Xi Yang1,2, Ke Ma1, Rui Chen1, Jian Zhao2, Cheng Wu1, Naiyi Zhang3, Xiuhua Ma4, Ying Dong5, Sainan Zhu6, Qinping Liao7. 1. Department of Obstetrics and Gynecology, Beijing Tsinghua Changgung Hospital, Medical Center of Tsinghua University, No. 168 Litang Road, Changping District, Beijing, China. 2. Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China. 3. Department of Gynecology, Beijing Cancer Hospital, Beijing, China. 4. Department of Gynecology, Beijing Daxing District Hospital, Beijing, China. 5. Department of Pathology, Peking University First Hospital, Beijing, China. 6. Department of Biostatistics, Peking University First Hospital, Beijing, China. 7. Department of Obstetrics and Gynecology, Beijing Tsinghua Changgung Hospital, Medical Center of Tsinghua University, No. 168 Litang Road, Changping District, Beijing, China. qinpingliao@126.com.
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.
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.
Authors: Stephanie R DeJong; Jamie N Bakkum-Gamez; Amy C Clayton; Michael R Henry; Gary L Keeney; Jun Zhang; Trynda N Kroneman; Shannon K Laughlin-Tommaso; Lisa J Ahlberg; Ann L VanOosten; Amy L Weaver; Nicolas Wentzensen; Sarah E Kerr Journal: Cancer Med Date: 2021-09-16 Impact factor: 4.711