Perdarahan perimenopause dan perdarahan menopause dapat disebabkan karena berbagai penyebab. Salah satu penyebab yang berbahaya adalah hiperplasia atipik dan karsinoma endometrium. Terdapat beberapa faktor risiko terhadap kemungkinan timbulnya karsinoma endometrium. Kelompok yang mempunyai risiko ini termasuk pada kelompok risiko tinggi. Pada kelompok risiko tinggi ini diperlukan suatu metode untuk mengetahui perubahan kelainan endometrium. Salah satu alternatifnya adalah pemeriksaan sitologi endometrium. Tujuan penelitian ini adalah untuk menguji sensitifitas, spesifitas serta uji kesesuaian antara sitologi endometrium dibandingkan dengan histologi endometrium. Penelitian merupakan penelitian uji diagnostik dengan membaningkan pemeriksaan sitologi endometrium dengan histologi endometrium. Sitologi endometrium dilakukan dengan modifikasi cytobrush dan selongsong IUD. Spesimen dilarutkan dalam NaCI, yang disentrifus, endapan diproses untuk pemeriksaan sitologi dengan pewarnaan Papanicolaou dan Giemsa. Setelah pengambilan sitologi, dilanjutkan dengan kuretase endometrium, spesimen diproses untuk pemeriksaan histologi. Keduanya diperiksa oleh spesialis patologi anatomi. Analisa statistik menggunakan uji diagnostik dengan baku emas pemeriksaan histologi spesimen kuretase. Dalam kurun waktu penelitian terkumpul 45 sampel penelitian, 12 (26.66%) adenokarsinoma endometrium, 6 (13.33%) dengan hiperplasia atipik, 11 (24.44%) hiperplasia nonatipik, 15 (33.33%) sampel tanpa kelainan dan 1 sampel dengan endometritis. Nilai kesesuaian nyata 57.8%, kesesuaian karena peluang 3.38%, kesesuaian bukan karena peluang 54.42%, potensi kesesuaian bukan karena peluang 96.62% dan Kappa 0.56. Disimpulkan bahwa pemeriksaan endometrial cytology dengan cytobrush dapat digunakan sebagai metoda screening pada kelainan ketebalan endometrium, dengan sensitivitas 62.5% dan spesivisitas 62.2%. (Med J Indones 2004; 14: 87-91)
Perimenopausal menopausal hemorrhage can be due to by a variety of causative factors. One of its dangerous causes is atypical hyperplasia and endometrial carcinoma. There are a number of risk factors for the occurrence of endometrial carcinoma. The group that has this risk belongs to high-risk group. In this high-risk group, it is necessary to have a method to identify the changes in endometrial abnormality. One of the alternatives is the examination of endometrial cytology. The objective of this study was to evaluate the sensitivity, specificity and correlation test between endometrial cytology and endometrial histology. This study was a diagnostic test of cytological examination of the endometrium as compared with endometrial histology. Endometrial cytology was performed with a modification of cytobrush and IUD shell. Specimen was dissolved into the centrifuged NaCl, and its deposits were then processed for cytological examination with Papanicolaou and Giemsa staining. After the taking of cytology, the process was continued with curettage of the endometrium, and the specimens were processed for cytological examination. Both of them were examined by anatomic pathologist. Statistical analysis used diagnostic test using histological examination of curettage specimens as gold standard. During the period of study 45 study samples were collected, among which 12 (26.66%) were endometrial adenocarcinoma, 6 (13.33%) with atypical hyperplasia, 11 (24.44%) with non-atypical hyperplasia, 15 (33.33%) were samples without abnormality, and one sample with endometritis. Actual correlation value was 57.8%, correlation because of possibility 3.38%, and correlation not because of possibility 54.42%, potential correlation not because of possibility 96.62%, and Kappa value 0.56. It was concluded that cytological examination of the endometrium with cytobrush could be employed as a screening method in the abnormalities of endometrial thickness, with sensitivity of 62.5% and specificity of 62.2%. (Med J Indones 2004; 14: 87-91)
