MICROCURETTAGE SAMPLING OF THE ENDOMETRIUM FOR HISTOPATHOLOGICAL EXAMINATION - SIMPLER BUT NOT SAFE - COMPARISON OF ENDOMETRIAL HISTOPATHOLOGY IN SAMPLES OBTAINED BY A DISPOSABLE MECHANICAL CURETTE AND BY TRADITIONAL CURETTAGE

The routine use of dilatation and curettage (D&C) is questioned as a s tandard procedure for endometrial sampling. Instruments have been deve loped in order to simplify the procedure. The aim of the present study was to estimate the sensitivity to detect malignancy/premalignancy by histological exmination of endometrial samples obtained by microcuret tage using a disposable plastic curette, Gynoscann(R). The histologica l examination of the combined microcurettage and D&C material was defi ned as the true diagnosis. All patients undergoing diagnostic D&C at t he two participating hospitals were included in the study. The endomet rial samples were evaluated at the Department of Pathology as part of their routine work. The microcurettage samples were re-examined indepe ndently by two pathologists (observer 1 and observer 2) who did not ha ve access to the rest of the tissue material nor the diagnosis given p reviously. A total of 902 patients were enrolled in the study. Endomet rial cancer was found in four women below 50 years of age. None of the se were detected by histological examination of the Gynoscann(R) obtai ned sample. Among women aged 50 and above, samples from 16 women turne d out to have endometrial cancer. The microcurettage samples were corr ectly classified as malignant/premalignant by observer 1 in 13 cases a nd by observer 2 in 14 cases. We conclude that diagnostic D&C among wo men 50 years and below cannot be replaced by histologlcal examination of Gynoscann(R) samples without the risk of overlooking significant pa thology.