[Comparison of diagnostic value of Uterobrush and Pipelle in the evaluation of endometrial samples]

Endometrial cancer is the most frequent cancer in the female genital system. Nowadays outpatient diagnostic procedures like pipelle and uterobrush have facilitated the diagnosis and treatment of endometrial cancer in early stages in high-risk patients. This study has been done to compare the accuracy and tissue sufficiency of biopsy by pipelle and uterobrush. Between 2005 and 2007, 70 candidates admitted for hysterectomy in Imam Hossein Hospital entered a clinical trial study. Under local or general anesthesia, biopsies were taken by pipelle and then uterobrush or vice versa. The order of using pipelle and uterobrush was selected randomly. The samples were sent to the pathology department and examined by an expert pathologist. The results of endometrial biopsies by pipelle and uterobrush were analyzed. After that the cases were grouped [each group consisted of 35 patients] according to the order of using the pipelle and uterobrush. The endometrial samples sufficiency from uterobrush and pipelle were 68.1% and 87.1%, respectively. The positive predictive value of pipelle was 100% and negative predictive value was 84%. These values for uterobrush were 100% and 90% respectively. It seems that pipelle is better for obtaining sufficient size samples. However in sufficient samples, uterobrush has higher sensitivity and accuracy. Order of using pipelle and uterobrush caused no significant difference in the results

[Assessment of serum LH, FSH /tumor fluid FSH, LH ratio in ovarian tumors]

As ovarian cancers are prevalent and have a high mortality rate, early diagnosis is important. Markers that detect ovarian malignancies earlier, include the levels of serum and ovarian cyst fluid gonadotropins. This study was performed in Imam Hossein hospital between 2008 and 2010 to determine the diagnostic value of the ratio of serum to ovarian cyst fluid gonadotropins in defining the type of ovarian tumors. This cross-sectional study was performed on patients operated because of ovarian mass. Their serum samples and cyst fluid were collected at the time of laparatomy and the histopathologic diagnosis was established after removal of the tumor. FSH and LH concentration were measured in serum and tumor fluid by Microparticle Enzyme Immunoassay technology in Imam Hossein laboratory and the ratios of serum FSH and LH to the cyst fluid gonadotropins were determined in four pathologic groups [simple cyst, benign, borderline and malignant]; statistical comparison was done with the Kruskal-Wallis and Mann-Whitney U-test. We studied 100 patients with ovarian masses; in 79 patients pathology was reported as epithelial tumors and simple cysts. The most common mass were simple cysts [48.1%], followed by benign tumors [27.8%], malignant tumors [16.5%] and borderline tumors [7.6%]. Serum FSH/ tumor fluid ratios were, 21.1 +/- 53.8 in simple cysts, 50.7 +/- 174.9 in benign tumors, 1.5 +/- 0.7 in borderline tumors and 1.9 +/- 1.9 in malignant tumors [P<0.001]. Serum LH/tumor fluid ratios were 12.1 +/- 26.5 in simple cysts, 20.0 +/- 29.1 in benign tumors, 2.6 +/- 2.3 in borderline tumors and 2.8 +/- 3.7 in malignant tumors [P<0.002]. Our findings suggest that serum/tumor fluid gonadotropins ratio can be used as a tumor marker for identification of ovarian tumors