Increasing diagnostic accuracy with a cell block preparation from thin-layer endometrial cytology: a feasibility study.
OBJECTIVE
To investigate (1) the feasibility of preparing cell blocks by inverted filter sedimentation (IFS-CB) from endometrial samplings processed by the ThinPrep (TP) technique (Cytyc Corp., Boxborough, Massachusetts, U.S.A.), and (2) the possibility of increasing the diagnostic accuracy of TP endometrial cytology by examining the tissue architecture as an adjunctive method of detecting endometrial lesions.


METHODS
Three hundred one endometrial samplings were obtained, using the Endogyn endometrial device (Biogyn S. n.c., Italy), from perimenopausal and postmenopausal women. The endometrial samplings were collected in a vial with liquid fixative for the TP processing. One TP slide was prepared from each case. If adequate material remained in the vial after the TP slide preparation, it was processed for IFS-CB preparation.


RESULTS
IFS-CB preparation was processed in 263 cases (87%) with adequate material. Diagnoses on IFS-CB preparations obtained by endometrial sampling matched those of the hysterectomy specimens. The addition of IFS-CB histology to the cytologic diagnosis by TP increased the diagnostic accuracy of endometrial cytology to 96.3% and 100% for benign/atrophic endometrium and adenocarcinoma, respectively (p = 0.39 and 0.46). In hyperplasia without atypia and hyperplasia with atypia, the diagnostic accuracy increased significantly, to 96% and 95.3%, respectively (p = 0.037 and < 0.001).


CONCLUSIONS
This study illustrates the merit of linking TP cytology with direct endometrial sampling, including small tissue fragments and material adequate for IFS-CB preparation. TP cytology provides an accurate cytologic diagnosis and the possibility of IFS-CB preparation, which could be a valuable diagnostic adjunct to TP cytology.
Kyroudi
Aspasia
A
Department of Histology and Embryology, Medical School of Athens University, Athens, Greece.
Paefthimiou
Maria
M
Symiakaki
Hera
H
Mentzelopoulou
Panagiota
P
Voulgaris
Zannis
Z
Karakitsos
Petros
P
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology; D002277:Carcinoma / Q000175:diagnosis* / Q000473:pathology; D003581:Cytodiagnosis; D004714:Endometrial Hyperplasia / Q000175:diagnosis* / Q000473:pathology; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000473:pathology; D004717:Endometrium / Q000473:pathology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D013048:Specimen Handling