Factors determining the degree of endometrial exfoliation and their diagnostic implications in endometrial adenocarcinoma.

Since the degree of endometrial exfoliation largely determines the ability of cytology to diagnose endometrial adenocarcinomas by the study of cervicovaginal smears, five features of their subsequent histologically diagnosed endometrial adenocarcinomas were studied in 28 patients whose smears contained endometrial cells. The surface area occupied by abnormal endometrium was found to be an important determinant in the degree of endometrial exfoliation. The tumor grade, endocervical involvement, pattern of growth and squamous-cell component were all factors that influenced cellular shedding. The extent of myometrial involvement did not affect the likelihood that an endometrial adenocarcinoma would be diagnosed cytologically prior to histologic examination.