The accuracy of endometrial sampling in XXXX with @entity548 : a systematic review and meta-analysis.

@entity1204 @entity1 @entity1127 @entity548 @entity1373 @entity1478
UNASSIGNED: @entity548 ( @entity548 ) can be the first sign of @entity1204 . In case of thickened endometrium, endometrial sampling is often used in these @entity1 . In this systematic review, we studied the accuracy of endometrial sampling for the diagnoses of @entity1204 , @entity1373 and @entity1478 (endometrial pathology, including benign @entity1127 ). We systematically searched the literature for studies comparing the results of endometrial sampling in @entity1 with @entity548 with two different reference standards: blind dilatation and curettage (D_C) and hysteroscopy with histology. We assessed the quality of the detected studies by the QUADAS-2 tool. For each included study, we calculated the fraction of @entity1 in whom endometrial sampling failed. Furthermore, we extracted numbers of cases of @entity1204 , @entity1373 and @entity1478 that were identified or missed by endometrial sampling. We detected 12 studies reporting on 1029 @entity1 with @entity548 : five studies with dilatation and curettage (D_C) and seven studies with hysteroscopy as a reference test. The weighted sensitivity of endometrial sampling with D_C as a reference for the diagnosis of @entity1204 was 100% (range 100-100%) and 92% (71-100) for the diagnosis of @entity1373 . Only one study reported sensitivity for @entity1478 , which was 76%. When hysteroscopy was used as a reference, weighted sensitivities of endometrial sampling were 90% (range 50-100), 82% (range 56-94) and 39% (21-69) for the diagnosis of @entity1204 , @entity1373 and @entity1478 , respectively. For all diagnosis studied and the reference test used, specificity was 98-100%. The weighted failure rate of endometrial sampling was 11% (range 1-53%), while insufficient samples were found in 31% (range 7-76%). In these @entity1 with insufficient or failed samples, an @entity1204 was found in 7% (range 0-18%). In @entity1 with @entity548 , the sensitivity of endometrial sampling to detect @entity1204 and especially @entity1373 and @entity1478 , including @entity1478 , is lower than previously thought. Therefore, further diagnostic work-up for focal pathology is warranted, after a benign result of endometrial sampling.
