Laparoscopy-guided myometrial biopsy in the definite diagnosis of diffuse adenomyosis

Cherng Jye Jeng, Cherng-Jye Jeng, Jeng CJ, Huang SH, Shih-Hung Huang, Shu-Hsien Huang, Jenta Shen, Junyu Shen, Shen J, Chou CS, Chih‐Wei Chou, Chun-Shan Chou, Tzeng CR, Chii‐Ruey Tzeng, Chii-Ruey Tzeng
Human Reproduction · 2007 · vol. 22(7) , pp. 2016–2019 · doi:10.1093/humrep/dem084 · PMID:17428879 · W2166549147
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Laparoscopy-guided myometrial biopsy definitively diagnosed diffuse adenomyosis in 92 of 100 patients, exhibiting superior sensitivity and specificity compared to ultrasound or CA-125.

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Abstract

BACKGROUND: The purpose of this study was to investigate the usefulness of laparoscopy-guided myometrial biopsy in the diagnosis of diffuse adenomyosis. METHODS: This prospective non-randomized study (Canadian Task Force classification II-1) was conducted in a tertiary medical center. One hundred patients who had clinical signs and symptoms strongly suggestive of adenomyosis were included as the study sample. Transvaginal sonography, serum CA-125 determination and laparoscopy-guided myometrial biopsy were performed. RESULTS: The mean largest myometrial thickness was 3.10+/-0.56 cm (range 2.30-4.50). The mean serum CA-125 level was 49.64+/-38.30 U/ml (range 10.90-205.28). Of these 100 patients, adenomyosis was pathologically proven in 92 patients, small leiomyoma in four patients and myometrial hypertrophy in four patients. The sensitivity of myometrial biopsy was 98% and the specificity 100%; the positive predictive value was 100% and the negative predictive value 80%, which were superior to those of transvaginal sonography, serum CA-125 determination or the combination of both. CONCLUSION: Laparoscopy-guided myometrial biopsy is a valuable tool for obtaining a definite diagnosis of diffuse adenomyosis with preservation of the uterus in infertility workup or in the evaluation of dysmenorrhea or chronic pelvic pain.

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Condition tags

endometriosisadenomyosischronic_pelvic_paindysmenorrheainfertility

MeSH descriptors

Biopsy Endometriosis Endometriosis Laparoscopy Myometrium Uterine Neoplasms Uterine Neoplasms Adult CA-125 Antigen CA-125 Antigen Endometriosis Female Humans Infertility Infertility Laparoscopy Middle Aged Myometrium Predictive Value of Tests Prospective Studies

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