Poor accuracy of endometrial sampling in patients with uterine carcinosarcomas: a nationwide analysis
- Author:
Eveline N.B. PHAM
1
;
Caroline B. VAN DEN BERG
;
Rachel VAN ES
;
Helena C. VAN DOORN
;
Floris H. GROENENDIJK
;
Heleen J. VAN BEEKHUIZEN
Author Information
- Publication Type:Original Article
- From:Journal of Gynecologic Oncology 2025;36(4):e52-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objective:To determine the accuracy of aspiration biopsy (AB), hysteroscopic biopsy (HB), and dilatation & curettage (D&C) in detecting uterine carcinosarcoma (UCS).
Methods:Pathology reports were retrieved from the Dutch Nationwide Pathology Databank PALGA for patients with a certain or suggested diagnosis of UCS in pre- and/or postoperative histology between 2001 and 2021. Patients without available pre- or postoperative pathology reports were excluded. The accuracy measures sensitivity, positive predictive value (PPV), accuracy, and concordance using Cohen’s kappa were calculated for AB, D&C, and HB, using postoperative histology as the reference. This was analyzed for 2 scenarios: Analysis A compared samples with a certain or suggested diagnosis of UCS vs. no mention of UCS.Analysis B compared samples with a certain diagnosis of UCS vs those without UCS.
Results:The study included 1,481 patients, totaling 1,685 samples. Sensitivity was similar for AB and HB (52.4% and 50.5%, respectively, for analysis A; 45.1% and 42.2% for analysis B).D&C showed the highest sensitivity (70.8% and 64.9% for analysis A and B, respectively).AB had the highest PPV (85.3% and 90.9% for analysis A and B, respectively), HB had the lowest PPV (79.7% and 80.9%, respectively). Accuracy was highest for D&C (44.4%) compared to AB (32.8%) and HB (29.5%). All Cohen’s kappa values were below 0.20, indicating poor correlation between preoperative and postoperative diagnoses.
Conclusion:The study reveals low accuracy measures across all conventional endometrial sampling techniques, highlighting the need for research to identify markers or tools to diagnose UCS.
