薄层细胞学和组织病理学在异常子宫出血评估中的应用
Thin-layer cytology and histopathology in the evaluation of abnormal uterine bleeding.
作者信息
Garcia Francisco, Barker Bel, Davis John, Shelton Troy, Harrigill Keith, Schalk Nicole, Meyer Jane, Hatch Kenneth
机构信息
Departments of Obstetrics and Gynecology and of Pathology, Hispanic Center of Excellence, University of Arizona Health Sciences Center, Tucson, 1501 North Campbell Avenue, Box 245078, Tucson, AZ 85724-5078, USA.
出版信息
J Reprod Med. 2003 Nov;48(11):882-8.
OBJECTIVE
To compare thin-layer endometrial cytology to endometrial biopsy and surgical pathology in women with abnormal uterine bleeding.
STUDY DESIGN
We performed a prospective study of 103 women. Patients underwent endometrial cytologic evaluation using an endometrial brush, followed by either endometrial biopsy, hysteroscopy with dilation and curettage, or hysterectomy, as clinically indicated. Test performance characteristics and adequacy of cytology and endometrial biopsy were assessed. Ki-67 immunocytochemical expression was evaluated in a random subset of 60 specimens.
RESULTS
Cytologic sampling demonstrated a sensitivity of 78%, a specificity of 96%, a positive predictive value of 78% and a negative predictive value of 96% for the detection of endometrial abnormalities. The unsatisfactory rate of uterine cytology was 15% as compared to 26% for endometrial biopsy. Of adenocarcinoma cases, 83% expressed Ki-67, as compared to 30% in benign cases.
CONCLUSION
Endometrial cytology may be useful in the detection of endometrial hyperplasia and neoplasia and provides adequate material for the assessment of Ki-67.
目的
比较薄层子宫内膜细胞学检查与子宫内膜活检及手术病理检查在子宫异常出血女性中的应用。
研究设计
我们对103名女性进行了一项前瞻性研究。患者使用子宫内膜刷进行子宫内膜细胞学评估，然后根据临床指征进行子宫内膜活检、宫腔镜下刮宫或子宫切除术。评估了细胞学检查和子宫内膜活检的检测性能特征及充分性。对60个标本的随机子集评估了Ki-67免疫细胞化学表达。
结果
细胞学采样检测子宫内膜异常的敏感性为78%，特异性为96%，阳性预测值为78%，阴性预测值为96%。子宫细胞学检查不满意率为15%，而子宫内膜活检为26%。在腺癌病例中，83%表达Ki-67，而良性病例中为30%。
结论
子宫内膜细胞学检查在检测子宫内膜增生和肿瘤方面可能有用，并为评估Ki-67提供足够的材料。
Zotero 插件