title: Clinical significance of benign endometrial cells found in papanicolaou tests of Turkish women aged 40 years and older.
abstract: BACKGROUND
  Spontaneously exfoliated benign-appearing endometrial cells (BEC) on a Papanicolaou smear might indicate endometrial pathology in postmenopausal women, necessitating further investigation. A cut-off age of 40 years was included in the Bethesda System 2001 based on studies of clinical significance of endometrial cells in Pap smears in Western countries.
  
  
  OBJECTIVE
  The purpose of this study was to determine the significance of age subgroup for women with a cytological diagnosis of BEC, regardless of menopausal status, in a retrospective cohort of Turkish women.
  
  
  METHODS
  Between October 2006 and November 2011, 41 patients with a BEC diagnosis and 64 patients with a cytological diagnosis of normal smear (NS) were enrolled; regardless of menopausal status, these women were 40 years and older and for whom follow-up endometrial biopsies had been performed.
  
  
  RESULTS
  On subsequent histopathologic evaluation, no malignant lesion was detected in women aged 40-50 years compared to three endometrioid-type adenocarcinomas in women older than 50 years with cytological diagnosis of BEC. There was a significant difference between women older than 50 years with cytologic diagnosis of BEC and NS in relation to premalignant lesions on histopathologic evaluation; however, this was not the case for women aged 40-50 years.
  
  
  CONCLUSIONS
  According to our study, reporting BEC for women aged between 40 and 50 years has minor clinical significance but is significant for women older than 50 years, regardless of menopausal status. Larger sample size would be appropriate to confirm the results of the current study.
authors.affiliation: Department of Pathology, Umraniye Education and Research Hospital, Istanbul, Turkey.
authors.forename: Gozde
authors.initials: G
authors.lastname: Kir
authors.forename: Ahmet
authors.initials: A
authors.lastname: Gocmen
authors.forename: Handan
authors.initials: H
authors.lastname: Cetiner
authors.forename: Cumhur Selcuk
authors.initials: CS
authors.lastname: Topal
authors.forename: Muberra Segmen
authors.initials: MS
authors.lastname: Yilmaz
authors.forename: Murat Hakan
authors.initials: MH
authors.lastname: Karabulut
keywords: Endometrial cells; endometrial cancer; pap test