Background: Endometrial aspiration cytology has long been undermined, but has now emerged as a powerful yet cost effective tool for diagnosing DUB in resource limited settings.                   

Purpose: The current study compares the accuracy of EAC with HPE as gold standard in diagnosis of   DUB in women. It also determines the various morphologic patterns of endometrium in DUB.

Methods: 70 women diagnosed as DUB were subjected to endometrial aspiration with 4mm Karman’s cannula and MR syringe prior to D&C and HPE sampling. Data was compiled & analysed with SPSS 18 package. Patients were analysed based on socioeconomic, clinical parameters; cytological diagnosis was compared against HPE diagnosis based on sensitivity, specificity, diagnostic accuracy. 

Result: EAC showed a sampling adequacy of 90%. The commonest lesion detected was proliferative endometrium followed by secretory endometrium and hyperplasia without atypia. Sensitivity for detecting proliferative endometrium was 100%, specificity 89.2% and accuracy of 89.2% against gold standard HPE. Sensitivity for detecting secretory endometrium was 100%, specificity 92.8% and accuracy was 88.5%. Sensitivity and specificity of detecting hyperplasia by aspiration cytology was 64% and 100% respectively. Accuracy was 90%. Sensitivity of aspiration cytology in detecting adenocarcinoma was 50% and specificity was 100% in this study with Accuracy of detection being 97% in this study.

Conclusion: Endometrial aspiration is an effective, useful and a minimally invasive procedure comparing with gold standard HPE.

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Dr PS. Shangreihow

Post Graduate Trainee, Dept. of Obs. & Gynae, JNIMS, Imphal Manipur