NEW CONCEPT IN DIAGNOSTIC ENDOMETRIAL CYTOLOGY - DIAGNOSTIC-CRITERIA BASED ON COMPOSITION AND ARCHITECTURE OF LARGE TISSUE FRAGMENTS IN SMEARS
NEW CONCEPT IN DIAGNOSTIC ENDOMETRIAL CYTOLOGY - DIAGNOSTIC-CRITERIA BASED ON COMPOSITION AND ARCHITECTURE OF LARGE TISSUE FRAGMENTS IN SMEARS
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DOI：
10.1136/jcp.39.1.36
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发表时间：
1986-01-01
影响因子：
3.4
通讯作者：
SKAARLAND, E
中科院分区：
文献类型：
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作者：
SKAARLAND, E
常规子宫内膜细胞学被用来代替刮宫作为子宫内膜形态学调查的第一步在绝经后出血的患者。绝经前妇女的症状或迹象表明，癌前或恶性疾病也研究使用这种方法。细胞学结果令人担忧的患者通过刮除进一步调查。子宫内膜细胞学的诊断标准尚未完全建立：本研究中使用了新的诊断标准，这是基于涂片中较大组织碎片的组成和结构。新标准对于解决由核大小变化引起的诊断问题特别有用。在三年内（1981年1月至1984年1月）进行了2,625次细胞学检查。2520例（96%）标本中有足够的诊断材料。在2378例（94%）病例中，基于细胞学的诊断为阴性，即不能指示恶性或癌前病变。1984年的后续研究没有出现假阴性结果。子宫内膜腺癌31例，宫颈癌或宫颈原位癌11例，卵巢癌4例，均经组织学检查证实。在报告的20例疑似癌中，有12例得到证实。腺瘤性增生的细胞学诊断敏感性低：50例组织学对照病例中只有10例在刮除后得到证实。
Routine endometrial cytology was used instead of curettage as the first step in a morphological investigation of the endometrium in patients with postmenopausal bleeding. Premenopausal women with symptoms or signs indicative of premalignant or malignant disease were also studied using this method. Patients with alarming cytological findings were further investigated with curettage. Diagnostic criteria for endometrical cytology have not been fully established: new diagostic criteria were used in this study, which were based on the composition and architecture of larger tissue fragments in the smears. The new criteria were especially useful for tackling diagnostic problems caused by variation in nuclear size. Two thousand six hundred and twenty five cytologial investigations were conducted over three years (January 1981 to January 1984). Adequate material for diagnosis was found in 2520 specimens (96%). Diagnosis based on the cytology was negative-that is, not indicative of malignant or premalignant disease in 2378 cases (94%). Follow up studies in 1984 showed no false negative results. Adenocarcinoma of the endometrium was diagnosed in 31 cases, carcinoma or carcinoma in situ of the cervix in 11 cases, and carcinoma of the ovary in four cases, all confirmed by histological investigation. Of 20 cases reported as suspected carcinoma, 12 of these were verified. The cytological diagnosis of adenomatous hyperplasia showed a low sensibility: only ten of 50 histologically controlled cases could be verified after curettage.