Objective: To evaluated the value of hysteroscopy and dilatation and curettage (DC) in diagnosis of endometrial cancer.
Methods: This retrospective analysis included clinical pathologic data of 3 676 patients with endometrial cancer from Jan. 1, 2000 to Dec. 31, 2010 in hospitals of endometrial cancer prevention projects in Guangdong Province.
Results: A total of 3 676 patients with endometrial cancer were divided into DC group (3 211 patients) and hysteroscopy group (465 patients). Compared to the results of pathological diagnosis, the accuracy rate between DC group and in hysteroscopy group were no statistically difference was 91.00% (2 922/3 211) vs 90.75% (422/465; χ² = 0.030, P = 0.862). The accuracy rate, sensitivity, specificity, positive predictive value and negative predictive value of cervical involvement between DC group and hysteroscopy group were 81.28% vs 86.45% (P < 0.01), 24.78% vs 23.68% (P > 0.05), 93.76% vs 98.71% (P < 0.01), 46.75% vs 78.26% (P < 0.01) and 84.95% vs 86.88% (P > 0.05), respectively. Rate of positive peritoneal cytology in DC group was 4.76% (153/3 211), and the rate was 3.23% (15/465) in hysteroscopy group, which were no statistically difference (χ² = 2.206, P = 0.137). There were no statistically difference in 5-year overall survival (91.02% vs 92.03%; χ² = 0.033, P = 0.856) and 5-year progression-free survival (89.81% vs 91.83%; χ² = 1.508, P = 0.219) between DC group and hysteroscopy group.
Conclusions: Hysteroscopy and dilatation and curettage is an effective method in diagnosis of endometrial cancer, especially hysteroscopy is better in diagnosis of cervical involvement. Hysteroscopy don't improve risks of positive peritoneal cytology and don't affect the prognosis of patients with endometrial cancer.