The THE ROLE OF HYSTEROSCOPY IN THE DIAGNOSIS OF ENDOMETRIAL CANCER AND ENDOMETRIAL HYPERPLASIA

Abstract

Objective: To evaluate the diagnostic accuracy of hysteroscopy with targeted biopsy in detecting endometrial cancer (EC) and atypical endometrial hyperplasia (AEH) compared to traditional blind endometrial sampling methods.

Methods: A systematic literature search was conducted in PubMed, ScienceDirect, Wiley Online Library, and Google Scholar, using MeSH terms and related synonyms. Following the PRISMA methodology, clinical studies published within the last 10 years were included in the analysis.

Results: Hysteroscopic biopsy, enabling direct visualization of the uterine cavity and targeted tissue sampling, demonstrated high diagnostic sensitivity (91.5–100%) and specificity compared with blind biopsy methods. Traditional techniques such as aspiration biopsy and dilatation & curettage showed limited sensitivity, particularly for focal lesions, and could yield false-negative results in up to 25.4% of malignant cases.

Conclusions: Hysteroscopy with targeted biopsy is the most reliable diagnostic method for EC and AEH detection. It should be considered when blind biopsy results are inconclusive or when the clinical suspicion of disease remains high.