ArticlePloS one2026
Transvaginal tru-cut biopsy versus ascitic fluid cytology in gynaecologic tumours: A comparative diagnostic study.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo compare the diagnostic performance- including adequacy, accuracy, safety, sensitivity, specificity, and predicitve values- of transvaginal tru-cut biopsy and ascitic fluid cytology in women with gynaecologic tumours.
methodsA retrospective review was conducted of women with gynaecologic tumours who underwent ultrasound-guided transvaginal tru-cut biopsy and ascitic fluid cytology at the Department of Obstetrics and Gynaecology, University Hospital Hradec Kralove, between January 2018 and December 2021.
resultsA total of 104 women with gynaecologic tumours underwent transvaginal tru-cut biopsy, of whom 47 also had ascitic fluid cytology. The diagnostic accuracy [93.3% (95% CI: 84.1%-97.4%) vs. 83.9% (95% CI: 67.4%-92.9%)], sensitivity [93.3% (95% CI: 82.1%-97.7%) vs. 79.2% (95% CI: 59.5%-90.8%)], and negative predictive value [82.4% (95% CI: 59.0%-93.8%) vs. 58.3% (95% CI: 32.0%-80.7%)] were higher for transvaginal tru-cut biopsy compared to ascitic fluid cytology. Adequacy [93.3% (95% CI: 86.8%-96.7%) vs. 93.6% (95% CI: 82.8%-97.8%)], specificity [93.3% (95% CI: 70.2%-98.8%) vs. 100.0% (95% CI: 64.6%-100.0%)], and positive predictive value [97.7% (95% CI: 88.2%-99.6%) vs. 100.0% (95% CI: 83.2%-100.0%)] were similar for the two methods. Only one tru-cut biopsy was complicated by bleeding, giving an overall complication rate of 1% (95% CI: 0.2%-5.3%). There was no complication with ascitic fluid cytology. Concordance of tru-cut histopathological diagnoses with ascitic fluid cytological diagnoses was 78% (95% CI: 63.6%-87.5%).
conclusionUltrasound-guided tru-cut biopsy provides more diagnostic information than ascitic fluid cytology and is the preferred method when feasible. However, ascitic fluid cytology remains a safe and practical option when biopsy is unavailable.
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