title: Evaluation of endometrial cytology: cytohistological correlations in 1,441 cancer patients.
abstract: BACKGROUND
  Endometrial cytology by direct intrauterine sampling is the most common test for an initial evaluation of the endometrium in Japan. However, its diagnostic value for endometrial cancer remains unknown. Here, we assess the correlation between cytopathology and histopathology to evaluate the diagnostic value of cytology for endometrial cancer.
  
  
  METHODS
  Patients with histologically confirmed endometrial cancer and controls with a normal endometrium confirmed by hysterectomy had all undergone preoperative endometrial cytology between 2001 and 2010 at our eight institutions and were retrospectively analyzed. The cytological results were compared by clinical stage, histological type, differentiation, and sampling instrument.
  
  
  RESULTS
  We analyzed 1,441 endometrial cancer and 1,361 control cases. Endometrial cytology detected cancer in 1,279 (916 positive and 363 suspicious) cases with a sensitivity (positive plus suspicious cases) of 88.8% and a specificity of 98.5%. The positive rate was high in advanced-stage, nonendometrioid, and undifferentiated cases, but there was no significant difference in sensitivity between these clinical conditions.
  
  
  CONCLUSIONS
  Endometrial cytology shows a relatively high sensitivity and specificity for endometrial cancer, and neither statistical measure is significantly affected by clinical stage, histological type, differentiation, sample numbers, or sampling instrument. These findings form a superior dataset for evaluating the efficacy of endometrial cytology.
authors.affiliation: Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Masashi
authors.initials: M
authors.lastname: Takano
authors.forename: Morikazu
authors.initials: M
authors.lastname: Miyamoto
authors.forename: Kazuto
authors.initials: K
authors.lastname: Nakamura
authors.forename: Yoshibumi
authors.initials: Y
authors.lastname: Kaneta
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Hanaoka
authors.forename: Michitaka
authors.initials: M
authors.lastname: Ohwada
authors.forename: Takanori
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Hirakawa
authors.forename: Keiichi
authors.initials: K
authors.lastname: Fujiwara
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Suzuki
mesh_terms: D000368:Aged; D001706:Biopsy; D016889:Endometrial Neoplasms / Q000473:pathology*; D004717:Endometrium / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging