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Minerva Medica 2021 February;112(1):12-9

DOI: 10.23736/S0026-4806.20.07123-2


language: English

New development on hysteroscopy for endometrial cancer diagnosis: state of the art

Jose CARUGNO 1 , Staci J. MARBIN 2, Antonio S. LAGANÀ 3, Salvatore G. VITALE 4, Luis ALONSO 5, Attilio DI SPIEZIO SARDO 6, Sergio HAIMOVICH 7

1 Miller School of Medicine, Unit of Minimally Invasive Gynecology, Division of Obstetrics, Department of Gynecology and Reproductive Sciences, University of Miami, Miami, FL, USA; 2 Miller School of Medicine, University of Miami, Miami, FL, USA; 3 Department of Obstetrics and Gynecology, Filippo del Ponte Hospital, University of Insubria, Varese, Italy; 4 Unit of Obstetrics and Gynecology, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy; 5 Unit of Gynecology Endoscopy, Gutenberg Center, Malaga, Spain; 6 School of Medicine, Department of Public Health, Federico II University, Naples, Italy; 7 Rappaport Faculty of Medicine, Hillel Yaffe Medical Center, Technion, Israel

Endometrial cancer (EC) is the most common gynecologic cancer diagnosed in developed countries and represents the second most frequent gynecologic cancer-related cause of death following ovarian cancer. There are 2 subtypes of EC. Type I tumors (endometrioid adenocarcinoma) representing 85-90% of the cases. They are likely to be low-grade tumors and are thought to have a link to estrogen exposure. Type II tumors represent 10-15% of EC. They are characterized as high-grade carcinomas, with serous or clear cell histology type, and carry poor prognoses. The benefits of hysteroscopy in achieving a targeted endometrial biopsy under direct visualization over blind biopsy techniques are widely accepted. Hysteroscopic endometrial biopsy is performed under direct visualization and is the only technique that allows for the selective biopsy of targeted areas of the endometrium. There is no screening protocol for the early detection of EC. Among the general population, advanced age, obesity, nulliparity and the use of exogenous hormones are known as risk factors for EC. There are additional situations that portend an increased risk of EC that deserve special consideration such as in patients diagnosed with Lynch Syndrome, using tamoxifen, obese, or the young patient with a desire for future fertility. We presented a narrative review of the current role of hysteroscopy for the diagnosis of endometrial cancer.

KEY WORDS: Hysteroscopy; Endometrial neoplasms; Biopsy

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