title: Liquid-based endometrial cytology associated with curettage in the investigation of endometrial carcinoma in postmenopausal women.
abstract: OBJECTIVE
  The aim of this study was to investigate the diagnostic accuracy of liquid-based endometrial cytology in postmenopausal women, in comparison with histology.
  
  
  METHODS
  There were 790 postmenopausal women scheduled for hysteroscopy enrolled in this study. After providing informed consent, all patients proceeded sequentially through endometrial cytology, hysteroscopy, and then dilatation and curettage (D&C). Cytology sampling was performed by brushing the uterus cavity using SAP-1 and the sample was prepared to liquid-based smear using SurePath technology. The slides were stained by Papanicolaou method. All cytological diagnoses were correlated with the D&C histological diagnoses.
  
  
  RESULTS
  Cytohistological correlations were possible in 567 (71.8%) patients: the D&C was inadequate in 204 (25.8%) patients; the cytology was inadequate in 32 (4.1%) patients; and both were inadequate in 13 (1.6%) patients. SAP-1 provided more sufficient material for cytology than D&C can for histology (p < 0.001). Taking atypical hyperplasia and endometrial carcinoma as a positive result, the diagnostic accuracy of liquid-based endometrial cytology was 81.5%; sensitivity was estimated at 75.9%, specificity at 83.3%, positive predictive value at 59.1% and negative predictive value at 91.6%.
  
  
  CONCLUSIONS
  Liquid-based endometrial cytology can be considered a useful method in the detection of endometrial pathology in postmenopausal women.
authors.affiliation: Department of Obstetrics and Gynecology, Beijing Tsinghua Changgung Hospital, Medical Center of Tsinghua University, Beijing, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Ma
authors.affiliation: Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of Obstetrics and Gynecology, Beijing Tsinghua Changgung Hospital, Medical Center of Tsinghua University, Beijing, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Chen
authors.affiliation: Department of Pathology, Peking University First Hospital, Beijing, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Pathology, Peking University First Hospital, Beijing, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Dong
authors.affiliation: Department of Gynecology, Beijing Cancer Hospital, Beijing, China.
authors.forename: Nai-Yi
authors.initials: NY
authors.lastname: Zhang
authors.affiliation: Department of Gynecology, Beijing Daxing District Hospital, Beijing, China.
authors.forename: Xiu-Hua
authors.initials: XH
authors.lastname: Ma
authors.affiliation: Department of Obstetrics and Gynecology, Beijing Tsinghua Changgung Hospital, Medical Center of Tsinghua University, Beijing, China. Electronic address: qinpingliao@126.com.
authors.forename: Qin-Ping
authors.initials: QP
authors.lastname: Liao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003581:Cytodiagnosis / Q000379:methods; D004107:Dilatation and Curettage / Q000379:methods*; D004714:Endometrial Hyperplasia / Q000473:pathology*; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D004717:Endometrium / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D008875:Middle Aged; D017698:Postmenopause; D012680:Sensitivity and Specificity; D016037:Single-Blind Method
keywords: endometrial atypical hyperplasia; endometrial carcinoma; endometrial cytology; screening