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Feasibility of endometrial sampling by vaginal tampons in women with Lynch syndrome.
BMC Women's Health Pub Date : 2020-03-17 , DOI: 10.1186/s12905-020-00920-y
Jorien M Woolderink 1, 2 , Geertruida H De Bock 3 , Bettien M van Hemel 4 , Erwin Geuken 5 , Harry Hollema 4 , Naomi Werner 4 , Marian J Mourits 2
Affiliation  

Endometrial sampling for the surveillance of women with Lynch syndrome is an invasive and painful procedure. The aim of this study was to evaluate the feasibility of a less invasive procedure of collecting vital cells by vaginal tampons. This was a prospective feasibility study of women scheduled to undergo annual gynecological surveillance, including endometrial sampling. We included consecutive asymptomatic women with Lynch syndrome or first-degree relatives and asked them to insert a vaginal tampon 2–4 h before attending their outpatient appointment. Feasibility was evaluated by the following metrics: patient acceptance, pain intensity of each procedure (assessed by visual analog scale; range 0–10), and the presence of vital cells obtained by tampon-based or endometrial sampling methods. Two pathologists independently evaluated all samples. In total, 25 of 32 approached women completed the tampon-based procedure, with 23 of these subsequently undergoing invasive endometrial sampling. The median visual analog scale scores for tampon use and invasive endometrial sampling were 0 (range, 0–10) and 5.5 (range, 1–10) (p < 0.001). None of the tampon samples analyzed by cytology showed endometrial cells, but they did contain vital squamous cells and granulocytes. By contrast, 18 (78%) of the invasive endometrial samples contained enough endometrial tissue for analysis. No endometrial abnormalities were found by endometrial sampling. Tampon-based endometrial surveillance was a well-accepted and non-painful procedure, and although tampons contained vital cells, they did not provide endometrial cells. However, this study was limited to asymptomatic women with Lynch syndrome (no endometrial pathology), indicating that research is needed to evaluate whether the tampon method has any utility for endometrial surveillance in women with Lynch syndrome.

中文翻译:

Lynch综合征妇女通过阴道棉塞进行子宫内膜取样的可行性。

子宫内膜采样对Lynch综合征妇女进行监视是一种侵入性且痛苦的过程。这项研究的目的是评估通过阴道棉塞收集生命细胞的微创手术的可行性。这是对计划进行年度妇科监测(包括子宫内膜采样)的妇女进行的前瞻性可行性研究。我们纳入了连续无症状的Lynch综合征或一级亲属的女性,并要求她们在就诊前2-4小时插入阴道棉塞。通过以下指标评估可行性:患者的接受程度,每种操作的疼痛强度(通过视觉模拟量表评估;范围为0-10)以及通过基于棉塞或子宫内膜采样的方法获得的活细胞的存在。两名病理学家独立评估了所有样本。总共有32名被访妇女中有25名完成了基于棉塞的手术,其中23名随后接受了侵入性子宫内膜采样。棉塞使用和有创子宫内膜取样的视觉模拟量表评分中位数分别为0(范围0-10)和5.5(范围1-10)(p <0.001)。细胞学分析的卫生棉条样品均未显示子宫内膜细胞,但确实含有重要的鳞状细胞和粒细胞。相比之下,侵入性子宫内膜样品中有18个(78%)包含足够的子宫内膜组织用于分析。通过子宫内膜取样未发现子宫内膜异常。基于卫生棉条的子宫内膜监视术是公认的且无痛苦的过程,尽管棉塞包含活细胞,但它们不提供子宫内膜细胞。然而,
更新日期:2020-04-22
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