Office aspiration curettage of the endometrium

Postmenopausal endometrial patterns and serum estradiol concentrations

Eighty postmenopausal women were subjected to endometrial biopsy. Inadequate biopsy was recorded in 30 cases. In the remaining cases (n = 50) the correlation between endometrial patterns and serum estradiol (E2) was performed. These cases were presenting with uterine bleeding (n = 38) or minor gynecological symptoms (n = 12). Proliferative endometrium was the predominant endometrial pattern whereas endometrial malignancy was only present in 15.8% of the bleeding cases. Serum E2 was significantly elevated in cases having malignant endometrium or adenomatous hyperplasia compared to cases having other endometrial patterns. Serum E2 measurement is recommended as a simple screening test for the detection of postmenopausal endometrial hyperplasia and/or malignancy.

Delayed diagnosis of endometrial cancer in Italy

This study considers the prevalence of early bleeding in a series of 173 cases of endometrial cancer, with particular reference to the lag time between the onset of symptoms and diagnosis. The length of this interval is examined in the light of patients' and tumor characteristics. Findings show a general delay in endometrial cancer diagnosis in the population studied. In addition there was a significant trend towards worsening of the tumor stage, depth of myometrial invasion and histological differentiation with increasing delay, thus underlining the need for more care in detection of endometrial cancer.

The cytologic diagnosis of endometrial adenocarcinoma

An outpatient diagnositc technique comparable to the Papanicolaou smear for carcinoma of the cervix is needed to permit early recognition of adenocarcinoma of the endometrium. Five different techniques of sampling the endometrial cavity were carried out on 1, 742 patients at the University of Michigan Medical Center. A total of 2,553 specimens were correlated with operating room curettings to assess the accuracy of each sampling technique. The methods of saline irrigation with an antrum cannula, endometrial brush sampling, high-vacuum aspiration, and the Gravlee jet washer proved not to be accurate enough to be used as a routine screeening test. There was excellent correlation (96 per cent) between endometrial biopsies and curettings. In our experience, endometrial biopsy with a suction or basket curette was the diagnostic technique short of curettage which permitted accurate diagnosis.