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Combining endometrium sampling device and SurePath preparation to screen for endometrial carcinoma: a validation study.

Wen J, Chen R, Zhao J, Dong Y, Yang X, Liao QP - Chin. Med. J. (2015)

Bottom Line: Histological samples were processed in routine pathology and stained by hematoxylin and eosin.Adequate specimens for cytology were obtained from 1458/1541 patients (96.3%), while adequate samples for pathology were obtained from 285/375 patients (76%).However, for postmenopausal women, 1006 of 1045 cytology (86.3%) were adequate, 153 of 238 histology (64.3%) were adequate, it was easier to collect cytological specimens than histological specimens (P < 0.05).

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.

ABSTRACT

Background: The aim of this study was to compare specimen adequacy of SAP-1 provided for cytology with that of dilation and curettage (D & C) or hysteroscopy for histology, and evaluate the accuracy of combining endometrium sampling by SAP-1 and liquid-based cytology using SurePath preparation for screening endometrial carcinoma and its precursor.

Methods: Endometrial specimens from women (n = 1514) with risk factors were obtained using an SAP-1 device for cytological analysis; histological samples were obtained from 375 of these women who underwent D & C or hysteroscopy. Cytological specimens were prepared to liquid-based smear using SurePath technology and stained by Papanicolaou. Histological samples were processed in routine pathology and stained by hematoxylin and eosin.

Results: Adequate specimens for cytology were obtained from 1458/1541 patients (96.3%), while adequate samples for pathology were obtained from 285/375 patients (76%). However, for postmenopausal women, 1006 of 1045 cytology (86.3%) were adequate, 153 of 238 histology (64.3%) were adequate, it was easier to collect cytological specimens than histological specimens (P < 0.05). The accuracy of endometrial cytology for detecting endometrial carcinoma and its precursor was 92.4% (sensitivity, 73%; specificity, 95.8%; positive predictive value, 75%; and negative predictive value, 95.3%).

Conclusions: Endometrial cytology using SAP-1 sampling and SurePath preparation may be a reliable approach for screening patients with endometrial carcinoma and its precursor.

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Related in: MedlinePlus

(a) Negative for endometrial lesions: Long, straight tube-shaped cell clumps with a small amount of stromal cells on the margin is the most common type of cell clumps in the proliferative endometrium, observed using a low-power microscope (Papanicolaou stain, ×20); (b) Benign endometrium: Dilated and branched cell clumps are always seen. The contour of the cell clumps is smooth and occasionally a few stromal cells can be observed (Papanicolaou stain, ×40); (c) Atypical endometrial cell: Double-layer or folded irregular cell clumps are observed (Papanicolaou stain, ×20); (d) Suspected endometrial carcinoma: Papillo-shaped bordered cell clumps with atypical cells can be observed (Papanicolaou stain, ×100).
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Figure 3: (a) Negative for endometrial lesions: Long, straight tube-shaped cell clumps with a small amount of stromal cells on the margin is the most common type of cell clumps in the proliferative endometrium, observed using a low-power microscope (Papanicolaou stain, ×20); (b) Benign endometrium: Dilated and branched cell clumps are always seen. The contour of the cell clumps is smooth and occasionally a few stromal cells can be observed (Papanicolaou stain, ×40); (c) Atypical endometrial cell: Double-layer or folded irregular cell clumps are observed (Papanicolaou stain, ×20); (d) Suspected endometrial carcinoma: Papillo-shaped bordered cell clumps with atypical cells can be observed (Papanicolaou stain, ×100).

Mentions: The cytological smears were evaluated by two independent gynecological cytologists who were blinded to the study procedures. Based on a previously-published diagnostic system,[5] the cytological results were subdivided into four categories as follows: Negative for epithelial lesions, benign endometrium, atypical endometrial cell, and suspected for malignant [Figures 3a–d and 4a–d]. 375 cases were performed D & C or hysteroscopic biopsy or hysterectomy. Endometrial tissue samples were fixed in neutral buffered formalin, embedded in paraffin, and stained with hematoxylin and eosin. Two gynecological pathologists independently assessed the slides, based on the World Health Organization diagnostic criteria[6] and EIN.[7] If a normal or benign endometrium was given, D & C or hysteroscopic pathology was regarded as a final result, we occasionally encountered a situation as cell features fall short of the criteria of simple/complex hyperplasia with atypia, we should carefully evaluated these lesions to determine whether or not a diagnosis of EIN could be made.


Combining endometrium sampling device and SurePath preparation to screen for endometrial carcinoma: a validation study.

Wen J, Chen R, Zhao J, Dong Y, Yang X, Liao QP - Chin. Med. J. (2015)

(a) Negative for endometrial lesions: Long, straight tube-shaped cell clumps with a small amount of stromal cells on the margin is the most common type of cell clumps in the proliferative endometrium, observed using a low-power microscope (Papanicolaou stain, ×20); (b) Benign endometrium: Dilated and branched cell clumps are always seen. The contour of the cell clumps is smooth and occasionally a few stromal cells can be observed (Papanicolaou stain, ×40); (c) Atypical endometrial cell: Double-layer or folded irregular cell clumps are observed (Papanicolaou stain, ×20); (d) Suspected endometrial carcinoma: Papillo-shaped bordered cell clumps with atypical cells can be observed (Papanicolaou stain, ×100).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4834777&req=5

Figure 3: (a) Negative for endometrial lesions: Long, straight tube-shaped cell clumps with a small amount of stromal cells on the margin is the most common type of cell clumps in the proliferative endometrium, observed using a low-power microscope (Papanicolaou stain, ×20); (b) Benign endometrium: Dilated and branched cell clumps are always seen. The contour of the cell clumps is smooth and occasionally a few stromal cells can be observed (Papanicolaou stain, ×40); (c) Atypical endometrial cell: Double-layer or folded irregular cell clumps are observed (Papanicolaou stain, ×20); (d) Suspected endometrial carcinoma: Papillo-shaped bordered cell clumps with atypical cells can be observed (Papanicolaou stain, ×100).
Mentions: The cytological smears were evaluated by two independent gynecological cytologists who were blinded to the study procedures. Based on a previously-published diagnostic system,[5] the cytological results were subdivided into four categories as follows: Negative for epithelial lesions, benign endometrium, atypical endometrial cell, and suspected for malignant [Figures 3a–d and 4a–d]. 375 cases were performed D & C or hysteroscopic biopsy or hysterectomy. Endometrial tissue samples were fixed in neutral buffered formalin, embedded in paraffin, and stained with hematoxylin and eosin. Two gynecological pathologists independently assessed the slides, based on the World Health Organization diagnostic criteria[6] and EIN.[7] If a normal or benign endometrium was given, D & C or hysteroscopic pathology was regarded as a final result, we occasionally encountered a situation as cell features fall short of the criteria of simple/complex hyperplasia with atypia, we should carefully evaluated these lesions to determine whether or not a diagnosis of EIN could be made.

Bottom Line: Histological samples were processed in routine pathology and stained by hematoxylin and eosin.Adequate specimens for cytology were obtained from 1458/1541 patients (96.3%), while adequate samples for pathology were obtained from 285/375 patients (76%).However, for postmenopausal women, 1006 of 1045 cytology (86.3%) were adequate, 153 of 238 histology (64.3%) were adequate, it was easier to collect cytological specimens than histological specimens (P < 0.05).

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.

ABSTRACT

Background: The aim of this study was to compare specimen adequacy of SAP-1 provided for cytology with that of dilation and curettage (D & C) or hysteroscopy for histology, and evaluate the accuracy of combining endometrium sampling by SAP-1 and liquid-based cytology using SurePath preparation for screening endometrial carcinoma and its precursor.

Methods: Endometrial specimens from women (n = 1514) with risk factors were obtained using an SAP-1 device for cytological analysis; histological samples were obtained from 375 of these women who underwent D & C or hysteroscopy. Cytological specimens were prepared to liquid-based smear using SurePath technology and stained by Papanicolaou. Histological samples were processed in routine pathology and stained by hematoxylin and eosin.

Results: Adequate specimens for cytology were obtained from 1458/1541 patients (96.3%), while adequate samples for pathology were obtained from 285/375 patients (76%). However, for postmenopausal women, 1006 of 1045 cytology (86.3%) were adequate, 153 of 238 histology (64.3%) were adequate, it was easier to collect cytological specimens than histological specimens (P < 0.05). The accuracy of endometrial cytology for detecting endometrial carcinoma and its precursor was 92.4% (sensitivity, 73%; specificity, 95.8%; positive predictive value, 75%; and negative predictive value, 95.3%).

Conclusions: Endometrial cytology using SAP-1 sampling and SurePath preparation may be a reliable approach for screening patients with endometrial carcinoma and its precursor.

Show MeSH
Related in: MedlinePlus