Liquid-based endometrial cytology in the management of sonographically thickened endometrium.
Liquid-based cytology represents an opportunity to re-evaluate endometrial cytology. We evaluated the accuracy of liquid-based endometrial cytology as compared to biopsy in 670 women scheduled for histeroscopy because of thickened endometrium (>4 mm), as evaluated by transvaginal sonography. Endometrial biopsy detected pathology in 41 (6%) of cases (21 of which were adenocarcinomas). Cytologic study found pathology in 62 (9%) cases (19 of which were adenocarcinomas). Two hundred ninety-one biopsies (43%) and 28 (4%) cytologies were inadequate. The sensitivity and the specificity were estimated, respectively, at 95% and 98%; the positive and negative predictive values were estimated, respectively, at 83% and 99%. Cytology provided sufficient material more often than biopsy (P < 0.01). We consider endometrial cytology an efficacious diagnostic opportunity. It could be usefully applied in association with transvaginal sonography. The combination of these procedures might reduce more invasive and expensive diagnostic procedures.
Buccoliero
Anna M
AM
Department of Human Pathology and Oncology, University of Florence, Florence, Italy. ambuccoliero@unifi.it
Gheri
Chiara F
CF
Castiglione
Francesca
F
Garbini
Francesca
F
Fambrini
Massimiliano
M
Bargelli
Gianni
G
Barbetti
Alfredo
A
Pappalardo
Salvatore
S
Taddei
Antonio
A
Boddi
Vieri
V
Scarselli
Gian F
GF
Marchionni
Mauro
M
Taddei
Gian L
GL
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003584:Cytological Techniques; D004714:Endometrial Hyperplasia / Q000000981:diagnostic imaging / Q000473:pathology*; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D004717:Endometrium / Q000000981:diagnostic imaging / Q000473:pathology*; D019160:Endosonography; D005260:Female; D006801:Humans; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014591:Uterine Diseases / Q000000981:diagnostic imaging / Q000473:pathology