Gomez-Fernandez C R, Ganjei-Azar P, Behshid K, Averette H E, Nadji M
Department of Pathology, University of Miami/Jackson Memorial Medical Center, Miami, Florida 33136, USA.
Obstet Gynecol. 2000 Dec;96(6):874-8. doi: 10.1016/s0029-7844(00)01038-3.
To determine whether the prevalence of normal endometrial cells in Papanicolaou smears of women with and those without endometrial carcinoma or hyperplasia differs significantly.
Papanicolaou smears of women with biopsy-proved endometrial hyperplasia or carcinoma diagnosed between 1990 and 1998 were reviewed for the presence of normal endometrial cells. Chi-square and a power analysis were used to compare these smears with results of smears from women older than 35 years of age with tissue diagnoses other than hyperplasia or carcinoma. All Papanicolaou smears obtained within the 5 years before endometrial sampling were reviewed. Each patient had at least one smear done within the previous 12 months. Clinical information was available for all patients.
Of the 201 women in whom endometrial hyperplasia (n = 103) or carcinoma (n = 98) was diagnosed, 4 (2%) had normal endometrial cells in otherwise negative Papanicolaou smears. Of the 289 women in the comparison group, 15 (5%) had normal endometrial cells in their Papanicolaou smears. The prevalence of normal endometrial cells did not differ significantly between the two groups (P =.071). The study had 80% power to detect a 5% or greater difference between groups.
The prevalence of normal endometrial cells in Papanicolaou smears of women with endometrial carcinoma or hyperplasia does not significantly differ from that in women without these conditions. Reporting normal endometrial cells in Papanicolaou smears according to the recommendations of the Bethesda System may lead to unnecessary procedures and patient anxiety.
确定患有和未患有子宫内膜癌或子宫内膜增生的女性巴氏涂片检查中正常子宫内膜细胞的患病率是否存在显著差异。
回顾1990年至1998年间经活检证实患有子宫内膜增生或癌的女性的巴氏涂片，以检查是否存在正常子宫内膜细胞。采用卡方检验和效能分析，将这些涂片与35岁以上、组织诊断非增生或癌的女性的涂片结果进行比较。回顾了在子宫内膜取样前5年内获得的所有巴氏涂片。每位患者在过去12个月内至少进行了一次涂片检查。所有患者均有临床资料。
在诊断为子宫内膜增生（n = 103）或癌（n = 98）的201名女性中，4名（2%）在其他方面为阴性的巴氏涂片中发现有正常子宫内膜细胞。在对照组的289名女性中，15名（5%）在巴氏涂片中发现有正常子宫内膜细胞。两组中正常子宫内膜细胞的患病率无显著差异（P = 0.071）。该研究有80%的效能检测出两组之间5%或更大的差异。
患有子宫内膜癌或增生的女性巴氏涂片中正常子宫内膜细胞的患病率与未患这些疾病的女性相比无显著差异。按照贝塞斯达系统的建议报告巴氏涂片中的正常子宫内膜细胞可能会导致不必要的检查和患者焦虑。
