El-Fakharany Mohamed, Meroueh Chady, Kurella Sreedevi, Mazzara Paul
Department of Pathology, St. John Hospital and Medical Center, Detroit, Michigan, USA.
Acta Cytol. 2007 Mar-Apr;51(2):178-82. doi: 10.1159/000325712.
To determine the impact of adding a qualifying educational note when exfoliated endometrial cells were present in the first half of the menstrual cycle.
We identified all Pap smears that had endometrial cells in women > or = 40 years, between July and November, 2004. When endometrial cells were seen in the first half of menstrual cycle, it was stated that, "endometrial cells correlate with the menstrual history provided." We then attempted to determine if this qualifying comment had an impact on the decision to obtain a follow-up endometrial biopsy.
A total of 325 women were identified. Of these, 51 (15.7%) had follow-up endometrial biopsy without clinical evidence of endometrial pathology, compared to a rate of 36.9% before implementation of the note (p < 0.0001). Biopsies were performed in 21 of 195 (10.8%) when the note indicated that endometrial cells correlated with menstrual history, compared to 30 of 130 (23%) in whom a different note was appended because endometrial cells were out of phase or patients were postmenopausal (p = 0.0032). Biopsies did not reveal significant endometrial pathology in any of the 51 patients.
Adding an educational note when endometrial cells are reported in the first half of the menstrual cycle in women > or = 40 years may help reduce unnecessary biopsies.
确定在月经周期前半期出现脱落的子宫内膜细胞时添加一条合格的教育性注释的影响。
我们识别出了2004年7月至11月期间年龄≥40岁的女性中所有存在子宫内膜细胞的巴氏涂片。当在月经周期前半期看到子宫内膜细胞时，会注明“子宫内膜细胞与所提供的月经史相关”。然后我们试图确定这条合格注释是否对进行后续子宫内膜活检的决定有影响。
共识别出325名女性。其中，51名（15.7%）进行了后续子宫内膜活检，但无子宫内膜病变的临床证据，而在该注释实施前这一比例为36.9%（p<0.0001）。当注释表明子宫内膜细胞与月经史相关时，195名女性中有21名（10.8%）进行了活检，相比之下，因子宫内膜细胞不同步或患者已绝经而附加不同注释的130名女性中有30名（23%）进行了活检（p=0.0032）。51名患者中均未发现明显的子宫内膜病变。
在年龄≥40岁女性月经周期前半期报告子宫内膜细胞时添加一条教育性注释可能有助于减少不必要的活检。
