Top

Archives of Gynecology and Obstetrics

Published in:

01-07-2017 | Gynecologic Oncology

Liquid-based endometrial cytology associated with curettage in the investigation of endometrial carcinoma in a population of 1987 women

Authors: Xi Yang, Ke Ma, Rui Chen, Jian Zhao, Cheng Wu, Naiyi Zhang, Xiuhua Ma, Ying Dong, Sainan Zhu, Qinping Liao

Published in: Archives of Gynecology and Obstetrics | Issue 1/2017

Abstract

Purpose

The aim of this study was to investigate the diagnostic accuracy of liquid-based endometrial cytology, in comparison with histology.

Methods

1987 patients scheduled for hysteroscopy were enrolled in this study. All patients proceeded sequentially through endometrial cytology, hysteroscopy and then dilatation and curettage (D&C). Cytology sampling was performed by brushing the uterus cavity using SAP-1 and the sample was prepared to liquid-based smear using SurePath technology. The slides were stained by Papanicolaou method. All cytological diagnosis was correlated with the D&C histological diagnosis.

Results

Cyto-histological correlations were possible in 1672 (89.3%) patients: in 254 (12.8%) patients the D&C was inadequate, in 75 (3.8%) patients the cytology was inadequate, and in 14 (0.7%) patients both were inadequate. In postmenopausal women, 758 of 790 cytologies (96.0%) were adequate, while 586 of 790 histologies (74.2%) were adequate. SAP-1 provided more sufficient materials for cytology than D&C for histology (P < 0.001). Taking atypical hyperplasia or worse as a positive result, the diagnostic accuracy of liquid-based endometrial cytology was 86.1%, sensitivity was estimated at 70.3%, specificity at 88.5%, positive predictive value at 48.0% and negative predictive value at 95.2%. Taking endometrial carcinoma as a positive result, the diagnostic accuracy of liquid-based endometrial cytology was 94.4%; sensitivity was estimated at 53.2%, specificity at 98.6%, positive predictive value at 79.8% and negative predictive value at 95.3%.

Conclusions

Liquid-based endometrial cytology can be considered a useful method for detecting of endometrial pathology as a first-line approach.

Siegel RL, Miller KD, Jemal A (2015) Cancer statistics, 2015. CA Cancer J Clin 65(1):5–29. doi:10.3322/caac.21254 CrossRefPubMed

Odeh M, Vainerovsky I, Grinin V, Kais M, Ophir E, Bornstein J (2007) Three-dimensional endometrial volume and 3-dimensional power Doppler analysis in predicting endometrial carcinoma and hyperplasia. Gynecol Oncol 106(2):348–353. doi:10.1016/j.ygyno.2007.04.021 CrossRefPubMed

Yasa C, Dural O, Bastu E, Ugurlucan FG, Nehir A, İyibozkurt AC (2016) Evaluation of the diagnostic role of transvaginal ultrasound measurements of endometrial thickness to detect endometrial malignancy in asymptomatic postmenopausal women. Arch Gynecol Obstet 294(2):311–316. doi:10.1007/s00404-016-4054-5 CrossRefPubMed

Abdelazim IA, Abdelrazak KM, Elbiaa AA, Al-Kadi M, Yehia AH (2015) Accuracy of endometrial sampling compared to conventional dilatation and curettage in women with abnormal uterine bleeding. Arch Gynecol Obstet 291(5):1121–1126. doi:10.1007/s00404-014-3523-y CrossRefPubMed

Garcia F, Barker B, Davis J, Shelton T, Harrigill K, Schalk N, Meyer J, Hatch K (2003) Thin-layer cytology and histopathology in the evaluation of abnormal uterine bleeding. J Reprod Med 48(11):882–888PubMed

Tsuda H, Nakamura H, Inoue T, Kawamura N, Adachi K, Bandera CA (2005) Transvaginal ultrasonography of the endometrium in postmenopausal Japanese women. Gynecol Obstet Investig 60(4):218–223. doi:10.1159/000087375 CrossRef

Mitchell H, Giles G, Medley G (1993) Accuracy and survival benefit of cytological prediction of endometrial carcinoma on routine cervical smears. Int J Gynecol Pathol 12(1):34–40CrossRefPubMed

Buccoliero AM, Resta L, Napoli A, Taddei GL (2009) Liquid-based endometrial cytology: the Florence and Bari experience. Pathologica 101(2):80–84PubMed

Friedlander MA, Rudomina D, Lin O (2008) Effectiveness of the thin prep imaging system in the detection of adenocarcinoma of the gynecologic system. Cancer 114(1):7–12. doi:10.1002/cncr.23257 CrossRefPubMed

10.

Norimatsu Y, Kouda H, Kobayashi TK, Moriya T, Yanoh K, Tsukayama C, Miyake Y, Ohno E (2008) Utility of thin-layer preparations in the endometrial cytology: evaluation of benign endometrial lesions. Ann Diagn Pathol 12(2):103–111. doi:10.1016/j.anndiagpath.2007.05.005 CrossRefPubMed

11.

Zhao J (2006) The diagnostic system of endometrial cytology. China J Reprod Health 17:6–8

12.

Tavassoli FA, Devilee P (2003) Tumours of the breast and female genital organs. Pathology and Genetics World Health Organization Classification of Tumours. IARC Press, Lyon

13.

Hao J, Zhao P, Chen WQ (2012) Chinese Cancer Registry annual report. Military Medical Science Press, Beijing, pp 100–101

14.

Tabor A, Watt HC, Wald NJ (2002) Endometrial thickness as a test for endometrial cancer in women with postmenopausal vaginal bleeding. Obstet Gynecol 99(4):663–670 (pii: S0029784401017719) PubMed

15.

Gull B, Karlsson B, Milsom I, Granberg S (2003) Can ultrasound replace dilation and curettage? A longitudinal evaluation of postmenopausal bleeding and transvaginal sonographic measurement of the endometrium as predictors of endometrial cancer. Am J Obstet Gynecol 188(2):401–408 (pii: S0002937802714841) CrossRefPubMed

16.

Yarandi F, Izadi-Mood N, Eftekhar Z, Shojaei H, Sarmadi S (2010) Diagnostic accuracy of dilatation and curettage for abnormal uterine bleeding. J Obstet Gynaecol Res. 36(5):1049–1052CrossRefPubMed

17.

Mossa B, Ebano V, Marziani R (2010) Reliability of outpatient endometrial brush cytology vs biopsy in postmenopausal symptomatic women. Eur J Gynaecol Oncol 31(6):621–626PubMed

18.

Yanoh K, Norimatsu Y, Hirai Y, Takeshima N, Kamimori A, Nakamura Y, Shimizu K, Kobayashi TK, Murata T, Shiraishi T (2009) New diagnostic reporting format for endometrial cytology based on cytoarchitectural criteria. Cytopathology 20(6):388–394. doi:10.1111/j.1365-2303.2008.00581.x CrossRefPubMedPubMedCentral

19.

Kyroudi A, Paefthimiou M, Symiakaki H, Mentzelopoulou P, Voulgaris Z, Karakitsos P (2006) Increasing diagnostic accuracy with a cell block preparation from thin-layer endometrial cytology: a feasibility study. Acta Cytol 50(1):63–69CrossRefPubMed

20.

Buccoliero AM, Caldarella A, Noci I, Borri P, Giachi M, Borrani E, Taddei GL (2003) Thin-layer cytology in endometrial diagnosis. Pathologica 95(4):179–184PubMed

21.

Buccoliero AM, Gheri CF, Castiglione F, Garbini F, Barbetti A, Fambrini M, Bargelli G, Pappalardo S, Taddei A, Boddi V, Scarselli GF, Marchionni M, Taddei GL (2007) Liquid-based endometrial cytology: cyto-histological correlation in a population of 917 women. Cytopathology 18(4):241–249. doi:10.1111/j.1365-2303.2007.00463.x CrossRefPubMed

22.

Buccoliero AM, Castiglione F, Gheri CF, Garbini F, Fambrini M, Bargelli G, Pappalardo S, Scarselli G, Marchionni M, Taddei GL (2007) Liquid-based endometrial cytology: its possible value in postmenopausal asymptomatic women. Int J Gynecol Cancer 17:182–187. doi:10.1111/j.1525-1438.2006.00757.x CrossRefPubMed

23.

Yanoh K, Hirai Y, Sakamoto A, Aoki D, Moriya T, Hiura M, Yamawaki T, Shimizu K, Nakayama H, Sasaki H, Tabata T, Ueda M, Udagawa Y, Norimatsu Y (2012) New terminology for intrauterine endometrial samples: a group study by the Japanese Society of Clinical Cytology. Acta Cytol 56(3):233–241. doi:10.1159/000336258 CrossRefPubMed

24.

Norimatsu Y, Miyamoto M, Kobayashi TK, Moriya T, Shimizu K, Yanoh K, Tsukayama C, Miyake Y, Ohno E (2008) Diagnostic utility of phosphatase and tensin homolog, beta-catenin, and p53 for endometrial carcinoma by thin-layer endometrial preparations. Cancer 114(3):155–164. doi:10.1002/cncr.23495 CrossRefPubMed

Title: Liquid-based endometrial cytology associated with curettage in the investigation of endometrial carcinoma in a population of 1987 women
Authors: Xi Yang
Ke Ma
Rui Chen
Jian Zhao
Cheng Wu
Naiyi Zhang
Xiuhua Ma
Ying Dong
Sainan Zhu
Qinping Liao
Publication date: 01-07-2017
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 1/2017
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-017-4400-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Liquid-based endometrial cytology associated with curettage in the investigation of endometrial carcinoma in a population of 1987 women

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2017

The relationship between postmenopausal women's sclerostin levels and their bone density, age, body mass index, hormonal status, and smoking and consumption of coffee and dairy products

Endometrial thickness influences neonatal birth weight in pregnancies with obstetric complications achieved after fresh IVF–ICSI cycles

Cytomegalovirus infection in pregnancy

Birth weight and its relation with medical nutrition therapy in gestational diabetes

Maternal ascites an independent prognostic factor in severe preeclampsia: a matched cohort study

Presentation and management of vesicovaginal fistulae after delivery at a German women’s hospital