Diagnosing endometrial carcinoma with cervical involvement by cervical cytology.
OBJECTIVE
To assess the relationship of a cervical cytologic diagnosis based on number, size and degeneration of malignant clusters and necrotic background to cervical involvement of endometrial carcinoma.


METHODS
Cervical smears of 53 women with endometrial carcinoma were evaluated for cervical involvement. The cytologic diagnosis was compared with actual involvement, and accuracy was calculated. Retrospectively, cytologic features, including number, size and degeneration of malignant clusters and necrotic background, were analyzed in involved and noninvolved cases.


RESULTS
Cervical involvement was confirmed in 15 patients (28.3%). The number and size of malignant clusters in the involved cases were significantly larger than those in the noninvolved cases (P < .001 and < .01, respectively). The proportion of degenerated malignant cells and necrotic background in involved cases were significantly higher than those in noninvolved cases (P < .05). Cytologic diagnosis had a sensitivity and specificity of 62.5% and 86.8%, respectively.


CONCLUSIONS
Cervical smears of involved cases revealed a large number and large size of malignant clusters. These findings support cytologic diagnosis based on number, size and degeneration of malignant cells and necrotic background. Cervical cytology is useful to exclude cervical involvement because of its high specificity and can help detect cervical involvement because of its moderately high sensitivity.
Morimura
Yutaka
Y
Department of Obstetrics and Gynecology, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
Nishiyama
Hiroshi
H
Hashimoto
Toshihiro
T
Takano
Yoshimasa
Y
Yamada
Hidekazu
H
Yanagida
Kaoru
K
Sato
Akira
A
D000328:Adult; D000368:Aged; D002452:Cell Count; D002584:Cervix Uteri / Q000473:pathology; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary; D014626:Vaginal Smears