Ma Ke, Yang Xi, Chen Rui, Zhao Jian, Dong Ying, Zhang Nai-Yi, Ma Xiu-Hua, Liao Qin-Ping
Department of Obstetrics and Gynecology, Beijing Tsinghua Changgung Hospital, Medical Center of Tsinghua University, Beijing, China.
Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China.
Taiwan J Obstet Gynecol. 2016 Dec;55(6):777-781. doi: 10.1016/j.tjog.2015.09.006.
The aim of this study was to investigate the diagnostic accuracy of liquid-based endometrial cytology in postmenopausal women, in comparison with histology.
There were 790 postmenopausal women scheduled for hysteroscopy enrolled in this study. After providing informed consent, all patients proceeded sequentially through endometrial cytology, hysteroscopy, and then dilatation and curettage (D&C). Cytology sampling was performed by brushing the uterus cavity using SAP-1 and the sample was prepared to liquid-based smear using SurePath technology. The slides were stained by Papanicolaou method. All cytological diagnoses were correlated with the D&C histological diagnoses.
Cytohistological correlations were possible in 567 (71.8%) patients: the D&C was inadequate in 204 (25.8%) patients; the cytology was inadequate in 32 (4.1%) patients; and both were inadequate in 13 (1.6%) patients. SAP-1 provided more sufficient material for cytology than D&C can for histology (p < 0.001). Taking atypical hyperplasia and endometrial carcinoma as a positive result, the diagnostic accuracy of liquid-based endometrial cytology was 81.5%; sensitivity was estimated at 75.9%, specificity at 83.3%, positive predictive value at 59.1% and negative predictive value at 91.6%.
Liquid-based endometrial cytology can be considered a useful method in the detection of endometrial pathology in postmenopausal women.
本研究旨在探讨与组织学相比，液基子宫内膜细胞学检查在绝经后女性中的诊断准确性。
本研究纳入了790例计划进行宫腔镜检查的绝经后女性。在获得知情同意后，所有患者依次进行子宫内膜细胞学检查、宫腔镜检查，然后进行刮宫术（D&C）。采用SAP-1刷取子宫腔进行细胞学采样，并使用SurePath技术制备液基涂片。玻片采用巴氏染色法染色。所有细胞学诊断均与刮宫术组织学诊断进行对照。
567例（71.8%）患者可进行细胞组织学对照：204例（25.8%）患者刮宫术取材不足；32例（4.1%）患者细胞学取材不足；13例（1.6%）患者两者取材均不足。与刮宫术组织学取材相比，SAP-1为细胞学提供了更充足的材料（p < 0.001）。将不典型增生和子宫内膜癌视为阳性结果，液基子宫内膜细胞学检查的诊断准确性为81.5%；敏感性估计为75.9%，特异性为83.3%，阳性预测值为59.1%，阴性预测值为91.6%。
液基子宫内膜细胞学检查可被认为是检测绝经后女性子宫内膜病变的一种有用方法。
