A Diagnostic Meta-Analysis:Endometrial Cytology Test For The Early Diagnosis Of Endometrial Cancer

Objective Diagnostic curettage is the most common and accurate diagnostic methods of endometrial cancer in the traditional sense, but because of the complexity of its operations and trauma makes medical workers hoping to find a new approach as an alternative. Endometrial Cytology Test was increasingly valued by medical researchers in the nearly 60 years. Today Endometrial Cytology Test in Japan and other countries is considered to be replacing the traditional curettage for early diagnosis of endometrial cancer. The use of this technique is believed to reduce the cost of the diagnostic work-up for abnormal uterine bleeding without reducing accuracy. This study performed a meta-analysis to assess the accuracy of endometrial sampling devices in the detection of endometrial carcinoma and atypical hyperplasia.Methods The author searched the literature for studies published in Pubmed, CNKI, Wanfang database through internet comparing the results of endometrial sampling with findings at D&C, hysteroscopy, and/or hysterectomy. All the literatures are further selected by rigid criteria formed in advance to include or exclude samples. The included literatures were evaluated by the QUADAS quality of evaluation criteria and the 2*2 tables were extracted. All the data extracted was put in Meta-disc1.4 software and analyzed by it. Meta-discl.4 was used to heterogeneity analysis, pooled sensitivity, pooled specificity. The SROC(summary receiver operator characteristic curve) was drawn and the area under the curve (AUC) was calculated with Meta-discl.4.Results According to the inclusion and exclusion criteria of the study, six literatures were included, five in English and one in Chinese. All studies in a total of 3806 subjects. These subjects were also received endometrial cytology and pathology gold standard examination. Meta-analysis results for the detection of endometrial carcinoma and atypical hyperplasia: pooled sensitivity, pooled specificity and under the AUC was 0.89,0.99,0.9958 respectively.Conclusion The sensitivity and specificity of endometrial cytology for the early diagnosis of endometrial cancer were higher, can be used for early diagnosis of endometrial cancer.