Endometrial glandular and stromal breakdown, part 2: Cytomorphology of papillary metaplastic changes
Endometrial glandular and stromal breakdown, part 2: Cytomorphology of papillary metaplastic changes
复制标题
DOI：
10.1002/dc.20512
复制
发表时间：
2006-10-01
影响因子：
1.3
通讯作者：
Ohno, Eiji
中科院分区：
文献类型：
--
作者：
Norimatsu, Yoshiaki;Shimizu, Keiko;Ohno, Eiji
仔细的细胞形态学评估异常子宫内膜病变使准确和可重复的显微镜评估成为可能。无排卵周期引起的功能失调性子宫出血患者的组织病理学通常包括子宫内膜腺和间质破裂（EGBD）和子宫内膜表面上皮乳头状化生，如果收集了适当的样本。我们经常在EGBD病例的细胞学涂片中发现异常的细胞团块。由化生细胞组成，细胞团边缘可见不规则的小突起。我们描述了子宫内膜细胞样本中不规则突起化生团块（MCIP）的定量。目前的研究提出了在EGBD病例中发现的化生变化的细胞形态学特征。在7年的时间里，144例患者在使用内吞细胞直接收集子宫内膜样本后，在子宫内膜刮除后获得了组织病理学诊断。材料包括49例正常增生性子宫内膜（NPE）（患者年龄28-51岁，平均39.9），32例EGBD（患者年龄30-67岁，平均49.6），63例无异型性子宫内膜增生（EH）（患者年龄35-65岁，平均47.7）。观察以下几点：(1)化生细胞的发生情况；(2) MCIP的发生和频率；(3)间质团凝聚的MCIP的发生。93.8%的EGBD病例出现化生细胞。MCIP细胞形态检出率为90.6%，发生率为16.1%。与其他病变（如NPE和EH）相比，含有浓缩基质团簇的MCIP的发生率（93.1%）与NPE和EH有很强的相关性。我们的数据似乎表明，伴有间质凝聚团的MCIP的出现源于发生在子宫内膜表面上皮的乳头状化生。这些细胞的细胞学观察可能是提供EGBD子宫内膜性质的有用指标。
Careful cytomorphologic evaluation of abnormal endometrial lesions has made accurate and reproducible microscopic assessment possible. Histopathology of patients with dysfunctional uterine bleeding due to an anovulatory cycle usually contain endometrial glandular and stromal breakdown (EGBD) and papillary metaplasia on the endometrial surface epithelium, if an appropriate sample has been collected. We often recognized abnormal cell clumps in the cytological smears with EGBD cases. They were composed of metaplastic cells, and some irregular small projection figures were observed from the margins of the cell clumps. We describe the quantitation of metaplastic clumps with irregular protrusions (MCIP) in endometrial endocyte samples. The current study presents the cytomorphological characteristics of the metaplastic changes recognized in EGBD cases.During a 7-yr period, 144 cases for which histopathological diagnoses were obtained following endometrial curettage, after collecting a direct endometrial sample using the endocyte. The material comprised 49 cases of normal proliprative endometrium (NPE) (patients aged 28-51, average 39.9), 32 cases of EGBD (patients aged 30-67, average 49.6), and 63 cases of endometrial hyperplasia without atypia (EH) (patients aged 35-65, average 47.7). The following points were investigated: (1) the occurrence of metaplastic cells; (2) the occurrence and the frequency of MCIP; and (3) the occurrence of MCIP that contains condensed stromal clusters.Metaplastic cells were seen in 93.8% of the EGBD cases. Cytomorphologic pattern identified with MCIP was 90.6%, and its frequency showed 16.1%. The occurrence of MCIP that contain condensed stromal clusters (93.1%) showed a strong association in comparison with other lesions, such as NPE and EH. Our data appear to indicate that the appearance of MCIP with condensed stromal clusters originated from the papillary metaplasia, which occurred on the endometrial sur(ace epithelium. The cytologic observation of those cells may be a useful indicator for providing the nature of EGBD endometrium.