Thin-layer cytology and histopathology in the evaluation of abnormal uterine bleeding.
OBJECTIVE
To compare thin-layer endometrial cytology to endometrial biopsy and surgical pathology in women with abnormal uterine bleeding.


METHODS
We performed a prospective study of 103 women. Patients underwent endometrial cytologic evaluation using an endometrial brush, followed by either endometrial biopsy, hysteroscopy with dilation and curettage, or hysterectomy, as clinically indicated. Test performance characteristics and adequacy of cytology and endometrial biopsy were assessed. Ki-67 immunocytochemical expression was evaluated in a random subset of 60 specimens.


RESULTS
Cytologic sampling demonstrated a sensitivity of 78%, a specificity of 96%, a positive predictive value of 78% and a negative predictive value of 96% for the detection of endometrial abnormalities. The unsatisfactory rate of uterine cytology was 15% as compared to 26% for endometrial biopsy. Of adenocarcinoma cases, 83% expressed Ki-67, as compared to 30% in benign cases.


CONCLUSIONS
Endometrial cytology may be useful in the detection of endometrial hyperplasia and neoplasia and provides adequate material for the assessment of Ki-67.
Garcia
Francisco
F
Departments of Obstetrics and Gynecology and of Pathology, Hispanic Center of Excellence, University of Arizona Health Sciences Center, Tucson, 1501 North Campbell Avenue, Box 245078, Tucson, AZ 85724-5078, USA. cisco@u.arizona.edu
Barker
Bel
B
Davis
John
J
Shelton
Troy
T
Harrigill
Keith
K
Schalk
Nicole
N
Meyer
Jane
J
Hatch
Kenneth
K
D000230:Adenocarcinoma / Q000150:complications / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003585:Cell Biology / Q000592:standards*; D003475:Curettage; D004714:Endometrial Hyperplasia / Q000150:complications / Q000473:pathology / Q000601:surgery; D016889:Endometrial Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007150:Immunohistochemistry; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014592:Uterine Hemorrhage / Q000209:etiology / Q000473:pathology* / Q000601:surgery