Determination of the utility of endometrial Tao brush in the detection of endometrial cancer and atypical hyperplasia

Abstract

Background: Endometrial cancer is among the most common gynecologic malignancies in Kenya as it is in other  developing countries. Screening using the Tao brush for direct sampling of the endometrium is a reliable technique for detecting lesions and can be done in an outpatient setting. These attributes enable early detection which is crucial for  favorable outcomes, as over 90% of patients with early stages of endometrial cancer can be cured with treatment.  

Objective: To determine the Utility of Endometrial Tao brush in the detection of endometrial malignancies.

Design:  Prospective Cross-sectional Study.

Setting: Department of Laboratory Medicine, Kenyatta National Hospital and Department of Obstetrics and Gynaecology, Kenyatta National Hospital.

Study setting: Kenyatta National Hospital  (KNH) gynecology Clinic.

Measurable Variables: Independent variables included demographic and clinical data  including; age, early menarche, late menopause, obesity, parity, and hypertension. Dependent variables included  histopathological parameters of lesions; tumor size, type, tumor invasion, and metastasis.

Results: Sixty women fulfilled  the study entry criteria and were evaluated. Histopathological diagnoses comprised of; 14 (23%) Endometrial  Cancers, 8 (13%) Complex hyperplasia with atypia, 16 (27%) Simple and mild hyperplasia without atypia, 3 (5%) Non- Diagnostic, and 19 (32%) patients with Negative Endometrial Histology. The specificity and sensitivity of cytology using  Tao Brush were 100% and 95.45% respectively. The kappa value was 0.912.

Conclusions: This study shows that  endometrial Tao brush had a high specificity and sensitivity with a nearly perfect agreement with the dilatation and  curettage samples. It therefore could have utility in most clinical settings in Kenya.