在1987名女性群体中，将液基子宫内膜细胞学检查与刮宫术相结合用于子宫内膜癌的调查。

Liquid-based endometrial cytology associated with curettage in the investigation of endometrial carcinoma in a population of 1987 women.

作者信息

Yang Xi, Ma Ke, Chen Rui, Zhao Jian, Wu Cheng, Zhang Naiyi, Ma Xiuhua, Dong Ying, Zhu Sainan, Liao Qinping

机构信息

Department of Obstetrics and Gynecology, Beijing Tsinghua Changgung Hospital, Medical Center of Tsinghua University, No. 168 Litang Road, Changping District, Beijing, China.

Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China.

出版信息

Arch Gynecol Obstet. 2017 Jul;296(1):99-105. doi: 10.1007/s00404-017-4400-2. Epub 2017 May 29.

DOI:10.1007/s00404-017-4400-2

PMID:28555323

Abstract

PURPOSE

The aim of this study was to investigate the diagnostic accuracy of liquid-based endometrial cytology, in comparison with histology.

METHODS

1987 patients scheduled for hysteroscopy were enrolled in this study. 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 diagnosis was correlated with the D&C histological diagnosis.

RESULTS

Cyto-histological correlations were possible in 1672 (89.3%) patients: in 254 (12.8%) patients the D&C was inadequate, in 75 (3.8%) patients the cytology was inadequate, and in 14 (0.7%) patients both were inadequate. In postmenopausal women, 758 of 790 cytologies (96.0%) were adequate, while 586 of 790 histologies (74.2%) were adequate. SAP-1 provided more sufficient materials for cytology than D&C for histology (P < 0.001). Taking atypical hyperplasia or worse as a positive result, the diagnostic accuracy of liquid-based endometrial cytology was 86.1%, sensitivity was estimated at 70.3%, specificity at 88.5%, positive predictive value at 48.0% and negative predictive value at 95.2%. Taking endometrial carcinoma as a positive result, the diagnostic accuracy of liquid-based endometrial cytology was 94.4%; sensitivity was estimated at 53.2%, specificity at 98.6%, positive predictive value at 79.8% and negative predictive value at 95.3%.

CONCLUSIONS

Liquid-based endometrial cytology can be considered a useful method for detecting of endometrial pathology as a first-line approach.

摘要

目的

本研究旨在探讨液基子宫内膜细胞学检查与组织学检查相比的诊断准确性。

方法

本研究纳入了1987例计划进行宫腔镜检查的患者。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）。通过使用SAP-1刷取子宫腔进行细胞学采样，并使用SurePath技术将样本制备成液基涂片。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相关。

结果

1672例（89.3%）患者可进行细胞-组织学相关性分析：254例（12.8%）患者刮宫术取材不足，75例（3.8%）患者细胞学取材不足，14例（0.7%）患者两者取材均不足。在绝经后女性中，790例细胞学检查中有758例（96.0%）取材充足，而790例组织学检查中有586例（74.2%）取材充足。与组织学检查的刮宫术相比，SAP-1为细胞学检查提供了更充足的材料（P < 0.001）。以非典型增生或更严重病变为阳性结果，液基子宫内膜细胞学检查的诊断准确性为86.1%，敏感性估计为70.3%，特异性为88.5%，阳性预测值为48.0%，阴性预测值为95.2%。以子宫内膜癌为阳性结果，液基子宫内膜细胞学检查的诊断准确性为94.4%；敏感性估计为53.2%，特异性为98.6%，阳性预测值为79.8%，阴性预测值为95.3%。