Liquid-Based Endometrial Cytology Using SurePath™ Is Not Inferior to Suction Endometrial Tissue Biopsy in Clinical Performance for Detecting Endometrial Cancer Including Atypical Endometrial Hyperplasia.
OBJECTIVE
We evaluated the clinical performance of liquid-based endometrial cytology (SurePath™) for detecting endometrial malignancies by comparison with the performance of suction endometrial tissue biopsy.


METHODS
From November 2011 to May 2013, we consecutively collected 1,118 liquid-based endometrial cytology specimens and 674 suction endometrial tissue biopsy specimens.


RESULTS
The rate of nonpositive final histology in nonpositive liquid-based endometrial cytology (98.2%) was higher than the rate of nonpositive final histology in nonpositive suction endometrial tissue biopsy (97.0%). None of the clinical performance values of liquid-based endometrial cytology for detecting the endometrial malignancies were statistically inferior to those of the suction endometrial tissue biopsy. When the positivity threshold was more than "atypical endometrial cells of undetermined significance," the rate of positive liquid-based endometrial cytology from cases with a positive final histology (84.5%) was higher than the rate of positive suction endometrial tissue biopsy from cases with a positive final histology (69.8%). However, there were still no significant differences among all the performance values.


CONCLUSIONS
Our liquid-based endometrial cytology would be more appropriate in various clinical situations as the initial detection tool for endometrial malignancies, rather than suction endometrial tissue biopsy. In addition, it could be used in screening for endometrial malignancies on a broader scale.
Department of Obstetrics and Gynecology, Faculty of Medicine, Tokyo Women's Medical University, Tokyo, Japan.
Fumiko
F
Yanaki
Yasuo
Y
Hirai
Azusa
A
Hanada
Ken
K
Ishitani
Hideo
H
Matsui
D001706:Biopsy; D003581:Cytodiagnosis / Q000295:instrumentation / Q000379:methods*; D055088:Early Detection of Cancer / Q000295:instrumentation / Q000379:methods*; D004714:Endometrial Hyperplasia / Q000175:diagnosis* / Q000473:pathology; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000473:pathology; D004717:Endometrium / Q000473:pathology*; D004867:Equipment Design; D005260:Female; D006801:Humans; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D013396:Suction
Comparative study; Endometrial suction tissue biopsy; Intrauterine sampling; Liquid-based endometrial cytology; SurePath™