Hagiwara T, Kaku T, Kobayashi H, Hirakawa T, Nakano H
Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Madashi, Fukuoka, Japan.
Cytopathology. 2005 Jun;16(3):125-31. doi: 10.1111/j.1365-2303.2005.00251.x.
The aim of this study was to determine whether or not we could distinguish uterine papillary serous carcinoma (UPSC) from other types of endometrial cancer by cytology.
We examined the cytological findings of the endometrium from five cases with UPSC and compared them with 10 cases with endometrioid adenocarcinoma, grade 1 (G1). A morphometric analysis was performed. Cytological samples from the cervix and ascites of the patients with UPSC were also reviewed.
All five patients had FIGO stage III and IV tumours. Three patients died of the disease and two are still alive with disease. The tumour cells of UPSC tended to be shed in papillary clusters with a tumour diathesis. Psammoma bodies were seen only in UPSC. The frequency of irregular-shaped nuclei, membrane thickness and eccentric nuclei in UPSC was higher than in G1. The chromatin pattern was coarsely granular, and both anisonucleosis and bare nuclei were prominent in UPSC. Cytomorphometrically, the maximum diameter of the nuclei in UPSC was significantly greater than that in G1. The nucleoli were also more often seen in UPSC than in G1. The findings of the nuclei and nucleoli in the cervical and peritoneal fluid cytology closely resembled those in endometrial smears. The features of the cervical smears and peritoneal fluid cytology were different from those of endometrial cytology regarding clear background and small clusters of cells.
As the endometrial cytology findings accurately suggested the histological diagnosis of UPSC, the diagnosis of UPSC was confirmed in this study by endometrial cytology. The cytological diagnosis of UPSC should be based on the findings of tumour diathesis, psammoma bodies and papillary clusters composed of tumour cells with enlarged nuclei and numerous nucleoli.
本研究旨在确定能否通过细胞学方法将子宫浆液性乳头状癌（UPSC）与其他类型的子宫内膜癌区分开来。
我们检查了5例UPSC患者子宫内膜的细胞学检查结果，并将其与10例1级（G1）子宫内膜样腺癌患者的结果进行比较。进行了形态计量分析。还对UPSC患者的宫颈和腹水细胞学样本进行了复查。
所有5例患者均为国际妇产科联盟（FIGO）III期和IV期肿瘤。3例患者死于该疾病，2例仍患有疾病存活。UPSC的肿瘤细胞倾向于呈带有肿瘤素质的乳头状簇脱落。仅在UPSC中可见砂粒体。UPSC中核形状不规则、核膜厚度和偏心核的频率高于G1。染色质模式为粗颗粒状，UPSC中核大小不均和裸核均很突出。在细胞形态计量学上，UPSC中核的最大直径明显大于G1。UPSC中核仁也比G1中更常见。宫颈和腹腔积液细胞学检查中核和核仁的表现与子宫内膜涂片非常相似。宫颈涂片和腹腔积液细胞学检查的特征在背景清晰和细胞小簇方面与子宫内膜细胞学检查不同。
由于子宫内膜细胞学检查结果准确提示了UPSC的组织学诊断，本研究通过子宫内膜细胞学检查证实了UPSC的诊断。UPSC的细胞学诊断应基于肿瘤素质、砂粒体以及由核增大和核仁众多的肿瘤细胞组成的乳头状簇的检查结果。
