CORRELATION OF HISTOLOGICAL SPECTRUM OF HYSTERECTOMY SPECIMENS WITH CLINICAL DIAGNOSIS. A MULTI-CENTRIC STUDY

Shagufta Nasir Pervez, Shazia Naz, Muhammad Asim, Farhan Balooch, Mushtaq Ahmad, Naila Ismail
In: Khyber Journal of Medical Sciences · 2024 · vol. 17(3) , pp. 168–174 · doi:10.70520/kjms.v17i3.541 · W4405852682
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A multi-centric study of 12,200 hysterectomy specimens found that while clinical diagnosis accurately identifies malignancy, it has low concordance with histopathological results for adenomyosis.

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This multi-centric retrospective study analyzed 12,200 hysterectomy specimens to evaluate the concordance between preoperative clinical diagnoses and final histopathological findings. The research team correlated patient demographics, surgical variables, and pathological results from five medical centers in Pakistan, noting that adenomyosis was the most frequently identified condition among the specimens. While high agreement was observed for malignancies, the analysis revealed significantly lower concordance for adenomyosis, indicating that clinical assessment alone is often insufficient for accurate diagnosis of this specific pathology. Relevance to endometriosis: Adenomyosis is explicitly named as the most common disease found in the cohort, though the paper’s primary focus is on diagnostic accuracy rather than endometriosis or adenomyosis treatment mechanisms.

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Abstract

Objective: To investigate the relationship between the histological spectrum of hysterectomy specimens and preoperative clinical diagnosis. Methodology: From January 2020 to December 2023, three major medical centers—MTI Hayatabad Medical Complex, Kabir Medical College, and Naseer Teaching Hospital, Peshawar and Saidu Medical College and Saidu Group of Teaching Hospital Swat—collected 12,200 hysterectomy specimens for our retrospective cross-sectional investigation. Information contained the histological results, preoperative clinical diagnosis, and patient demographics. Histopathological and clinical diagnoses were correlated and at every stage of the study, patient confidentiality and conformity with ethical standards were guaranteed by institutional review board approval. Results: There are 12,200 hysterectomy cases in the research. The patients were primarily 53 ± 6 years of age. They were operated on for a variety of clinical manifestations, such as irregular uterine hemorrhage, pelvic pain, and masses. Histopathological results showed that adenomyosis was the most common disease. High agreement for malignancy but lower agreement for adenomyosis was revealed by concordance analysis. Conclusion: This study shows that clinical diagnosis has an invaluable role in recognizing pathologies of the uterus but the proper diagnosis and treatment required histopathological examination. In conditions where there is high concordance such as malignancies, clinical assessment may be quite accurate, this is because there is low agreement in diseases such as adenomyosis hence, the validity of clinical diagnosis may be limited. These results underscore the significance of the combined use of clinical and histopathological approaches in helping patients achieve the best possible results
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Objective

To investigate the relationship between the histological spectrum of hysterectomy specimens and preoperative clinical diagnosis. Methodology: From January 2020 to December 2023, three major medical centers—MTI Hayatabad Medical Complex, Kabir Medical College, and Naseer Teaching Hospital, Peshawar and Saidu Medical College and Saidu Group of Teaching Hospital Swat—collected 12,200 hysterectomy specimens for our retrospective cross-sectional investigation. Information contained the histological results, preoperative clinical diagnosis, and patient demographics. Histopathological and clinical diagnoses were correlated and at every stage of the study, patient confidentiality and conformity with ethical standards were guaranteed by institutional review board approval.

Results

There are 12,200 hysterectomy cases in the research. The patients were primarily 53 ± 6 years of age. They were operated on for a variety of clinical manifestations, such as irregular uterine hemorrhage, pelvic pain, and masses. Histopathological results showed that adenomyosis was the most common disease. High agreement for malignancy but lower agreement for adenomyosis was revealed by concordance analysis.

Conclusion

This study shows that clinical diagnosis has an invaluable role in recognizing pathologies of the uterus but the proper diagnosis and treatment required histopathological examination. In conditions where there is high concordance such as malignancies, clinical assessment may be quite accurate, this is because there is low agreement in diseases such as adenomyosis hence, the validity of clinical diagnosis may be limited. These results underscore the significance of the combined use of clinical and histopathological approaches in helping patients achieve the best possible results

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