Which Endometrial Pathologies Need Intraoperative Frozen Sections?


Background: Endometrial cancers are the most common gynecologic cancers. Endometrial sampling is apreferred procedure for diagnosis of the endometrial pathology. It is performed routinely in many clinics priorto surgery in order to exclude an endometrial malignancy. We aimed to investigate the accuracy of endometrialsampling in the diagnosis of endometrial pathologies and which findings need intra-operative frozen sections.Materials and
Methods: Three hundred nine women applying to a university hospital and undergoing endometrialsampling and hysterectomy between 2010 and 2012 were included to this retrospective study. Data were retrievedfrom patient files and pathology archives.
Results: There was 17 patients with malignancy but endometrialsampling could detect this in only 10 of them. The endometrial sampling sensitivity and specificity of detectingcancer were 58.8% and 100%, with negative and positive predictive values of 97.6%, and 100%, respectively. In7 patients, the endometrial sampling failed to detect malignancy; 4 of these patients had a preoperative diagnosisof complex atypical endometrial hyperplasia and 2 patients had a post-menopausal endometrial polyps and 1with simple endometrial hyperplasia.
Conclusions: There is an increased risk of malignancy in post-menopausalwomen especially with endometrial polyps and complex atypia hyperplasia. Endometrial sampling is a goodchoice for the diagnosis of endometrial pathologies. However, the diagnosis should be confirmed by frozen sectionin patients with post-menopausal endometrial polyps and complex atypia hyperplasia.