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Minerva Medica 2021 Jan 13

DOI: 10.23736/S0026-4806.20.07123-2


lingua: Inglese

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

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

1 Minimally Invasive Gynecology Unit, Obstetrics, Gynecology and Reproductive Sciences Department, Miller School of Medicine, 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 Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy; 5 Gynecology Endoscopy Unit, Centro Gutenberg, Malaga, Spain; 6 Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy; 7 Hillel Yaffe Medical Center, Rappaport Faculty of Medicine Technion, Hadera, 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 present a narrative review of the current role of hysteroscopy for the diagnosis of endometrial cancer.

KEY WORDS: Hysteroscopy; Endometrial cancer; Endometrial biopsy

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