title: Hysteroscopy in women with abnormal uterine bleeding: a meta-analysis on four major endometrial pathologies.
abstract: OBJECTIVE
  To determine the accuracy of hysteroscopy in diagnosing endometrial cancer, hyperplasia, polyps and submucous myomas.
  
  
  METHODS
  Relevant articles were retrieved from the MEDLINE and the Cochrane Library (1986-2011). Studies were selected blindly. Results for diagnostic accuracy were extracted to form separate 2 × 2 tables (for endometrial cancer, hyperplasia, polyps and submucous myomas). A summary sensitivity and specificity point reflected the average accuracy observed. Summary ROCs (SROCs) were also calculated according to the HSROC model.
  
  
  RESULTS
  For endometrial cancer, the estimated sensitivity was 82.6% (95% CR 66.9-91.8%) and the specificity was 99.7% (95% CR 98.1-99.9%). For endometrial hyperplasia, sensitivity was 75.2% (95% CR 55.4-88.1 %), while specificity was 91.5% (95% CR 85.7-95.0%). For endometrial polyps, sensitivity was 95.4% (95% CR 87.4-98.4%) and specificity was 96.4% (95% CR 93.7-98.0%). Finally, for submucous myomas, sensitivity was estimated to 97.0% (95% CR 89.8-99.2%) and specificity to 98.9% (95% CR 93.3-99.8%).
  
  
  CONCLUSIONS
  Diagnostic accuracy for hysteroscopy is high for endometrial cancer, polyps and submucous myomas, but only moderate for endometrial hyperplasia.
authors.affiliation: Department of Obstetrics and Gynecology, Medical School, University of Ioannina, Ioannina, Greece.
authors.forename: Fani
authors.initials: F
authors.lastname: Gkrozou
authors.forename: George
authors.initials: G
authors.lastname: Dimakopoulos
authors.forename: Thomas
authors.initials: T
authors.lastname: Vrekoussis
authors.forename: Lazaros
authors.initials: L
authors.lastname: Lavasidis
authors.forename: Anastasios
authors.initials: A
authors.lastname: Koutlas
authors.forename: Iordanis
authors.initials: I
authors.lastname: Navrozoglou
authors.forename: Theodore
authors.initials: T
authors.lastname: Stefos
authors.forename: Minas
authors.initials: M
authors.lastname: Paschopoulos
mesh_terms: D004714:Endometrial Hyperplasia / Q000175:diagnosis / Q000473:pathology; D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000473:pathology; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000175:diagnosis / Q000473:pathology; D015907:Hysteroscopy / Q000379:methods*; D009214:Myoma / Q000175:diagnosis / Q000473:pathology; D011127:Polyps / Q000175:diagnosis / Q000473:pathology; D012680:Sensitivity and Specificity; D014592:Uterine Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000473:pathology