title: The value of hysteroscopic biopsy in the diagnosis of endometrial polyps.
abstract: Several studies have demonstrated that the combination of hysteroscopy with endometrial biopsy is more accurate in differentiating endometrial polyps from endometrial hyperplasia and cancer. However, blind biopsy not always confirms hysteroscopic findings due to high rates of inadequate or insufficient material. The objective of this clinical, prospective, and comparative study was to establish a correlation between the histological results of office-based endometrial biopsies (hysteroscopically guided and blind) with the surgical polypectomy specimens. We evaluated 82 patients with hysteroscopic diagnosis of endometrial polyp, who randomly underwent hysteroscopically guided biopsy or blind biopsy, referred for surgical resection. A total of 36 women (43.9%) underwent hysteroscopically guided biopsy and 46 women (56.1%) underwent blind biopsy. The sensitivity of hysteroscopically guided biopsy for the diagnosis of endometrial polyps ranged between 35.3 and 36.8%, when carried out at the apex and base of the lesion, compared with 29.2% for blind biopsy. Specificity was 33.3, 50, and 60%, respectively, for each biopsy. The positive predictive values were 75, 77.8, and 87.5%, and negative predictive values were 8.3, 14.3, and 8.1% respectively, compared with surgical polypectomy specimens. The office-based endometrial biopsies had low diagnostic accuracy for endometrial polyps compared with surgical polypectomy specimens.
authors.affiliation: Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University-FMB/UNESP, Botucatu, Brazil ddias.sp@fmb.unesp.br.
authors.forename: Daniel
authors.initials: D
authors.lastname: Spadoto-Dias
authors.affiliation: Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University-FMB/UNESP, Botucatu, Brazil.
authors.forename: Flávia Neves
authors.initials: FN
authors.lastname: Bueloni-Dias
authors.affiliation: Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University-FMB/UNESP, Botucatu, Brazil.
authors.forename: Leonardo Vieira
authors.initials: LV
authors.lastname: Elias
authors.affiliation: Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University-FMB/UNESP, Botucatu, Brazil.
authors.forename: Nilton José
authors.initials: NJ
authors.lastname: Leite
authors.affiliation: Instituto de Atendimento Médico Hospitalar-IAM, Assis, Brazil.
authors.forename: Waldir Pereira
authors.initials: WP
authors.lastname: Modotti
authors.affiliation: Department of Gynecology, Federal Fluminense University-UFF, Niterói, Brazil.
authors.forename: Ricardo Bassil
authors.initials: RB
authors.lastname: Lasmar
authors.affiliation: Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University-FMB/UNESP, Botucatu, Brazil.
authors.forename: Rogério
authors.initials: R
authors.lastname: Dias
mesh_terms: D000328:Adult; D001707:Biopsy, Needle / Q000379:methods; D001938:Brazil; D004714:Endometrial Hyperplasia / Q000473:pathology; D016889:Endometrial Neoplasms / Q000473:pathology; D004717:Endometrium / Q000473:pathology*; D005260:Female; D006801:Humans; D020702:Hysteroscopes; D015907:Hysteroscopy / Q000379:methods; D008875:Middle Aged; D011127:Polyps / Q000473:pathology*; D011446:Prospective Studies; D014591:Uterine Diseases / Q000473:pathology*
keywords: Biopsy or diagnosis or methods; histology; histology or diagnosis; hysteroscopy; polyps or anatomy