This study aims to evaluate the diagnostic accuracy of the Pipelle biopsy based on sensitivity and specificity in women with abnormal uterine bleeding. This retrospective observational study included women who reported abnormal uterine bleeding and underwent endometrial sampling via a Pipelle, followed by hysterectomy at a Turkish tertiary hospital. Women with abnormal uterine bleeding were excluded from the study if they underwent hysteroscopy for biopsy, dilation and curettage, or if their data could not be accessed. All women with abnormal uterine bleeding underwent an endometrial Pipelle biopsy using an index test. Women who underwent hysterectomy were used as references. The study confirmed the sensitivity, specificity, predictive values, and accuracy of the Pipelle biopsy for various endometrial diseases. A total of 501 patients were definitively assessed for eligibility. Of them, 45 were excluded from the study. Finally, 456 patients were retained. The Pipelle endometrial biopsy is a reliable method for detecting endometrial cancer, with a sensitivity of 88.63% and a specificity of 100%. It has a perfect positive predictive value of 100% and a high negative predictive value of 98.80%, ensuring reliability. Its overall diagnostic accuracy of 98.90% confirms its superiority in diagnosis. Eighty-one endometrial polyps were detected in the hysterectomy specimens, but only 27 (33.33%) could be diagnosed using a Pipelle biopsy. The assessment of endometrial polyps shows a sensitivity of 33.33%, specificity of 88.00%, a positive predictive value of 37.50%, and a negative predictive value of 85.93%. The diagnostic accuracy of endometrial polyps was 78.25%. Pipelle biopsy is a highly effective and straightforward method for diagnosing endometrial cancer. Early diagnosis is crucial and significantly enhances treatment options. However, the polyps could not be identified. A positive biopsy result definitively confirms the diagnosis; however, a negative biopsy result does not eliminate the possibility of endometrial disease.
Oncu et al. (Fri,) studied this question.