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微观组织学与细胞学相结合可提高子宫内膜病变的诊断准确性。

Micro-histology combined with cytology improves the diagnostic accuracy of endometrial lesions.

机构信息

Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.

Department of Pathology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.

出版信息

Cancer Med. 2023 Aug;12(16):17028-17036. doi: 10.1002/cam4.6338. Epub 2023 Jul 17.

Abstract

BACKGROUND

In the study, we aimed to evaluate the ability of micro-histology combined with cytology to improve the quality of slides and diagnose endometrial lesions.

METHODS

Endometrial specimens were collected from Li Brushes. Every specimen was prepared for micro-histological and cytological slides, using cell block (CB) and liquid-based cytology (LBC) technologies. Semi-quantitative scoring system was used to evaluate the qualities of slides. CB slides were assessed by 5-category scoring system. Diagnostic accuracy was calculated in LBC, CB, and LBC + CB groups based on the histological gold standard. Endometrial atypical hyperplasia, and endometrial cancer were considered positive, whereas others were considered negative.

RESULTS

A total of 167 patients were enrolled. CB slides were inferior to LBC slides only in cellularity (p < 0.001), but superior in the other six parameters (all p < 0.001). The satisfaction rate of micro-histology accounted for 92.3%. The accuracy index in the CB group was higher than in the LBC group in terms of sensitivity (85.5% vs. 82.7%) and specificity (98.9% vs. 95.7%). The sensitivity and specificity in the LBC + CB group were increased to 94.2% and 99.0%, respectively.

CONCLUSIONS

The quality of micro-histological slides was higher than that of cytological slides. By combining micro-histology with cytology, higher accuracy was achieved for endometrial lesions diagnosis.

摘要

背景

本研究旨在评估微组织学结合细胞学提高切片质量和诊断子宫内膜病变的能力。

方法

采用 Li 刷采集子宫内膜标本,分别采用细胞块(CB)和液基细胞学(LBC)技术制备微组织学和细胞学切片。采用半定量评分系统评估切片质量。CB 切片采用 5 分类评分系统评估。根据组织学金标准,计算 LBC、CB 和 LBC+CB 组的诊断准确性。子宫内膜非典型增生和子宫内膜癌视为阳性,其他视为阴性。

结果

共纳入 167 例患者。CB 切片仅在细胞数量方面劣于 LBC 切片(p<0.001),但在其他六个参数方面均优于 LBC 切片(均 p<0.001)。微组织学的满意度为 92.3%。CB 组在敏感性(85.5%比 82.7%)和特异性(98.9%比 95.7%)方面的准确率指标均高于 LBC 组。LBC+CB 组的敏感性和特异性分别提高到 94.2%和 99.0%。

结论

微组织学切片的质量高于细胞学切片。通过将微组织学与细胞学相结合,可以提高子宫内膜病变诊断的准确性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0640/10501300/013506392977/CAM4-12-17028-g002.jpg

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