Endoskopie 2010; 19(2): 50-52

Significance of hysteroscopy in diagnostics of gynaecological malignancy - clinical experience

MUDr.Monika Dvorská¹, MUDr.Daniel Driák, Ph.D.¹, RNDr.Iva Švandová³, MUDr.Borek Sehnal¹, MUDr.Petr Holý¹, prof.MUDr.Michael Halaška, DrSc.¹, MUDr.Kamila Benková², MUDr.Zuzana Špůrková²

¹ Gynekologicko-porodnická klinika, 1 LF UK a FN Na Bulovce, Praha

² Oddělení patologie, FN Na Bulovce, Praha

³ Katedra fyziologie živočichů, Univerzita Karlova v Praze, Přírodovědecká fakulta

Objectives: Hysteroscopy provides optical evaluation of uterine cavity. Hysteroscopy can be performed in diagnostics, transcervical

surgery or lymphatic mapping in patients with endometrial cancer.

Endometrial cancer is the second most common malignancy of the female genital tract. Its incidence in the Czech Republic is 32/100,000

women and year with a permanent increasing tendency. The most controversial issue is the potential risk of microscopic extrauterine

dissemination of cancerous cells within the peritoneal cavity and circulation during hysteroscopy, and the question if the relatively high

pressure of distension medium used during hysteroscopies may or may not multiply the risk. The aim of our study was to verify presence

of malignant cells in peritoneal washing performed after previous hysteroscopy.

Materials and Methods: Totally, 407 endometrial biopsies were collected during years 2007–2009 at our clinic. In 56 patients, endometrial

cancer was diagnosed. Afterwards, 45 women underwent surgery, during which peritoneal washing (lavage) and cytological

examination were done.

Results: Fifty-six patients with histologically verified endometrial carcinoma were studied. The samples examined in the study were

classified by grading as follows: G1 n = 34, G1–2 n = 10, G2 n = 10, G3–4 n = 2. In 45 cases that underwent radical surgery, no cancerous

cells in peritoneal washings were found. Only in 1 case, the cytology obtained from peritoneal washing was considered to be suspicious.

In 9 cases, carcinoma on the base of the polyp was detected, and in 2 cases, no residuum of cancer was observed after hysterectomy.

Conclusion: In accordance with contemporary literature and based on result of our study, we suggest that hystero-resectoscopy does

not increase the risk of dissemination of malignant cells within the peritoneal cavity and does not worsen the prognosis of the disease.

On the contrary, the samples taken under visual control provide more precise and earlier diagnostics of endometrial cancer.

Keywords: endometrial cancer, dilatation & curretage, hysteroscopy

Published: June 1, 2010  Show citation