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Archives of Gynecology and Obstetrics
Published in: Archives of Gynecology and Obstetrics 6/2023

Open Access 22-09-2023 | Hysteroscopy | General Gynecology

Hysteroscopic versus histopathological agreement in the diagnosis of chronic endometritis: results from a retrospective observational study

Authors: Belén Almoguera Pérez-Cejuela, Salvatore Giovanni Vitale, Tirso Pérez-Medina, Mar Rios-Vallejo, Luigi Della Corte, Ana Royuela Vicente, Stefano Angioni, Laura Calles-Sastre

Published in: Archives of Gynecology and Obstetrics | Issue 6/2023

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Abstract

Purpose

To evaluate the agreement rate between hysteroscopy and pathological examination in case of chronic endometritis.

Methods

A retrospective observational study carried out at Gynecology and Obstetrics Department, Puerta de Hierro Hospital, Autónoma University of Madrid, Spain, from January 2021 to June 2022 was performed by obtaining data from 115 medical records of women who underwent office hysteroscopies that was compared with the findings of final histological examination of endometrial biopsy. Cohen's kappa index was used to evaluate this agreement rate. In addition, sensitivity, specificity, positive and negative predictive value and diagnostic accuracy were obtained.

Results

The agreement between hysteroscopic findings and histological examination showed a modest result with a Cohen’s kappa index of 34%. In addition, we obtained a specificity of 70% and a sensitivity of 64%. The positive and negative predictive value were 60.8% and 73.4%, respectively. An excellent agreement rate (100%) between histological and hysteroscopic results was observed in presence of hyperemia and micropolyps.

Conclusion

Although the sample size is not as large as that of other studies published so far, the first glance of our experience is that hysteroscopic signs are not yet sufficient to make an accurate diagnosis of chronic endometritis, thus requiring a histopathological confirmation to make it.
Literature
1.
Cravello L, Porcu G, D’Ercole C, Roger V, Blanc B (1997) Identification and treatment of endometritis. Contracept Fertil Sex 25:585–586 PubMed
2.
Kitaya K, Yasuo T (2011) Immunohistochemistrical and clinicopathological characterization of chronic endometritis. Am J Reprod Immunol 66(5):410–415 CrossRefPubMed
3.
Greenwood SM, Moran JJ (1981) Chronic endometritis: morphologic and clinical observations. Obstet Gynecol 58:176–184 PubMed
4.
Farooki MA (1967) Epidemiology and pathology of chronic endometritis. Int Surg 48:566–573 PubMed
5.
Cicinelli E, Vitagliano A, Kumar A, Lasmar RB, Bettocchi S, Haimovich S, International Working Group for Standardization of Chronic Endometritis Diagnosis (2019) Unified diagnostic criteria for chronic endometritis at fluid hysteroscopy: proposal and reliability evaluation through an international randomized-controlled observer study. Fertil Steril 112(1):162–173 CrossRefPubMed
6.
Marín Montes A (2021) Endometritis crónica y reproducción: revisión de la literatura. Revista Iberoamericana de Fertilidad y Reproducción Humana 38:Enero-Febrero-Marzo
7.
Moreno I, Cicinelli E, Garcia-Grau I, Gonzalez-Monfort M, Bau D, Vilella F et al (2018) The diagnosis of chronic endometritis in infertile asymptomatic women: a comparative study of histology, microbial cultures, hysteroscopy, and molecular microbiology. Am J Obstet Gynecol 218(6):602 CrossRef
8.
Liu H, Song J, Zhang F, Li J, Kong W, Lv S et al (2020) A new hysteroscopic scoring system for diagnosing chronic endometritis. J Minim Invasive Gynecol 27(5):1127–1132 CrossRefPubMed
9.
Vitale SG, Buzzaccarini G, Riemma G, Pacheco LA, Di Spiezio Sardo A, Carugno J et al (2023) Endometrial biopsy: indications, techniques and recommendations. An evidence-based guideline for clinical practice. J Gynecol Obstet Hum Reprod. 52(6):102588 CrossRefPubMed
10.
Di Spiezio SA, De Angelis MC, Della Corte L, Carugno J, Zizolfi B, Guadagno E et al (2020) Should endometrial biopsy under direct hysteroscopic visualization using the grasp technique become the new gold standard for the preoperative evaluation of the patient with endometrial cancer? Gynecol Oncol 158(2):347–353 CrossRef
11.
Vitale SG, Laganà AS, Caruso S, Garzon S, Vecchio GM, La Rosa VL et al (2021) Comparison of three biopsy forceps for hysteroscopic endometrial biopsy in postmenopausal patients (HYGREB-1): a multicenter, single-blind randomized clinical trial. Int J Gynaecol Obstet 155(3):425–432 CrossRefPubMed
12.
Kato H, Yamagishi Y, Hagihara M, Hirai J, Asai N, Shibata Y et al (2022) Systematic review and meta-analysis for impacts of oral antibiotic treatment on pregnancy outcomes in chronic endometritis patients. J Infect Chemother 28(5):610–615 CrossRefPubMed
13.
Cicinelli E, Resta L, Loizzi V, Pinto V, Santarsiero C, Cicinelli R et al (2021) Antibiotic therapy versus no treatment for chronic endometritis: a case-control study. Fertil Steril 115:1541–1548 CrossRefPubMed
14.
Murtinger M, Wirleitner B, Spitzer D, Bralo H, Miglar S, Schuff M (2022) Diagnosing chronic endometritis: when simplification fails to clarify. Hum Reprod Open 2022:hoac023 CrossRefPubMedPubMedCentral
15.
Bayer-Garner IB, Korourian S (2001) Plasma cells in chronic endometritis are easily identified when stained with syndecan-1. Mod Pathol 14(9):877–879 CrossRefPubMed
16.
Nomiyama M, Yamasaki F, Tokunaga M, Ohbuchi Y, Sago N, Arima K, Nishiyama W, Hashiguchi M, Kojima K (2021) Endometrial polyps with increased plasma cells are associated with chronic endometritis in infertility patients: hysteroscopic findings and post-polypectomy pregnancy rates. Reprod Med Biol 20(4):494–504 CrossRefPubMedPubMedCentral
17.
Riemma G, Vitale SG, Manchanda R, Rathore A, Török P, De Angelis C et al (2022) The role of hysteroscopy in reproductive surgery: today and tomorrow. J Gynecol Obstet Hum Reprod 51(4):102350 CrossRefPubMed
18.
Matteo M, Cicinelli E, Greco P, Massenzio F, Baldini D, Falagario T et al (2009) Abnormal pattern of lymphocyte subpopulations in the endometrium of infertile women with chronic endometritis. Am J Reprod Immunol 61(5):322–329 CrossRefPubMed
19.
Della Corte L, Vitale SG, Foreste V, Riemma G, Ferrari F, Noventa M et al (2021) Novel diagnostic approaches to intrauterine neoplasm in fertile age: sonography and hysteroscopy. Minim Invasive Ther Allied Technol 30(5):288–295 CrossRefPubMed
20.
Vitale SG, Laganà AS, Török P, Lasmar RB, Carugno J, Palumbo M et al (2022) Virtual sonographic hysteroscopy in assisted reproduction: a retrospective cost-effectiveness analysis. Int J Gynaecol Obstet 156(1):112–118 CrossRefPubMed
21.
Chiofalo B, Palmara V, Vilos GA, Pacheco LA, Lasmar RB, Shawki O et al (2021) Reproductive outcomes of infertile women undergoing “see and treat” office hysteroscopy: a retrospective observational study. Minim Invasive Ther Allied Technol 30(3):147–153 CrossRefPubMed
22.
23.
Vitale SG, Riemma G, Alonso Pacheco L, Carugno J, Haimovich S, Tesarik J et al (2021) Hysteroscopic endometrial biopsy: from indications to instrumentation and techniques. A call to action. Minim Invasive Ther Allied Technol 30(5):251–262 CrossRefPubMed
24.
Cicinelli E, Tinelli R, Lepera A, Pinto V, Fucci M, Resta L (2010) Correspondence between hysteroscopic and histologic findings in women with chronic endometritis. Acta Obstet Gynecol Scand 89(8):1061–1065 CrossRefPubMed
Metadata
Title
Hysteroscopic versus histopathological agreement in the diagnosis of chronic endometritis: results from a retrospective observational study
Authors
Belén Almoguera Pérez-Cejuela
Salvatore Giovanni Vitale
Tirso Pérez-Medina
Mar Rios-Vallejo
Luigi Della Corte
Ana Royuela Vicente
Stefano Angioni
Laura Calles-Sastre
Publication date
22-09-2023
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 6/2023
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-023-07163-w

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