Correlation of Endometrial Biopsy histology with Post Hysterectomy histopathology in Abnormal uterine bleeding

Background: Abnormal uterine bleeding (AUB) is the most common presenting complaint among gynecological outpatients and occurs in all age groups in women. In women with AUB, detecting endometrial pathologies at an earlier stage plays an important role in treating them. The standard diagnostic procedure of choice is Endometrial biopsy; therefore, a minimally invasive outpatient procedure is preferred which is a Pipelle endometrial biopsy.
Objectives: To examine the morphological pattern of endometrial biopsies and find the correlation between endometrial biopsy histology with post hysterectomy histopathology.
Methods: A retrospective study was conducted among 100 women within the age group between 35 to 65 years with complaints of abnormal uterine bleeding from January 2023 to October 2023. All the patients underwent endometrial biopsy (with Pipelle endometrial biopsy) and were examined for histopathological changes to study the morphological pattern and further compared them with post operative histopathology reports of the women who underwent hysterectomies for various causes like symptomatic fibroids, polyps and in failed medical management. The data was collected and tabulated in Microsoft excel sheet and the percentages were calculated.
Results: This study included 100 women with abnormal uterine bleeding, aged between 35 and 65 years. The endometrial biopsy morphology was studied for all the patients, where 82 (82%) showed normal endometrium showing either proliferative (40) or secretory phase (42), 5 (5%) had carcinoma including (both endometrium and cervix), 4 (4%) had precancerous lesions, 4 (4%) had endometrial hyperplasia with atypia, 3 (3%) had endometrial hyperplasia without atypia and 2 (2%) had polyps respectively. We correlated between endometrial biopsy and post hysterectomy histopathological examination among women who underwent hysterectomies for symptomatic fibroid, polyps and failed medical management. The proliferative phase and secretory phase endometrium were 51% in hysterectomy HPE when compared with endometrial biopsy which was 82% which showed some differences, however it was consistent among the other findings.
Conclusion: We conclude that, endometrial biopsy is a good diagnostic tool for identifying endometrial hyperplasia, endometrial cancer, and has a good post-hysterectomy correlation.