Narrow-Band Imaging in Diagnosis of Endometrial Cancer and Hyperplasia: A New Option?
Received 1 July 2009; accepted 29 October 2009. published online 28 June 2010.
Abstract
Study Objective
To estimate whether the use of narrow-band imaging (NBI) hysteroscopy increases concordance between visual identification and a histologic diagnosis of endometrial cancer and hyperplasia.
Design
Prospective study (Canadian Task Force classification: II-2).
Setting
Department of obstetrics and gynecology, University of Eastern Piedmont, Novara, Italy.
Patients
209 consecutive patients with abnormal uterine bleeding.
Interventions
White-light hysteroscopy and NBI hysteroscopy followed by direct biopsy.
Measurements and Main Results
The sensitivity and specificity of conventional hysteroscopy in predicting a diagnosis of cancer and hyperplasia were, respectively, 84.21% (95% confidence interval [CI], 79.27–89.15) and 99.47% (95% CI, 98.49–100.0), and 64.86% (95% CI, 58.39–71.34) and 98.77% (95% CI, 97.27–100.0), and of NBI hysteroscopy were 94.74% (95% CI, 91.71–97.76) and 97.89% (95% CI, 95.95–99.84), and 78.38% (95% CI, 72.8–83.96) and 97.67% (95% CI, 96.63–99.72). The concordance of conventional and NBI hysteroscopy with the histopathologic findings (measured using the Cohen κ) was, respectively, 88.80% (95% CI, 86.2%–96.3%) and 91.78% (95% CI, 89.6%–98.2%), a difference of 2.98% (95% CI, 0–9) in favor of NBI.
Conclusion
Narrow-band imaging hysteroscopy can accurately predict a histologic diagnosis of endometrial cancer or hyperplasia.
aAdvanced Gynecological Oncology Centre, Departments of Obstetrics and Gynecology, Novara, Italy
bClinical and Experimental Medicine–Epidemiology, University of Eastern Piedmont, Novara, Italy
cDepartment of Obstetrics and Gynecology, Sant'Anna Institute, Brescia, Italy
Corresponding author: Daniela Surico, MD, Departments of Obstetrics and Gynecology, Ospedale Maggiore della Carità, Viale Mazzini 18, 28100 Novara, Italy.
The authors have no commercial, proprietary, or financial interest in the products or companies described in this article.
ABSTRACT