Can Hysteroscopy Reliably Detect a Malignity?(Analysis of 1200 Hysteroscopic Findings)

Overview

Objective:
The aim of this study was retrospective analysis of how accurate was per-operationalvisual evaluation of malign process in an uterus cavity during hysteroscopy. And to evaluatewhether increasing experience of hysteroscopiers leads to significant accuracy considering theneoplasm of an uterus cavity.Setting: Department of Gynaecology and Obstetrics, Havířov.Method: In Havířov Hospital, 1.200 hysteroscopies altogether were performed in the period fromDecember 1995 to March 1999. In this group, there were 26 cases of histologically verified endo-metrial cancer. The authors retrospectively attempted to evaluate how accurately the suspecteddisorder was already stated during the per-operational hysteroscopy. The advantage of compa-ring the sub-group was taken in the first 690 hysteroscopies, of which the complex analysis waspublisched in Čs. Gynekologie 5/98, and in the sub-group of 510 hysteroscopies performed in thefollowing period, to state whether experience can more precisely define the per-operational ma-lignity recognition. The statistical analysis was performed by means of the Fischer exact test ofnumerical charts. Among other things, the MEDLINE database was used during discussion.Results: The endometrial cancer was encountered 26 times altogether, it means in 2.2% cases ofhysteroscopies. Carcinoma in situ occured three times, the stage IA three times, IB 17 times, ICthree times. A hysteroscopier described the negative finding incorrectly 13 times altogether, itmeans 50% of all cases. The sensitivity and the specificity of hysteroscopy for endometrial cancerprediction was 50% and 99.5% (P

Key words:
hysteroscopy, endometrial neoplasm, endometrium, adenocarcinoma-diagnosis