EFFICACY OF THE ENDO-PAP SAMPLER IN DETECTING ENDOMETRIAL LESIONS

OBJECTIVE: To determine the efficacy of the Endo-pap sampler, a device used to collect endometrial tissue fragments for cytologic examinatio n, in detecting endometrial lesions. STUDY DESIGN: Reports from 1,983 Endo-pap smears collected from 1,248 outpatients over a 44-month perio d were retrospectively examined in conjunction with corresponding biop sy or hysterectomy reports. Endo-pap smears, histologic sections and c linical information were reviewed in cases originally reported as abno rmal. RESULTS: Endometrial abnormalities were reported in 29 Endo-pap smears (1.5%). Among 21 reported as atypical, follow-up was normal in 19 but revealed hyperplasia in 1 and hyperplasia with a focus of carci noma in 1 on histologic examination. Three were interpreted as maligna nt and one as suspicious; all had adenocarcinoma at endometrial biopsy . Endometrial abnormalities were reported in 19 of 220 patients who un derwent endometrial biopsy following a previous Endo-pap smear reporte d as negative for malignancy. Their diagnoses included endometrial pol yps (14), hyperplasia without atypia (3), atypical hyperplasia (1) and endometrial adenocarcinoma (1) three years after a negative Endo-pap smear. CONCLUSION: Although the sensitivity and specificity for malign ancy were 100%, the overall sensitivity for any pathologic lesion was only 28%. We recommend proceeding directly to endometrial biopsy for a conclusive diagnosis in symptomatic patients.