Department of Pathology , NYU Langone Health, New York, NY.
Department of Pathology, NYU Robert I. Grossman School of Medicine, NYC Health + Hospitals, New York, NY.
Am J Clin Pathol. 2020 Aug 5;154(3):381-386. doi: 10.1093/ajcp/aqaa041.
The 2014 Bethesda System (TBS 2014) guidelines for reporting cervical cytology revised the age for reporting benign endometrial cells (BECs) from 40 years or older to age 45 years or older. We evaluated this change and further investigated if extending the reporting age to 50 years or older may be acceptable.
We reviewed cases with BECs reported on Papanicolaou tests in women age 40 years or older and 45 years or older before and after implementation of TBS 2014. Follow-up endometrial biopsy/curettage results were categorized as benign, endometrial hyperplasia with or without atypia, or malignant. Hyperplasia and malignant follow-up were considered clinically significant. Clinical data were documented. Results were compared for women age 40 to 44, 45 to 49, and 50 years or older.
Follow-up in 15 (100%) women age 40 to 44 years was benign. In women age 45 to 49 years, 61 (96.8%) had benign follow-up, one (1.6%) had atypical hyperplasia, and one (1.6%) had malignant follow-up. In women age 50 years or older, 57 (86.5%) had benign follow-up, four (6%) had malignant follow-up, and seven (7.5%) had atypical or nonatypical hyperplasia. There was a significant difference in follow-up between the age groups of 40 to 49 and 50 or older (P = .023).
We conclude that the TBS 2014 revision was justified. Our data suggest that age 50 years or older rather than age 45 years or older may be an acceptable cutoff for reporting BECs.
2014 年贝塞斯达系统（TBS 2014）宫颈细胞学报告指南修订了报告良性子宫内膜细胞（BEC）的年龄标准，从 40 岁或以上改为 45 岁或以上。我们评估了这一变化，并进一步研究将报告年龄延长至 50 岁或以上是否可以接受。
我们回顾了在 TBS 2014 实施前后，年龄在 40 岁或以上和 45 岁或以上的女性中报告有 BEC 的巴氏涂片检查病例。随访子宫内膜活检/刮宫结果分为良性、有或无不典型增生的子宫内膜增生、恶性。增生和恶性随访被认为具有临床意义。记录临床数据。比较了年龄在 40 岁至 44 岁、45 岁至 49 岁和 50 岁或以上的女性的结果。
在年龄在 40 岁至 44 岁的 15 名（100%）女性中，随访均为良性。在年龄在 45 岁至 49 岁的 61 名（96.8%）女性中，有 61 名（96.8%）随访为良性，1 名（1.6%）为不典型增生，1 名（1.6%）为恶性。在年龄在 50 岁或以上的 57 名（86.5%）女性中，有 57 名（86.5%）随访为良性，4 名（6%）为恶性，7 名（7.5%）为不典型或非典型增生。40 岁至 49 岁和 50 岁或以上两个年龄组之间的随访结果有显著差异（P =.023）。
我们的结论是 TBS 2014 的修订是合理的。我们的数据表明，50 岁或以上的年龄可能比 45 岁或以上更适合作为报告 BEC 的截止年龄。
