Nishida Naoyo, Murakami Fumihiro, Kuroda Aki, Sakamoto Yoshitaka, Tasaki Kazuto, Tasaki Shingo, Shimomura Takuya
Department of Pathology, St. Mary's Hospital, Kurume, Japan.
Acta Cytol. 2017;61(6):441-446. doi: 10.1159/000479307. Epub 2017 Aug 23.
To investigate the diagnostic utility of endometrial (EM) cell block (CB) cytology for the detection of intrauterine malignancy in postmenopausal women.
We reviewed the medical records of 104 postmenopausal women between January 2012 and November 2014. We reviewed symptoms upon admission, body mass index, parity, transvaginal ultrasonographic findings, and histopathological results based on CB and conventional cytology.
The mean age was 62.6 (range 48-95) years. The mean menopausal age was 50.8 years and the mean duration of menopause was 12.0 years. The sensitivity of CB and conventional cytology was 82.3% (29/35) and 85.7% (30/35) and the specificity was 98.6% (68/69) and 94.2% (65/69), respectively. The sensitivity and specificity of CB cytology combined with conventional cytology were 82.3% (29/35) and 94.2% (65/69), respectively. The predictive values for EM hyperplasia and type-II carcinoma were 100 and 85.7%, respectively.
CB cytology provides specimens for examination in a single outpatient session. Additionally, immunohistochemical staining can provide useful information for histological diagnosis. A combination of CB and conventional cytology can improve the diagnostic accuracy of EM lesions and may be a valid method for screening in postmenopausal women.
探讨子宫内膜(EM)细胞块(CB)细胞学检查在绝经后妇女子宫内恶性肿瘤检测中的诊断价值。
回顾性分析2012年1月至2014年11月期间104例绝经后妇女的病历。我们回顾了入院时的症状、体重指数、产次、经阴道超声检查结果以及基于CB和传统细胞学的组织病理学结果。
平均年龄为62.6岁(范围48 - 95岁)。平均绝经年龄为50.8岁,平均绝经时间为12.0年。CB和传统细胞学的敏感性分别为82.3%(29/35)和85.7%(30/35),特异性分别为98.6%(68/69)和94.2%(65/69)。CB细胞学与传统细胞学联合的敏感性和特异性分别为82.3%(29/35)和94.2%(65/69)。EM增生和II型癌的预测值分别为100%和85.7%。
CB细胞学可在单次门诊检查中提供标本进行检查。此外,免疫组化染色可为组织学诊断提供有用信息。CB与传统细胞学相结合可提高EM病变的诊断准确性,可能是绝经后妇女筛查的有效方法。