Significance of cytologically normal endometrial cells in cervical smears from postmenopausal women.
OBJECTIVE
To determine the significance of cytologically normal endometrial cells in cervicovaginal (CV) smears from postmenopausal women over age 55 years.


METHODS
From January 1995 to January 1998, 220 women had CV smears demonstrating cytologically normal endometrial cells. The menopausal status, hormone replacement therapy (HRT) and information related to subsequent CV smears and endometrial sampling within 12 months of the initial diagnosis was recorded.


RESULTS
Eighty-one of the 220 cases (36.8%) had histologic sampling of the endometrium. Thirty-four of 81 (42%) showed no endometrial pathology. Endometrial pathology was identified in 28 of 81 (34%), of which 19 were endometrial polyps (23.4%), 4 were endometrial hyperplasia (4.9%), 4 were endometrial carcinoma (4.9%) and 1 was a leiomyoma (1.2%). Nineteen (23.4%) were insufficient for diagnosis. Ninety-one of 220 women were on HRT, and 129 were not. In the group without HRT, endometrial disease was identified in 22/51 (43%) cases as compared to 6/30 (20%) in the group with HRT (P < .001). Endometrial carcinoma was identified in three (5.8%) cases and one (3.3%) case without and with HRT, respectively.


CONCLUSIONS
Although the finding of normal endometrial cells in Pap smears from postmenopausal women was without any clinical significance in the majority of women in this study, in a small number it was associated with endometrial hyperplasia and carcinoma. Women who were not on HRT had a higher incidence of endometrial pathology.
Department of Pathology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio, USA.
V R
VR
Sarode
A E
AE
Rader
P G
PG
Rose
M
M
Rodriguez
F W
FW
Abdul-Karim
D000368:Aged; D002277:Carcinoma / Q000473:pathology*; D016889:Endometrial Neoplasms / Q000473:pathology*; D004717:Endometrium / Q000473:pathology*; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D006965:Hyperplasia / Q000473:pathology; D008875:Middle Aged; D065006:Papanicolaou Test; D017698:Postmenopause; D012189:Retrospective Studies; D014626:Vaginal Smears