title: Which endometrial pathologies need intraoperative frozen sections?
abstract: BACKGROUND
  Endometrial cancers are the most common gynecologic cancers. Endometrial sampling is a preferred procedure for diagnosis of the endometrial pathology. It is performed routinely in many clinics prior to surgery in order to exclude an endometrial malignancy. We aimed to investigate the accuracy of endometrial sampling in the diagnosis of endometrial pathologies and which findings need intra-operative frozen sections.
  
  
  METHODS
  Three hundred nine women applying to a university hospital and undergoing endometrial sampling and hysterectomy between 2010 and 2012 were included to this retrospective study. Data were retrieved from patient files and pathology archives.
  
  
  RESULTS
  There was 17 patients with malignancy but endometrial sampling could detect this in only 10 of them. The endometrial sampling sensitivity and specificity of detecting cancer were 58.8% and 100%, with negative and positive predictive values of 97.6%, and 100%, respectively. In 7 patients, the endometrial sampling failed to detect malignancy; 4 of these patients had a preoperative diagnosis of complex atypical endometrial hyperplasia and 2 patients had a post-menopausal endometrial polyps and 1 with simple endometrial hyperplasia.
  
  
  CONCLUSIONS
  There is an increased risk of malignancy in post-menopausal women especially with endometrial polyps and complex atypia hyperplasia. Endometrial sampling is a good choice for the diagnosis of endometrial pathologies. However, the diagnosis should be confirmed by frozen section in patients with post-menopausal endometrial polyps and complex atypia hyperplasia.
authors.affiliation: Obstetrics and Gynecology, Medicine, Recep Tayyip Erdogan Univercity , Rize, Turkey E-mail : gulsahbalik@gmail.com.
authors.forename: Gulsah
authors.initials: G
authors.lastname: Balik
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kagitci
authors.forename: Isik
authors.initials: I
authors.lastname: Ustuner
authors.forename: Funda
authors.initials: F
authors.lastname: Akpinar
authors.forename: Emine Seda
authors.initials: ES
authors.lastname: Guvendag Guven
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004714:Endometrial Hyperplasia / Q000473:pathology* / Q000601:surgery; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005629:Frozen Sections; D006801:Humans; D007044:Hysterectomy; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011379:Prognosis; D012189:Retrospective Studies