# The Clinicopathological Comparison of Diagnostic Curettage and Total Abdominal Hysterectomy Results in Patients with Endometrial Cancer Referred to Shahid Sadoughi Hospital, Yazd, During the Years 2019 To 2023: The Diagnostic Accuracy of Curettage in Endometrial Cancer

## TL;DR

This study compares the accuracy of diagnostic curettage and total abdominal hysterectomy in diagnosing endometrial cancer, finding that curettage is generally reliable but has limitations.

## Contribution

The study provides new clinicopathological evidence on the diagnostic accuracy of curettage in endometrial cancer compared to hysterectomy.

## Key findings

- Diagnostic curettage showed 84.21% sensitivity and 83.33% specificity in detecting endometrial cancer.
- The kappa coefficient of 0.587 indicates moderate agreement between curettage and hysterectomy results.
- Curettage is a relatively suitable diagnostic method but has lower positive predictive value, requiring caution.

## Abstract

The use of curettage in diagnosing endometrial disorders the most common
diagnostic method before performing hysterectomy. The previous studies
showed that curettage is an inadequate diagnostic method for focal uterine
lesions but has high diagnostic accuracy in endometrial hyperplasia and
carcinoma. The objective of the present study is to compare the
clinicopathological results of diagnostic curettage and total abdominal
hysterectomy in patients with endometrial cancer.

This cross-sectional analytical study was conducted on 85 women with
endometrial cancer; 19 high and 66 with low tumor grade between 21.3.2019
and 19.03.2024 who underwent diagnostic curettage and total abdominal. All
reports related to pathology samples were extracted according to the
inclusion and exclusion criteria of the study. All the information required
for the study including the pathological result of diagnostic curettage, the
pathological result of a total abdominal hysterectomy, tumor grade was
extracted. the statistical tests of Fisher’s Exact Test, Chi-Square Tests
were used in SPSS 22.0 software; the significance level was considered equal
to 0.05. Furthermore, sensitivity, specificity, positive predictive value,
negative predictive value and Kappa coefficient were obtained.

The mean age of the studied samples was 58.825 ± 11.324 (33-90) years. The
most common clinical manifestations in the participants were reported
postmenopausal bleeding with a frequency of (49.4%) for 42 patients and
abnormal uterine bleeding with a frequency of (41.2%) for 35 patients,
respectively. The sensitivity, specificity, positive and negative predictive
values calculated for curettage were 84.21%, 83.33%, 59.25% and 94.82%,
respectively and the kappa coefficient was reported equal to 0.587. it can
be said that the results obtained from histopathology of curettage and
hysterectomy are consistent (P-value=0.001).

Therefore, in the present study it is concluded that the diagnostic accuracy
of curettage, compared to total hysterectomy, is a relatively suitable
diagnostic method for evaluating endometrial cancer; this method may be used
in the timely diagnosis of this disease. However, caution is required due to
the lower PPV, necessitating further evaluation before definitive
management.