Hysteroscopy reveals diagnostic accuracy disparities in benign vs. malignant endometrial processes, indicating better outcomes for benign cases.
Research purpose. To develop differential diagnostics of benigh and malignant hyperplastic processes of endometrium. Materials and methods. All patients which entered in research parted on three groups of comparison depending on character of pathology of endometrium: I a group is 138 patients with the of benigh hyperplastic processes of endometrium; The II group is 509 patients with the cancer of endometrium part on three sub-groups: IIа - 200 patients from highly differentiated adenocarcinoma; IIв - 171 sick with moderately differentiated adenocarcinoma; IIс - 138 patients with low-grade differentiated adenocarcinoma; The III group is 67 patients without pathology of endometrium. The laboratory methods of researches were included by biochemical, endocrinology and immunological indexes. Results. At comparison of information of hysteroscopy with the results of histological research of operating material, divergence of diagnoses was marked only in 4 (2,9%) cases. At histological research of these cases simple hyperplasia was verified, that glandular hyperplasia of endometrium. We defined that than higher degree of differentiation of adenocarcinoma of endometrium, the more so the amount of cases of discrepancy of diagnoses (mainly toward false-positive diagnostics of benigh hyperplastic processes of endometrium) is marked and vice versa, - diagnostic exactness, specificity and test-sensitivity, grow as far as diminishing of degree of differentiation of malignant tumour of uterus. It was also set that specificity, sensitiveness and diagnostic exactness of hysteroscopy higher at diagnostics of benigh hyperplastic processes of endometrium, what at diagnostics of malignant processes of cavity of uterus. Consequently, we are set high specificity (from 81,6% to 95,4%), sensitiveness (from 78,2% to 91,2%) and diagnostic exactness (from 82,4% to 95,8%) of method of benigh on the stage of preoperative diagnostics at the of benigh hyperplastic processes of endometrium and by a endometrial cancer. Conclusion. Combined use of hysteroscopic and ultrasonic information, and also indexes of intracellular metabolism of enzymes, lipid peroxidation and antioxidant system, is the high-informing methods of differential diagnostics of benigh and malignant hyperplasia of endometrium on preclinical and pre-hospital stages.
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Yuliya V. Strakhovetska (2025) studied this question.
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