Diagnostic Accuracy of Endometrial Suction Kit for Collection of Endometrial Sample Compared to Fractional Curettage Procedure in Diagnosis of Endometrial Hyperplasia/Endometrial Carcinoma

Background: Endometrial carcinoma is one of the most common gynecological malignancies in women. The diagnosis of the disease at early stage or at premalignant condition is crucial for the disease prognosis. Objective: To find out the diagnostic accuracy of the endometrial suction kit for diagnosing endometrial hyperplasia / endometrial carcinoma when fractional curettage is considered as gold standard. Methods: After taking informed written consent and matching eligibility criteria, a total eighty-four women from 40-70 years of age, were selected in this cross-sectional analytic study. This study was conducted in the department of gynecological oncology, BSMMU for one year from January 2019 to December 2019. At first endometrial sample was collected by Endometrial suction kit without anesthesia or analgesia and without cervical dilatation at ward. Then on the same day, fractional curettage was performed under general anesthesia in operating theater. The histopathology reports of the samples obtained by both procedures were compared and diagnostic accuracy of endometrial suction kit was determined. Histopathology reports of the samples obtained by fractional curettage was considered as the gold standard. Sampling duration, costs and complications of the both procedures were compared. Statistical analyses of the results were obtained by using window-based computer software devised with Statistical Packages for Social Sciences (SPSS-22). Results: The sensitivity, specificity, accuracy, PPV and NPV of Endometrial suction kit device for the diagnosis of endometrial hyperplasia with or without atypia and endometrial carcinoma were 100.0%. The sensitivity, specificity, accuracy, PPV and NPV of the device for diagnosing endometrial polyp were 31.3%, 98.5%, 85.7%, 83.3% and 85.9% respectively. The device had sensitivity, specificity, accuracy, PPV and NPV of 86.5%,89.4%,86.5%,89.4%,88.1% respectively in the evaluation of normal histology (proliferative, secretory, atrophic endometrium, chronic endometritis). About 87% of the samples obtained by Fractional curettage and 75% of the samples obtained by the Endometrial suction kit device were adequate for histopathological examination. But the adequacy of endometrial sample obtained by two methods had good agreement. Inadequate tissue was more frequent and polyp was less detected by endometrial suction kit biopsy than fractional curettage but the difference was not statistically significant (p=0.175). Endometrial suction kit procedure is also cost-effective and less time-consuming procedure. There was no major complication in both procedures. Conclusion: The Endometrial suction kit is a cost-effective, accurate outpatient procedure and has a high sensitivity and specificity for the detection of endometrial hyperplasia and endometrial carcinoma. So, it can be used as an initial diagnostic procedure. DOI: https://doi.org/10.52783/jchr.v15.i2.7971