Efficacy of the Endo-pap sampler in detecting endometrial lesions.
OBJECTIVE
To determine the efficacy of the Endo-pap sampler, a device used to collect endometrial tissue fragments for cytologic examination, in detecting endometrial lesions.


METHODS
Reports from 1,983 Endo-pap smears collected from 1,248 outpatients over a 44-month period were retrospectively examined in conjunction with corresponding biopsy or hysterectomy reports. Endo-pap smears, histologic sections and clinical information were reviewed in cases originally reported as abnormal.


RESULTS
Endometrial abnormalities were reported in 29 Endo-pap smears (1.5%). Among 21 reported as atypical, follow-up was normal in 19 but revealed hyperplasia in 1 and hyperplasia with a focus of carcinoma in 1 on histologic examination. Three were interpreted as malignant and one as suspicious; all had adenocarcinoma at endometrial biopsy. Endometrial abnormalities were reported in 19 of 220 patients who underwent endometrial biopsy following a previous Endo-pap smear reported as negative for malignancy. Their diagnoses included endometrial polyps (14), hyperplasia without atypia (3), atypical hyperplasia (1) and endometrial adenocarcinoma (1) three years after a negative Endo-pap smear.


CONCLUSIONS
Although the sensitivity and specificity for malignancy were 100%, the overall sensitivity for any pathologic lesion was only 28%. We recommend proceeding directly to endometrial biopsy for a conclusive diagnosis in symptomatic patients.
van Hoeven
K H
KH
Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, USA.
Zaman
S S
SS
Deger
R B
RB
Artymyshyn
R L
RL
D016889:Endometrial Neoplasms / Q000473:pathology*; D004717:Endometrium / Q000473:pathology*; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D065006:Papanicolaou Test; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014626:Vaginal Smears / Q000379:methods*