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

Archives of Gynecology and Obstetrics volume 296, pages 99–105 (2017)Cite this article

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.

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Author notes

  1. Xi Yang and Ke Ma are contributed equally to this work.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Beijing Tsinghua Changgung Hospital, Medical Center of Tsinghua University, No. 168 Litang Road, Changping District, Beijing, China

    Xi Yang, Ke Ma, Rui Chen, Cheng Wu & Qinping Liao

  2. Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China

    Xi Yang & Jian Zhao

  3. Department of Gynecology, Beijing Cancer Hospital, Beijing, China

    Naiyi Zhang

  4. Department of Gynecology, Beijing Daxing District Hospital, Beijing, China

    Xiuhua Ma

  5. Department of Pathology, Peking University First Hospital, Beijing, China

    Ying Dong

  6. Department of Biostatistics, Peking University First Hospital, Beijing, China

    Sainan Zhu

Authors
  1. Xi Yang
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  2. Ke Ma
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  4. Jian Zhao
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  7. Xiuhua Ma
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Corresponding author

Correspondence to Qinping Liao.

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There are no funding or financial disclosures for the work.

Ethical standards

The protocol of the study was approved by the Institutional Review Board of the Peking University First Hospital.

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The authors have no conflicts of interest relevant to this article.

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Yang, X., Ma, K., Chen, R. et al. Liquid-based endometrial cytology associated with curettage in the investigation of endometrial carcinoma in a population of 1987 women. Arch Gynecol Obstet 296, 99–105 (2017). https://doi.org/10.1007/s00404-017-4400-2

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Keywords

  • Screening
  • Endometrial cytology
  • Endometrial precancers
  • Endometrial carcinoma