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管芯细胞学和活检在诊断子宫内膜样腺癌中的应用。

Utility of Pipet Curet Cytology and Biopsy as a Diagnostic Method for Endometrial Endometrioid Carcinoma.

机构信息

Department of Diagnostic Pathology, Tokai University Hachioji Hospital, Tokyo, Japan,

Department of Diagnostic Pathology, Tokai University Hachioji Hospital, Tokyo, Japan.

出版信息

Acta Cytol. 2024;68(5):413-422. doi: 10.1159/000541279. Epub 2024 Sep 5.

DOI:10.1159/000541279
PMID:39236701
Abstract

INTRODUCTION

We aimed to determine the utility of Pipet Curet cytology (PCC) and Pipet Curet biopsy (PCB) for diagnosing uterine endometrial endometrioid carcinoma (EEC).

METHODS

We divided 77 patients with EEC into two groups per Federation of Gynecology and Obstetrics (FIGO) grades: G1 (n = 44) and G2/3 (n = 33) and compared the diagnostic sensitivity of PCC, PCB, and PCC and PCB combined, retrospectively. Next, we investigated any diagnostic discordance between PCC-based and PCB-based diagnoses per FIGO grade group.

RESULTS

The diagnostic sensitivity of PCC, PCB, and the two modalities combined was significantly higher for G2/3 EECs than for G1 EECs (72.7% vs. 45.5%, p = 0.0209; 84.8% vs. 63.6%, p = 0.0434; and 93.9% vs. 65.9%, p = 0.0046, respectively), likely due to more friable cancer cells in higher grade EEC cases. Among our 77 EEC patients, there were 4 patients (5.19%) with PCC-based concordant but PCB-based discordant results against EEC, in the G2/3 group predominantly. Diagnostic sensitivity of all cases increased from 72.7% (56/77) by PCB alone to 77.9% (60/77) by use of both modalities combined.

CONCLUSION

Cytologic evaluation can reduce the number of false-negative histologic diagnoses. By providing complementary information, the two modalities combined from the Pipet Curet procedure would be valuable as a diagnostic method for EEC.

摘要

简介

本研究旨在评估 Pipet Curet 细胞学(PCC)和 Pipet Curet 活检(PCB)在诊断子宫内膜子宫内膜样癌(EEC)中的作用。

方法

我们根据美国妇产科医师学会(FIGO)分级将 77 例 EEC 患者分为 G1 组(n=44)和 G2/3 组(n=33),并回顾性比较了 PCC、PCB 以及二者联合的诊断敏感性。接下来,我们研究了 FIGO 分级组中基于 PCC 和 PCB 的诊断之间的任何诊断差异。

结果

对于 G2/3 EEC,PCC、PCB 以及二者联合的诊断敏感性显著高于 G1 EEC(72.7% vs. 45.5%,p=0.0209;84.8% vs. 63.6%,p=0.0434;93.9% vs. 65.9%,p=0.0046),这可能是由于高级别 EEC 中癌细胞更脆。在我们的 77 例 EEC 患者中,G2/3 组中 4 例(5.19%)患者的 PCC 结果与 EEC 相符但 PCB 结果不符。所有病例的诊断敏感性从单独使用 PCB 的 72.7%(56/77)增加到联合使用两种方法的 77.9%(60/77)。

结论

细胞学评估可减少假阴性的组织学诊断。Pipet Curet 操作的两种方法联合使用可以提供互补信息,对 EEC 的诊断具有重要价值。

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