[Screening and sampling of endometrial carcinoma accuracy of the endometrial cytology test for the screening of endometrial cancer].
OBJECTIVE
To evaluate the accuracy of endometrial cytology test (ECT) for the diagnosis of endometrial cancer or precancerous lesions and then discuss the value of ECT as a screening tool for endometrial cancer.Secondly, to investigate related characteristics and independent risk factors of epidemiology of endometrial carcinomas and atypical endometrial hyperplasia to advise proper crowd for endometrial carcinomas screening and monitoring.


METHODS
Totally 1717 preoperative questionnaires on hysteroscopy + dilation & curettage, histopathology and endometrial cytological tests in Peking University First Hospital, People's Hospital of Beijing Daxing District and Beijing Cancer Hospital, from March 2009 to May 2013 were completed. Histopathologic diagnoses were used as the gold standard for determining the accuracy of ECT.Extrapolation: applied binary logistic regression method to narrow down the risk factors of histopathology and endometrial cytological examination.


RESULTS
Satisfaction rate of cytological specimens and pathological specimens were 96.45% (1656/1717) and 91.44% (1570/1717), respectively. ECT provided sufficient material for the diagnosis significantly more often than histopathology (P < 0.05). For the ECT diagnosis of endometrial cancer: accuracy was estimated at 88.2%, sensitivity at 87.3%, specificity at 88.3%, positive predictive value (PPV) at 41.9%, negative predictive value (NPV)at 98.6%.Univariate analysis revealed that risk factors of diagnosis of endometrial carcinomas and atypical hyperplasia of histopathology were included:body mass index (BMI) ≥ 25 kg/m(2), age ≥ 40 years old, diabetes mellitus, hypertension, menopause, family history of malignant tumor (all P < 0.10). Multifactor analysis revealed that the independent risk factors were included:BMI ≥ 25 kg/m(2), age ≥ 40 years, menopause and family history of malignant tumor (all P < 0.05).


CONCLUSIONS
The results of the current study indicated that the accuracy of ECT for the diagnosis of endometrial cancer was high.Furthermore, ECT could be a useful tool for the screening of endometrial cancer.Independent risk factors of endometrial carcinomas and atypical endometrial hyperplasia including:age over 40 years, BMI ≥ 25 kg/m(2), menopause and family history of malignant tumor.
Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.
Xi
X
Yang
Email: qinping_liao@163.com.
Qin-ping
QP
Liao
Cheng
C
Wu
Nai-yi
NY
Zhang
Jian
J
Zhao
Rui
R
Chen
Nan
N
Zhang
Xiu-hua
XH
Ma
Yu-nong
YN
Gao
Wan-li
WL
Gao
Hong
H
Zheng
Zhen
Z
Zeng
Jia
J
Wen
Ying
Y
Dong
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003581:Cytodiagnosis / Q000379:methods*; D004714:Endometrial Hyperplasia / Q000175:diagnosis / Q000473:pathology; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000473:pathology; D004717:Endometrium / Q000473:pathology*; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D011230:Precancerous Conditions / Q000175:diagnosis* / Q000473:pathology; D011237:Predictive Value of Tests; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013048:Specimen Handling; D014626:Vaginal Smears; D055815:Young Adult