Wu Ming-Zhe, Gu Na-Jin, Xiao Ming-Ming, Liu Dong-Ge, Jin Mu-Lan, Liu Xu-Yan, Wang Jian, Xu Hong-Tao, Zhang Yi, Wu Guang-Ping
Department of Gynecology, The First Hospital of China Medical University, Shenyang, 110001, China.
Department of Pathology, The Second Hospital of Dalian Medical University, Dalian, 116027, China.
Diagn Pathol. 2025 Apr 1;20(1):32. doi: 10.1186/s13000-025-01631-4.
The accurate cytological diagnosis of endometrial carcinomas by minimally invasive method has a broad application. There are several articles described the morphological characteristics but not arrangements of endometrial lesion cells on LBC slides.
A retrospective study was conducted using 175 endometrial samples obtained by direct negative pressure suction with disposable endometrial sampler. All lesions were diagnosed both cytologically and histologically, and the diagnostic results were compared and analyzed.
The cytological diagnoses of polyps, simple or complex hyperplasia, and atypical hyperplasia were highly consistent with the histological diagnosis. The cytological features of polyps and normal endometrium, as well as simple and complex hyperplasia, are the same. Among 82 cases of histologically confirmed adenocarcinoma, the cytological diagnosis were adenocarcinoma cells (46 cases, 56.10%), suspected for adenocarcinoma cells (22 cases, 26.83%), and false negative (14 cases,17.07%). Retrospective reviewing the slide suggest diagnostic parameters such as significantly enlarged nuclei, multistage papillary arrangements, large and numerous nucleoli, and large vacuoles containing neutrophils in the cytoplasm are reliable diagnostic criteria for endometrial carcinoma cells; on the other hand, ignorance of lobulated arrangements and escaped arrangements are the main reasons for missed diagnosis.
The cytological diagnosis of endometrial lesions not only depends on the morphological characteristics of cells, but also need careful observations of the cellular arrangements.
通过微创方法对子宫内膜癌进行准确的细胞学诊断具有广泛的应用。有几篇文章描述了液基薄层制片(LBC)玻片上子宫内膜病变细胞的形态特征,但未提及细胞排列情况。
采用一次性子宫内膜采样器直接负压吸引获取175份子宫内膜样本进行回顾性研究。所有病变均进行了细胞学和组织学诊断,并对诊断结果进行了比较和分析。
息肉、单纯性或复杂性增生以及非典型增生的细胞学诊断与组织学诊断高度一致。息肉与正常子宫内膜以及单纯性和复杂性增生的细胞学特征相同。在82例经组织学确诊的腺癌中,细胞学诊断为腺癌细胞(46例,56.10%)、疑似腺癌细胞(22例,26.83%)和假阴性(14例,17.07%)。回顾玻片发现,核显著增大、多级乳头样排列、核仁大且多以及细胞质中含有中性粒细胞的大空泡等诊断参数是子宫内膜癌细胞可靠的诊断标准;另一方面,忽略分叶状排列和游离排列是漏诊的主要原因。
子宫内膜病变的细胞学诊断不仅取决于细胞的形态特征,还需要仔细观察细胞排列情况。