New Terminology for Intrauterine Endometrial Samples: A Group Study by the Japanese Society of Clinical Cytology
New Terminology for Intrauterine Endometrial Samples: A Group Study by the Japanese Society of Clinical Cytology
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DOI：
10.1159/000336258
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发表时间：
2012-01-01
期刊：
影响因子：
1.8
通讯作者：
Norimatsu, Yoshiaki
中科院分区：
文献类型：
--
作者：
Yanoh, Kenji;Hirai, Yasuo;Norimatsu, Yoshiaki
目的：评价子宫内膜细胞学诊断的敏感性和特异性，采用描述性报告格式进行子宫内膜细胞学诊断。研究设计：对日本13家不同医院的10152例子宫内膜刮片进行分析。细胞学结果分为“恶性阴性”、“非典型子宫内膜细胞”（ATEC）、“子宫内膜增生”、“非典型子宫内膜增生”或“恶性肿瘤”。ATEC被细分为“未确定意义的ATEC”（ATEC- us）和“不能排除非典型子宫内膜增生或更多的ATEC”（ATEC- a）。将细胞学结果与组织学诊断作为金标准进行比较。当细胞学结果为“恶性阴性”且没有后续的组织学检查时，当经阴道超声检查子宫内膜正常且没有异常子宫出血时，该病例被认为是真阴性。结果：排除未行组织学检查1083例，“标本不满意”557例，ATEC-US 76例。其余8436例中，检测不典型子宫内膜增生或恶性肿瘤的敏感性和特异性分别为79.0和99.7%，阳性预测值和阴性预测值分别为92.9和98.9%。结论：建立了日本子宫内膜细胞学诊断标准。特异性对排除癌症或癌前病变是满意的。巴塞尔S. Karger股份有限公司版权所有
Objective: To evaluate the sensitivity and specificity of endometrial cytology obtained by intrauterine sample using a descriptive reporting format for endometrial cytological diagnosis. Study Design: 10,152 consecutive endometrial scrapings obtained in 13 different Japanese hospitals were analyzed. Cytological results were classified as 'negative for malignancy', 'atypical endometrial cells' (ATEC), 'endometrial hyperplasia', 'atypical endometrial hyperplasia' or 'malignant tumor'. ATEC was subclassified as 'ATEC, of undetermined significance' (ATEC-US) and 'ATEC, cannot exclude atypical endometrial hyperplasia or more' (ATEC-A). Cytological results were compared with the histological diagnosis as a gold standard. When the cytological result was 'negative for malignancy' and there was no subsequent histological examination, the case was considered a true negative when the endometrium was assessed as normal on transvaginal ultrasonography and there was no abnormal uterine bleeding. Results: 1,083 cases in which histology was not performed, 557 cases of 'unsatisfactory specimen' and 76 cases of ATEC-US were excluded. In the remaining 8,436 cases, the sensitivity and specificity, positive predictive value and negative predictive value for detecting atypical endometrial hyperplasia or malignant tumors were 79.0 and 99.7, 92.9 and 98.9%, respectively. Conclusion: The current diagnostic standards for endometrial cytology in Japan were established. Specificity is satisfactory for excluding cancer or precancerous diseases. Copyright (C) 2012 S. Karger AG, Basel