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Query: UMLS:C0476089 (endometrial cancer)
 11,379 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A study was made of 201 asymptomatic women over age 40 (range, 40-74 years) who underwent uterine sounding and endometrial screening by the negative-pressure jet irrigation technique, without anesthesia, in private gynecologists' offices. Introduction of the irrigator was accomplished in 88 percent of these patients. In 97 percent of the successful irrigations, the specimens obtained were satisfactory for cytologic and histologic diagnosis of neoplasia. No occult endometrial carcinomas were discovered. The factors which interfered with endometrial screening by these methods are analyzed. Cervical stenosis prevented endometrial irrigation in 13 of the 24 unsuccessful attempts. Acceptance by the patients was high, in that 74.2 percent reported slight or no discomfort and only 4.7 percent complained of severe discomfort. Although 12.5 percent experienced pelvic cramping after irrigation, no other significant side effects were observed. The results of this investigation indicate the feasibility of using the endometrial irrigation technique for massive screening studies of asymptomatic women who are at risk for the development of endometrial carcinoma.
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PMID:Endometrial screening of asymptomatic women by irrigation technique in the private gynecology office. 83 42

Outpatient diagnostic hysteroscopy with endometrial sampling was performed in 160 women. The aim was to assess patient acceptance of the procedure when performed under para-cervical block. The most common indication was abnormal uterine bleeding. In 152 patients the procedure was successful, allowing thorough inspection of the uterine cavity, and in almost half of them no abnormality was detected. Thirty-one required subsequent elective admission, mainly for fibroid polypectomy. In most women the level of discomfort was assessed as 'tolerable', but in two the procedure was abandoned because of severe discomfort. Endometrial carcinoma was detected in six patients. There were no complications attributable to the procedure. Outpatient hysteroscopy considerably reduces the need for hospital admission and can provide early investigation for patients with a spectrum of gynaecological disorders, at low cost and with minimal facilities.
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PMID:Outpatient diagnostic hysteroscopy. 234 Feb 54

The cytologic diagnosis of endometrial cancer using material obtained with the Endocyte endometrial sampler was assessed for 874 patients. The samples obtained were smeared directly on slides for fixation and staining; the smears were more difficult to assess than cervicovaginal smears, however, due to the presence of blood, the small size and density of the cells and the flattened three-dimensional architecture of the tissue fragments obtained. Only 8.2% of the samples were classified as inadequate; repeat sampling in some of those cases produced diagnostic material. All 12 cases of carcinoma (including one case in a woman less than 40 years of age) were diagnosed by cytology as malignant; however, the original cytologic sample in one of those cases was inadequate. For the diagnosis of benign versus malignant, cytology had a sensitivity of 92%, a specificity of 100% and predictive value of 100%. Cytology also diagnosed as suspicious the smears from 5 of 13 cases of endometrial hyperplasia and 2 of the 9 cases of endometrial polyps. The cytologic findings for benign and malignant samples are described and illustrated in detail. Relative to other endometrial sampling devices, the Endocyte is inexpensive and was easily used by the gynecologist and well tolerated by the patients, with no complications and minimal discomfort.
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PMID:Endocyte endometrial smears in the cytodiagnosis of endometrial carcinoma. 234 95

Many gynecologists use routine endometrial sampling prior to hysterectomy to detect an unsuspected endometrial carcinoma. Gynecologists who formerly performed uterine curettage under anesthesia before hysterectomy now often use an outpatient endometrial sampling technique. Although safe, this procedure is complicated by discomfort, cost, and the risk of infection or uterine perforation. The purpose of this study was to determine the utility of pre-hysterectomy endometrial sampling. Between 1981-1985, 619 patients undergoing hysterectomy had preoperative endometrial sampling using Vabra aspiration, the Novak curette, or D&C. The endometrial sampling histology was compared with that in the hysterectomy specimen. There were 30 instances in which the endometrial sampling failed to identify either endometrial hyperplasia or carcinoma. In the two cases of endometrial carcinoma, D&C was the sampling method used. The findings of this study indicate that these three techniques of endometrial sampling are equal in their diagnostic capabilities. The results confirm the need for biopsy in patients with postmenopausal bleeding or with abnormal uterine bleeding at age 35 years or older. Our findings do not support routine endometrial sampling prior to hysterectomy.
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PMID:Endometrial sampling prior to hysterectomy. 291 64

A new disposable mechanical curette, the Inocurette, was used to obtain endometrial samples for histopathology and cytology. The instrument was tested on 120 patients; 37 patients were known from a previous conventional curettage (D & C) to have an endometrial cancer and 83 patients were referred to the County Hospital of Trelleborg for curettage because of dysfunctional bleedings. In all 120 patients a D & C followed the microcurettage procedure. The samples were randomized, coded and analyzed blind without any clinical information. In all but 3 patients with a known endometrial cancer, sufficient microcurettage sample material for either histopathology or cytology was obtained. In all but one of these 34 patients either a malignant diagnosis or seriously atypical cells were found. Using only cytology five out of 34 samples were designated adequate but normal. In a further 5 of the 37 patients the samples obtained at the subsequent D & C were inadequate for diagnosis; one sample was denoted as normal. In the 83 patients with dysfunctional bleedings, sufficient material for diagnosis after microcurettage, cytology and D & C was obtained in 74, 83 and 79 patients respectively. One endometrial cancer was disclosed by all three methods. Inocurette sampling causes little discomfort and requires no special training. The combined microcurettage--cytology procedure may be recommended as an alternative to conventional curettage, though, for the time being, D & C should not be replaced for cytology alone.
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PMID:Uterine microcurettage with combined endometrial histopathology and cytology. An alternative to conventional curettage. 321 56

To study the feasibility of endometrial sampling in a family physician's office we examined 42 asymptomatic women 50 years of age or older with the use of a Milan-Markley helix to obtain cytopathologic material. Nine procedures could not be completed because of stenosis of the introitus or cervix. The procedure took less than 3 minutes to complete for 30 women, and there was no technical difficulty for 27. Adequate amounts of tissue for diagnosis were obtained from 32 women. One or more risk factors for endometrial carcinoma were present in 34 women. Nine samples showed atypical hyperplasia. Although 37 women experienced discomfort and 19 experienced spotting, 35 were willing to have the procedure repeated annually or as indicated by their physician.
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PMID:Endometrial carcinoma: feasibility of case-finding in a family physician's office. 333 22

The Curity-Isaacs Endometrial Cell (CIEC) sampler was used for endometrial tissue and cell sampling in 230 patients before dilatation and curettage to determine the efficacy of its use as an outpatient endometrial sampler. Its use was found to be safe and without complication. It could be easily inserted into the uterine cavity in 92.0% of patients and did not cause undue discomfort in 88.9% of them. Using histopathological diagnostic techniques, there was 100% accuracy in the diagnosis of endometrial carcinoma. However, it was found that diagnostic accuracy of endometrial hyperplasia was only 33.3%. It is suggested that the CIEC sampler could be used as a first-line diagnostic procedure to exclude endometrial carcinoma in patients with abnormal vaginal bleeding.
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PMID:Diagnosis of endometrial carcinoma by histopathological examination of the endometrial aspirate by the Curity-Isaacs sampler. 343 62

The Isaacs Curity Endometrium Cell Sampler (ICECS) is a new device for the detection of precancerous lesions of the endometrium and asymptomatic endometrial carcinoma. Our clinical experience with the ICECS in a group of 136 women 45 years of age and older with an increased risk for endometrial cancer showed that it was easily used, caused minimal discomfort to the patients and gave good results. The cytologic smears were acceptable for screening in 130 of the 136 cases (95.6%). Normal premenopausal or postmenopausal endometrial cells were found in 100 cases. Hyperplastic changes were found in 18 cases. Carcinoma were diagnosed in 12 cases; all were proven by histologic examination of tissue obtained by curettage. Our results indicate that the new device is valuable for mass cytologic screening for endometrial cancer.
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PMID:Clinical experience with a new endometrial cell sampling kit (Isaacs curity endometrium cell sampler) in the early detection of endometrial cancer. 695 14

The woman past 65 years of age is as much in need of periodic gynecologic examinations and the ancillary tests used to diagnose early genital cancer as her premenopausal counterpart. Many gynecologic ills peculiar to the geriatric patient result from the tissue shrinkage that follows menopausal loss of estrogen secretion. Some of the resulting distress can be relieved by local estrogen or androgen therapy. A number of minor vulvar and vaginal disorders may appear with advancing age, often causing the patient discomfort and worry until she is reassured that they are benign. The incidence of some genital neoplasms declines after menopause, but several others--notably vulvar, vaginal, and endometrial carcinoma--actually increase in incidence as patients become older. Geriatric gynecology is not a separate discipline, but older women with genital disorders are a special group of people. Many are very old; some are sick. They are easily worried and frightened. They need not only awareness of their problems but also kindness, tact, gentleness, and thoughtfulness, all of which should be natural attributes of a physician.
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PMID:Gynecologic disorders in the geriatric patient. 705 78

Endometrial samples were obtained with the Accurette and the Vabra aspirator and were compared with samples obtained by dilation and curettage in 40 patients with postmenopausal bleeding. The degree of discomfort and patient acceptability of the two outpatient procedures, the adequacy of the samples for cytological and histological examination, and the cytological and histological diagnosis were compared. The Accurette and the Vabra aspirator could not be inserted in 5 out of 40 patients because of cervical stenosis. From approximately 30 of the remaining 35 patients, adequate samples were obtained. Six cases of endometrial hyperplasia and 3 of endometrial carcinoma were diagnosed by all the methods employed, except for 1 case of endometrial hyperplasia in which the sample obtained with the Accurette was inadequate for histological examination but was nevertheless adequate for cytological examination. Of the 5 patients in whom endometrial sampling by both the Accurette and the Vabra aspirator could not be performed because of cervical stenosis, 2 cases of endometrial carcinoma were found on uterine curettage. In patients with cervical stenosis, however, dilatation and curettage under general anaesthesia is mandatory. The Accurette has the advantage of being less expensive and more suitable for routine endometrial sampling for the detection of endometrial hyperplasia or carcinoma and dating of the endometrium in cases of infertility. Both the Accurette procedure and Vabra aspiration appeared to be reliable methods of obtaining endometrial samples.
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PMID:A comparison of endometrial sampling with the Accurette and Vabra aspirator and uterine curettage. 705 25


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