Xiaohua Chen1, Fenglang Xiao1, Qingfeng Xue1, Ling Lu1, Meiyuan Jin2, Yingyu Yao2,*
1Department of Obstetrics and Gynecology, Wuxing District People's Hospital of Huzhou City (Wuxing District Maternal and Child Health Hospital of Huzhou City), Huzhou 313000, Zhejiang, China.
2Department of Obstetrics and Gynecology, Tongde Hospital of Zhejiang Province, Hangzhou 310013, Zhejiang, China.
*Corresponding author: Yingyu Yao
Funding: This paper is supported by the Huzhou City Science and Technology Bureau Project (2021GYB43).
Abstract
Objective: To explore the factors affecting the success and failure rates of endometrial biopsy by comparing the accuracy of pathological diagnosis of endometrial tissue obtained by endometrial suction biopsy and diagnostic curettage, and to provide help for clinical selection of appropriate techniques for endometrial biopsy. Methods: A total of 180 patients who received endometrial suction biopsy and diagnostic curettage endometrial pathological examination in our hospital from January 2019 to December 2023 were analyzed, including 90 cases in the study group who received endometrial suction biopsy and 90 cases in the control group who received diagnostic curettage. The pathological diagnosis of diagnostic curettage was used as the gold standard to evaluate the accuracy of using endo-metrial suction biopsy and to analyze the related factors of failure. Results: Among the 180 patients, 9 patients had sampling failure, including 8 cases of endometrial suction biopsy failure (4.40%); among the 171 cases (95.00%) of successful endometrial suction biopsy and diagnostic curettage, the insufficient endometrial suction biopsy sampling was 8.89% (8/90); among the 82 cases of patients with sufficient endometrial sampling, the inconsistency of diagnostic curettage pathology was 15.85% (13/82). Multivariate regression analysis showed that menopause status, cervical surgery history, and ultrasonography suggesting uterine volume were related factors affecting the successful implementation of endometrial suction biopsy. Menopause status and ultrasonography suggesting endometrial thickness < 7 mm were associated with insufficient endometrial suction biopsy sampling. The inconsistency of pathology of endometrial hyperplasia was 27.58% (24/87), endometrial atypical hyperplasia and endometrial cancer were 28.57% (2/7), and endometrial polyps were 64.28% (9/14). Conclusion: Endometrial suction biopsy is a simple and effective method, but endometrial suction biopsy is more likely to miss a diagnosis in postmenopausal women, with a history of cervical surgery and cases of focal lesions, and it needs to be used with caution. Therefore, when choosing a method of endometrial biopsy, comprehensive consideration should be given. In addition, endometrial sampling failure is related to personnel operation, and relevant training should be carried out before using this technology.
References
[1] Cornier E. The Pipelle: a disposable device for endometrial biopsy. Am J Obstet Gynecol. 2017;148(1):109-110.
[2] Narice BF, Delaney B, Dickson JM. Endometrial sampling in low-risk patients with abnormal uterine bleeding: a systematic review and meta-synthesis. BMC Fam Pract. 2021;19(1):135.
[3] Du J, Li Y, Lv S, et al. Endometrial sampling devices for early diagnosis of endometrial lesions. Cancer Res Clin Oncol. 2022;142(12):2515-2522.
[4] Ewies AA, Shaaban KA, Merard R, et al. Endometrial biopsy in women with abnormal uterine bleeding: inadequate and unassessable categorisation is not clinically relevant. J Clin Pathol. 2022;67(8):673-677.
[5] Piatek S, Panek G, Wielgos M. Assessment of the usefulness of pipelle biopsy in gynecological diagnostics. Ginekologia Polska. 2023;87(8):559-564.
[6] Adambekov S, Goughnour SL, Mansuria S, et al. Patient and provider factors associated with endometrial Pipelle sampling failure. Gynecol Oncol. 2024;144(2):324-328.
[7] Rezk M, Dawood R, Masood A. The safety and acceptability of Pipelle endometrial sampling in premenopausal women in comparison to postmenopausal women with abnormal uterine bleeding. Minerva Ginecol. 2023;68(5):492-496.
[8] Piatek S, Warzecha D, Kisielewski F, et al. Pipelle biopsy and dilatation and curettage in clinical practice: are factors affecting their effectiveness the same? Obstet Gynaecol Res. 2024;45(3):645-651.
[9] Xie B, Qian C, Yang B, et al. Risk factors for unsuccessful office-based endometrial biopsy: a comparative study of office-based endometrial biopsy (pipelle) and diagnostic dilation and curettage. J Minim Invasive Gynecol. 2024;25(4):724-729.
[10] Yi Y, Bryce CL, Adambekov S, et al. Cost-effectiveness analysis of biopsy strategies for endometrial cancer diagnosis in women with postmenopausal bleeding: Pipelle sampling curette versus dilatation & curettage. Gynecol Oncol. 2024;150(1):112-118.
[11] Reijnen C, Visser NCM, Bulten J, et al. Diagnostic accuracy of endometrial biopsy in relation to the amount of tissue. J Clin Pathol. 2023;70(11):941-946.
[12] Ilavarasi CR, Jyothi GS, Alva NK. Study of the efficacy of pipelle biopsy technique to diagnose endometrial diseases in abnormal uterine bleeding. J Midlife Health. 2020;10(2):75-80.
[13] Piriyev E, Mellin W, Römer T. Comparison of aspirating pipettes and hysteroscopy with curettage. Arch Gynecol Obstet. 2020;301(6):1485-1492.
[14] Utida GM, Kulak J Jr. Hysteroscopic and aspiration biopsies in the histologic evaluation of the endometrium, a comparative study. Medicine (Baltimore). 2024;98(40):e17183.
[15] Guido RS, Kanbour-Shakir A, Rulin MC, et al. Pipelle endometrial sampling. Sensitivity in the detection of endometrial cancer. Reprod Med. 2022;40(8):553-555.
How to cite this paper
Endometrial Suction Biopsy for Screening Endometrial Lesions: Success Rate and Risk Factors Analysis Research
How to cite this paper: Xiaohua Chen, Fenglang Xiao, Qingfeng Xue, Ling Lu, Meiyuan Jin, Yingyu Yao. (2025) Endometrial Suction Biopsy for Screening Endometrial Lesions: Success Rate and Risk Factors Analysis Research. International Journal of Clinical and Experimental Medicine Research, 9(5), 527-533.
DOI: http://dx.doi.org/10.26855/ijcemr.2025.09.006