Evaluation of Endometrial Cytology: Cytohistological Correlations in 1,441 Cancer Patients
Evaluation of Endometrial Cytology: Cytohistological Correlations in 1,441 Cancer Patients
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DOI：
10.1159/000368162
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发表时间：
2015-01-01
期刊：
影响因子：
3.5
通讯作者：
Suzuki, Mitsuaki
中科院分区：
文献类型：
--
作者：
Fujiwara, Hiroyuki;Takahashi, Yoshifumi;Suzuki, Mitsuaki
背景：在日本，子宫内膜细胞学检查是子宫内膜最常见的初步评估方法。然而，其对子宫内膜癌的诊断价值仍然未知。在此，我们评估细胞病理学和组织病理学之间的相关性，以评估细胞学对子宫内膜癌的诊断价值。研究方法：组织学证实的子宫内膜癌患者和子宫切除术证实的正常子宫内膜对照组均在2001年至2010年期间在我们的8家机构进行了术前子宫内膜细胞学检查，并进行了回顾性分析。根据临床分期、组织学类型、分化程度和取材工具对细胞学结果进行比较。结果：我们分析了1,441例子宫内膜癌和1,361例对照病例。子宫内膜细胞学检查在1，279例（916例阳性和363例可疑）病例中检出癌症，灵敏度（阳性加可疑病例）为88.8%，特异性为98.5%。在晚期、非类胶质瘤和未分化的病例中阳性率较高，但这些临床条件之间的敏感性无显著差异。总结：子宫内膜细胞学检查对子宫内膜癌具有较高的敏感性和特异性，临床分期、组织学类型、分化程度、样本数量或取样工具均不影响其统计学指标。这些发现形成了一个上级数据集，用于评价子宫内膜细胞学检查的有效性。(C)2014年S. Karger AG，巴塞尔
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. Conclusion: 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. (C) 2014 S. Karger AG, Basel