UČINKOVITOST UPORABE MATERNIČNE ČETKICE PRI DOBIVANJU UZORAKA I DIJAGNOSTICI ENDOMETRIJSKIH LEZIJA

Ines Krivak Bolanča, Suzana Katalenić Simon, Tanja Bota, Danijela Vincetić

Endometrijski karcinom najčešća je invazivna neoplazma ženskoga genitalnog trakta s rastućom incidencijom u posljednjim desetljećima. Cilj je ovog rada upozoriti na učinkovitost metode ma-terničnog četkanja (uterobrush) pri dobivanju uzoraka materništa i postavljanju citološke di-jagnoze endometrijskih lezija. Materijal i metode: Tijekom godine dana četkicom su uzeti uzorci materništa od 162 simptomatske bolesnice u perimenopauzi i postmenopauzi koje su došle u Kliniku za ženske bolesti i porode KB-a Merkur. Patohistološke dijagnoze, dobivene nakon frakcionirane kiretaže (n = 36) ili nakon kirurškog zahvata (n = 16), usporedilo se s postavljenim citološkim dijagnozama, a 97 bolesnica pratilo se godišnjim ultrazvučnim pregledima. Iz istraživanja su isključeni uzorci neadekvatni za analizu. Rezultati: Citološka dijagnoza postavlje-na s pomoću metode materničnog četkanja bila je u skladu s patohistološkom dijagnozom u 69,2% (36/52) bolesnica. Citološki i histološki potvrđeni su: sedam karcinoma, ukupno 13 hiper-plazija endometrija, jedan polip te 14 nalaza s benignim promjenama. Pacijentice praćene ul-trazvukom nisu više imale ginekoloških simptoma. Zaključak: Uporaba maternične četkice omogućuje dobivanje prikladnog i reprezentativnog uzorka materništa za prepoznavanje lezija endometrija i sudjeluje u postupniku obrade simptomatskih bolesnica.

Objective: Endometrial carcinoma is the most common invasive neoplasm of the female genital tract, with a rising incidence over the past few decades. The aim of the study was to evaluate the efficacy of endometrial cytology using uterobrush in the collection of samples and diagnosis of endometrial lesions. Methods and examinees: During the 12-month period direct endometrial samples by uterobrush were collected from 162 perimenopausal or postmenopausal symptomatic patients at Gynaecology Department at Merkur University Hospital. Results were compared with histology of the endometrium obtained by dilatation and curettage (n= 36), or hysterectomy (n=16), or the patients follow –up mainly by ultrasonography (n=97). Inadequate samples were excluded from the study. Results: Cytological findings were confirmed by histology in 69.2% (36/52) of cases. Seven cancers, 13 hyperplasias, one polyp and 14 benign disorders were diag-nosed and confirmed by histology. After using uterobrush device, patients who were followed-up by ultrasonography showed no gynaecological symptoms. Conclusion: Endometrial cytology by using uterobrush method can provide direct, adequate and representative endometrial sample. Cytology can recognise endometrial lesions and provide data for an algorithm for further evalua-tion of symptomatic patients.