Liquid-based endometrial cytology: cyto-histological correlation in a population of 917 women
Liquid-based endometrial cytology: cyto-histological correlation in a population of 917 women
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DOI：
10.1111/j.1365-2303.2007.00463.x
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发表时间：
2007-08-01
期刊：
影响因子：
1.3
通讯作者：
Taddei, G. L.
中科院分区：
文献类型：
--
作者：
Buccoliero, A. M.;Gheri, C. F.;Taddei, G. L.
目的：液基细胞学检查，由于其减少模糊因素和提供薄层标本的能力，代表了一个机会，以重新评估子宫内膜细胞学。为了评估实用的液体为基础的方法在子宫内膜的诊断，我们评估其准确性比较histologic.Methods：九百一十七名妇女计划宫腔镜入组本研究。在提供知情同意后，所有的妇女依次进行宫腔镜检查，子宫内膜细胞学检查，然后活检子宫内膜sampling.Results：细胞组织学相关性可能在519例（57%）：在361例（39%）的活检是不充分的，在15（2%）的细胞学检查是不充分的，在22（2%）都是不充分的。活检时，25例（3%）妇女患有腺癌，5例（1%）患有腺瘤性不典型增生，21例（2%）患有单纯非不典型增生。在细胞学检查中，2例腺癌和1例腺瘤性不典型增生被低估为不典型增生和非不典型增生; 2例单纯非不典型增生报告为阴性; 8例为假阳性（细胞学检查为非不典型增生，活检为阴性）。在我们的人群中，细胞学比活检提供更多的足够的材料（P < 0.04）。敏感性96%，特异性98%，阳性预测值86%，阴性预测值99%。结论：子宫内膜细胞学检查是一种有效的诊断方法。它可以单独应用于选定的患者或与超声检查相结合。这两种非侵入性手术的结合可以提高诊断准确性，减少不必要的宫腔镜检查，从而为妇女和社会带来好处。
Objective: Liquid-based cytology, because of its capacity to reduce the obscuring factors and to provide thin-layer specimens, represents an opportunity to reevaluate endometrial cytology. In order to assess the utility of the liquid-based method in endometrial diagnosis, we evaluated its accuracy in comparison with histology.Methods: Nine hundred and seventeen women scheduled for hysteroscopy were enrolled in the study. After providing informed consent, all the women proceeded sequentially to hysteroscopy, endometrial cytology and then biopsy endometrial sampling.Results: Cyto-histological correlations were possible in 519 cases (57%): in 361 (39%) cases the biopsy was inadequate, in 15 (2%) the cytology was inadequate, and in 22 (2%) both were inadequate. At biopsy 25 (3%) women had adenocarcinoma, 5 (1%) had adenomatous atypical hyperplasia and 21 (2%) had simple non atypical hyperplasia. At cytology two adenocarcinomas and one adenomatous atypical hyperplasia were underrated as atypical hyperplasias and as non-atypical hyperplasia; two simple non-atypical hyperplasias were reported as negative; and eight cases were false positive (non-atypical hyperplasia at cytology, negative at biopsy). In our population, the cytology provided sufficient material more often than biopsy (P < 0.04). Sensitivity was estimated at 96%, specificity at 98%, positive predictive value at 86% and negative predictive value at 99%.Conclusions: We concluded that endometrial cytology may be an efficient diagnostic method. It could be applied to selected patients solely or in association with ultrasonography. The combination of these two noninvasive procedures may improve their diagnostic accuracy and reduce unnecessary hysteroscopies, thereby producing benefits for women and society.