000473:pathology* / Q000821:virology*