Diagnostic performance of Cornier’ pipelle endometrial biopsy in comparison with dilatation and uterine curettage

T. Áron, S. Béla, L. Puşcaşiu, M. E. Căpîlna, L. Chira

Abstract: The main objective of the study was to determine the reliability of the Cornier’ pipelle endometrial biopsy in determining endometrial cancer, and the comparison of this with the gold standard method, dilatation and curettage. A number of 105 patients with indication of endometrial biopsy were included in this study. Initially the Cornier’ pipelle endometrial biopsy was achieved, followed immediately by dilatation and curettage. It was measure the insertion failure rate of the water gauge, the rate of the inadequacy specimen for histological assessment, agreement of histophatological results between the two methods, patients comfort and associated complications. The mean age of the patients included in the study was 53.8 years (SD 10,4; between 30 to 80 years). Majority of the patients were post-menopausal (54%) the rest of 30% being in perimenopausal period. In 9 cases (8,6%) from post-menopausal patients with cervical stenosis, Cornier’s pipelle water gauce could not be introduced into the uterine cavity than only after cervical dilatation and in 7 cases (6.7%) the Cornier’s pipelle method did not obtain sufficient material for histological examination. Kappa coeficient of 0.61 (p<.001) showed a substantial to moderate line between the two methods. Cornier’s pipelle endometrial biopsy detected 14 cases of endometrial cancer from 16, and in two cases was diagnosed complex hyperplasia with endometrium atypia, with suspicious invasion areas. Cornier’s pipelle sensibility method was 92.3% for simple hyperplasia, 61.5% for polyps and 59.4% for benign pathology of the endometrium. The Cornier’s pipelle method caused less pain than uterin curettage at patients taken in the study. In the cases in which this method cannot be used or the obtained sample is failure, it is recommended an additional evaluation of the patients. Cornier’s pipelle method is reliable, precise and convenient for detecting endometrial cancer, the sensibility of this being modest in diagnosis of benign pathology of the endometrium.
Keywords: curretage, biopsy, endometrium, cancer