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Omine H, Ishida K, Sasaki N, Kato H, Nagai T, Ishikawa M, Takaoka M, Noda S, Matsuda H, Mitsuhashi A. Endometrial cytological findings for a mesonephric-like endometrial adenocarcinoma: A case report. Diagn Cytopathol 2024; 52:E129-E133. [PMID: 38454318 DOI: 10.1002/dc.25300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 02/22/2024] [Accepted: 03/01/2024] [Indexed: 03/09/2024]
Abstract
A mesonephric-like endometrial adenocarcinoma (ML-EAC) is very rare and has a worse prognosis than other endometrial carcinomas. We describe an ML-EAC and report our endometrial cytological findings. A 76-year-old woman presented with irregular genital bleeding and a uterine mass. Endometrial cytology revealed atypical cylindrical or spindle-shaped cells in the form of small aggregates or solitary cells. The cell aggregates exhibited irregularly stacked papillary structures, small glandular structures, and fenestrated structures. The atypical cells had a nucleus with fine-granular chromatin and a granular cytoplasm, and nuclear grooves and intranuclear pseudo-inclusions were present. Hyaline globules were observed in the glandular lumens and in the background. The presumptive histological type was an adenocarcinoma, but the cytological features were different from those of an endometrioid carcinoma. A histological examination of the endometrial biopsy revealed an adenocarcinoma, and a simple hysterectomy was performed. A grayish-white elevated mass measuring 90 mm × 70 mm × 40 mm was observed on the uterine corpus in the hysterectomy specimen. Histologically, the tumor proliferated as complex tubular structures containing eosinophilic colloid-like materials and trabecular structures. The tumor cells were diffuse and positive for GATA-3 and partially positive for thyroid transcription factor-1. Estrogen and progesterone receptors were negative. An ML-EAC was diagnosed. The tumor was invasive and extended beyond one-half of the muscle layer with a high degree of vascular invasion. In conclusion, we need to focus on the various shapes of the cell aggregate, nuclear grooves, and intranuclear pseudo-inclusions of tumor cells to distinguish an ML-EAC from other endometrial carcinomas in endometrial cytology.
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Affiliation(s)
- Hirotaka Omine
- Department of Pathology, Dokkyo Medical University Hospital, Mibu, Japan
| | - Kazuyuki Ishida
- Department of Pathology, Dokkyo Medical University Hospital, Mibu, Japan
- Department of Diagnostic Pathology, Dokkyo Medical University, Mibu, Japan
| | - Natsuki Sasaki
- Department of Pathology, Dokkyo Medical University Hospital, Mibu, Japan
| | - Hikaru Kato
- Department of Pathology, Dokkyo Medical University Hospital, Mibu, Japan
| | - Tamiko Nagai
- Department of Pathology, Dokkyo Medical University Hospital, Mibu, Japan
| | - Mihoko Ishikawa
- Department of Pathology, Dokkyo Medical University Hospital, Mibu, Japan
| | - Mina Takaoka
- Department of Diagnostic Pathology, Dokkyo Medical University, Mibu, Japan
| | - Shuhei Noda
- Department of Diagnostic Pathology, Dokkyo Medical University, Mibu, Japan
| | - Hadzki Matsuda
- Department of Diagnostic Pathology, Dokkyo Medical University, Mibu, Japan
| | - Akira Mitsuhashi
- Department of Obstetrics and Gynecology, Dokkyo Medical University, Mibu, Japan
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Dongre TA, Maimoon SA. Endometrial Aspiration Cytology: A Cross-Sectional Comparative Study of Its Efficacy and Sensitivity in Diagnosing Gynecological Disorders. Cureus 2023; 15:e41699. [PMID: 37575759 PMCID: PMC10413996 DOI: 10.7759/cureus.41699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction Endometrial aspiration cytology (EAC) is a noninvasive, rapid, and cost-effective procedure for diagnosing gynecological disorders. This study aimed to validate endometrial aspiration as a routine, safe, and efficient outpatient diagnostic procedure, correlating its findings with histopathology evaluations to facilitate early surgical planning for patients with abnormal uterine bleeding. Materials and methods This cross-sectional study involved patients of reproductive, menopausal, and postmenopausal age groups who presented with diverse gynecological concerns that required dilatation and curettage. Endometrial aspiration was performed using a Karman cannula (Angiplast Pvt. Ltd., Vatva, India), and the obtained material was prepared into smears and stained for evaluation. Sampling adequacy, the nature of glandular and stromal cells, phasing of the endometrium, and other abnormalities were assessed and correlated with histology to examine the diagnostic utility of endometrial cytology. Results EAC showed 90.66% sampling adequacy with the Karman cannula. The sensitivity of EAC for diagnosing benign and malignant conditions was 88.7% and 100%, respectively. Conditions including secretory endometrium, proliferative phase, tuberculous endometritis, and glandular hyperplasia were diagnosed using EAC and confirmed by histopathology. Six malignancies were successfully diagnosed on cytology smears, while challenges in differentiation and sampling errors were recognized as limitations of the technique. Conclusions This study established EAC as a highly sensitive, minimally invasive preliminary diagnostic tool for gynecological disorders, particularly effective in diagnosing malignancy. Despite certain limitations, the procedure's ease, cost-effectiveness, and safety underscore its potential for routine use by surgeons.
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Affiliation(s)
- Trupti A Dongre
- Pathology, N.K.P. Salve Institute of Medical Sciences and Research Centre and Lata Mangeshkar Hospital, Nagpur, IND
| | - Sabiha A Maimoon
- Pathology, N.K.P. Salve Institute of Medical Sciences and Research Centre and Lata Mangeshkar Hospital, Nagpur, IND
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Wang T, Jiang R, Yao Y, Wang Y, Liu W, Qian L, Li J, Weimer J, Huang X. Endometrial Cytology in Diagnosis of Endometrial Cancer: A Systematic Review and Meta-Analysis of Diagnostic Accuracy. J Clin Med 2023; 12:jcm12062358. [PMID: 36983358 PMCID: PMC10054381 DOI: 10.3390/jcm12062358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 02/25/2023] [Accepted: 03/02/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Because the incidence of endometrial cancer has been increasing every year, it is important to identify an effective screening method for it. The endometrial cytology test (ECT) is considered to be the more acceptable technique compared to invasive endometrial sampling. METHODS The study followed the Priority Reporting Project for Systematic Evaluation and Meta-Analysis (PRISMA-DTA) protocol. This systematic rating searched EMBASE and Web of Science databases for studies on ECT for endometrial cancer from the databases' dates of inception to 30 September 2022. All literature screening and data extraction were performed by two researchers, while the methodological quality of the included studies was assessed against defined inclusion criteria. And a third researcher resolves the disagreements. RESULTS Twenty-six studies were eventually included in this final analysis. Meta-analysis results showed that the diagnostic accuracy characteristics of ECT for endometrial cancer were as follows: combined sensitivity = 0.84 [95% confidence interval (CI) (0.83-0.86)], combined specificity = 0.98 [95% CI (0.98-0.98)], combined positive likelihood ratio = 34.65 [95% CI (20.90-57.45)], combined negative likelihood ratio = 0.21 [95% CI (0.15-0.30)], and area under the summary receiver operating characteristic curve = 0.9673. CONCLUSIONS ECT had the ability to detect endometrial cancer with strong specificity, although some studies have demonstrated significant differences in sensitivity.
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Affiliation(s)
- Ting Wang
- Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Ruoan Jiang
- Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Yingsha Yao
- Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Yaping Wang
- Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Wu Liu
- Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Linhua Qian
- Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Juanqing Li
- Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Joerg Weimer
- Department of Gynecology and Obstetrics, University Medical Center Schleswig-Holstein, 24103 Kiel, Germany
| | - Xiufeng Huang
- Zhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
- Department of Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
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Nimura R, Kondo E, Yoshida K, Kubo‑Kaneda M, Nii M, Ikeijiri M, Nakamura M, Imai H, Okugawa Y, Nakatani K, Ikeda T. Cancer‑associated gene analysis of cervical cytology samples and liquid‑based cytology significantly improve endometrial cancer diagnosis sensitivity. Oncol Lett 2022; 24:376. [PMID: 36238840 PMCID: PMC9494621 DOI: 10.3892/ol.2022.13496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/10/2022] [Indexed: 11/06/2022] Open
Abstract
To the best of our knowledge, there are no useful screening methods for early detection of endometrial cancer in asymptomatic individuals. The present study evaluated the usefulness of genetic analysis of liquid-based cytology (LBC) specimens by assessing whether pathological genetic mutations detected in cancer tissue sections were detected in LBC specimens from the cervix and uterus. The primary endpoint was genetic analysis of cervical cytology specimens and LBC for the detection of endometrial cancer. Endometrial thickening (>11 mm) assessed using transvaginal ultrasonography was present in 60% of cases and adenocarcinoma assessed using cervical cytology was present in 50% of cases. In 70% of cases, pathogenic mutations detected in cancer tissue sections were also detected in cervical and/or endometrial LBC specimens. The pathogenic variants identified were PTEN in four cases, tumor protein P53, PI3K catalytic subunit α and fibroblast growth factor receptor 2 in two cases each and APC regulator of WNT signaling pathway, KRAS and catenin β1 in one case each. In the present study, a combination of endometrial thickening assessed by transvaginal ultrasonography, cervical cytology and genetic analysis resulted in a high sensitivity of 90% for detection of endometrial cancer. The combination of these tests is more expensive than conventional methods, but delayed detection of uterine cancer requires multidisciplinary treatment, which increases healthcare costs. Increased spending on early detection of uterine cancer is better economically and may improve patient quality of life.
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Affiliation(s)
- Ryo Nimura
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Tsu, Mie 514‑8507, Japan
| | - Eiji Kondo
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Tsu, Mie 514‑8507, Japan
| | - Kenta Yoshida
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Tsu, Mie 514‑8507, Japan
| | - Michiko Kubo‑Kaneda
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Tsu, Mie 514‑8507, Japan
| | - Masafumi Nii
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Tsu, Mie 514‑8507, Japan
| | - Makoto Ikeijiri
- Department of Genomic Medicine, Mie University School of Medicine, Mie University Hospital, Tsu, Mie 514‑8507, Japan
| | - Maki Nakamura
- Department of Genomic Medicine, Mie University School of Medicine, Mie University Hospital, Tsu, Mie 514‑8507, Japan
| | - Hiroshi Imai
- Pathology Division, Mie University Hospital, Tsu, Mie 514‑8507, Japan
| | - Yoshinaga Okugawa
- Department of Genomic Medicine, Mie University School of Medicine, Mie University Hospital, Tsu, Mie 514‑8507, Japan
| | - Kaname Nakatani
- Department of Genomic Medicine, Mie University School of Medicine, Mie University Hospital, Tsu, Mie 514‑8507, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Tsu, Mie 514‑8507, Japan
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Liang D, Tuo X, Wang Q, Zhao L, Zhang K, Wang Y, Feng X, Yin P, Guo L, Liu Y, Wang L, Han L, An R, Li Q. Near-Infrared Fluorescent Agent for In Vitro Screening of Endometrial Cancer and Precancerous Lesions. Front Oncol 2021; 11:713583. [PMID: 34277456 PMCID: PMC8281888 DOI: 10.3389/fonc.2021.713583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/22/2021] [Indexed: 11/30/2022] Open
Abstract
The lack of cytopathologists delays the advancement of screening for endometrial cancer. It was urgent to develop a new dye for rapid diagnosis. Our study aimed to synthesize a targeted folate receptor-α near-infrared (NIR) fluorescent agent, folic acid-zwitterionic NIR fluorophore (ZW-FA), and explore the feasibility for screening of endometrial cancer and precancerous change. Folic acid was conjugated with zwitterionic NIR fluorophore. The preparation of ZW-FA was validated by 1H NMR, mass spectrometric, ultraviolet spectra and fluorescence spectra. ZW-FA was incubated with endometrial cytology samples obtained from patients who underwent dilation and curettage or total hysterectomy. Diagnostic utility was calculated by applying laser confocal microscope, Image-J and statistical models, such as enumeration, receiver operating characteristic curve, logistic regression, support vector machine and decision tree were used. The purity of ZW-FA was > 95% determined by 1H NMR. ZW-FA had the strongest absorption peak at 633 nm in ultraviolet spectra. Photostability of ZW-FA was over 8 hours. In clinical validation, a total of 92 patients were enrolled. The cut-off value of ZW-FA was 49 in enumeration, which was used to distinguish the type of samples. Indicators about diagnostic utility are as follows: sensitivity 90.77%, specificity 62.96%, false-positive rate 37.04%, false-negative rate 9.23%, positive predictive value 85.51% and negative predictive value 73.91%. The samples processed by ZW-FA did not affect further Hematoxylin-Eosin staining and pathological diagnosis. It was an effective cytologic strategy for in vitro diagnosis of endometrial cancer and precancerous change by using ZW-FA.
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Affiliation(s)
- Dongxin Liang
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Xiaoqian Tuo
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Qing Wang
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Lanbo Zhao
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Kailu Zhang
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Yiran Wang
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Xue Feng
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Panyue Yin
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Lin Guo
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Yu Liu
- Department of Pathology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Lei Wang
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Lu Han
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Ruifang An
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Qiling Li
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
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6
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Matsumoto H, Nasu K, Shikama A, Shiozaki T, Futagami M, Kai K, Mori T, Yano M, Yamada T, Teramoto N. Pathological processes and pretreatment cytologic diagnosis of neuroendocrine carcinoma of the endometrium: addendum report of the Kansai Clinical Oncology Group/Intergroup study in Japan. Med Mol Morphol 2021; 54:237-244. [PMID: 33934220 DOI: 10.1007/s00795-021-00288-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 04/09/2021] [Indexed: 11/28/2022]
Abstract
A previous retrospective study of a neuroendocrine carcinoma of the endometrium including 42 cases employed a central pathologic review to ensure the reliability of the findings. However, the pathological processes were not described in detail. In this study, we further analyzed these processes and the results of pretreatment endometrial cytology of neuroendocrine carcinoma. Of the 65 patients from 18 institutions registered in the study, 42 (64.6%) were diagnosed with neuroendocrine carcinoma of the endometrium based on the central pathological review. Thirteen of the 23 excluded cases conflicted from their original diagnoses: 5 (38.5%) were diagnosed with endometrioid adenocarcinoma, 5 (38.5%) with undifferentiated carcinoma, and 3 (23.1%) with carcinosarcoma. Immunohistochemical staining led to a change in diagnosis for 8 (61.5%) of the 13 cases. Pretreatment endometrial cytology was examined in 38 (90.5%) cases; 34 (89.5%) of these 38 cases were found, or suspected, to be positive. To ensure the selection of appropriate therapy and keeping patients correctly informed, it is important to distinguish neuroendocrine carcinoma from other similar histologic types. Endometrial cytology may help in the early detection of this disease.
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Affiliation(s)
- Harunobu Matsumoto
- Department of Obstetrics and Gynecology, Faculty of Medicine, Oita University, Hasama-machi, Yufu-shi, Oita, 8795593, Japan.
| | - Kaei Nasu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Oita University, Hasama-machi, Yufu-shi, Oita, 8795593, Japan
| | - Ayumi Shikama
- Department of Obstetrics and Gynecology, University of Tsukuba, Tsukuba-shi, Ibaraki, Japan
| | - Takaya Shiozaki
- Division of Gynecology, Hyogo Cancer Center, Akashi-shi, Hyogo, Japan
| | - Masayuki Futagami
- Department of Obstetrics and Gynecology, Hirosaki University, Hirosaki-shi, Aomori, Japan
| | - Kentaro Kai
- Department of Obstetrics and Gynecology, Faculty of Medicine, Oita University, Hasama-machi, Yufu-shi, Oita, 8795593, Japan
| | - Taisuke Mori
- Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Kyoto-shi, Kyoto, Japan
| | - Mitsutake Yano
- Division of Pathology, Saitama Medical University International Medical Center, Hidaka-shi, Saitama, Japan
| | - Takashi Yamada
- Department of Pathology, Osaka Medical College, Takatsuki-shi, Osaka, Japan
| | - Norihiro Teramoto
- Division of Pathology, Shikoku Cancer Center, Matsuyama-shi, Ehime, Japan
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Njoku K, O'Flynn H, Jones E, Ramchander NC, White H, Macey R, Crosbie EJ. Screening tests for endometrial cancer in the general population. Hippokratia 2021. [DOI: 10.1002/14651858.cd013859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Kelechi Njoku
- Division of Cancer Sciences; Faculty of Biology, Medicine and Health, The University of Manchester; Manchester UK
| | - Helena O'Flynn
- Division of Cancer Sciences; Faculty of Biology, Medicine and Health, The University of Manchester; Manchester UK
| | - Eleanor Jones
- Division of Cancer Sciences; Faculty of Biology, Medicine and Health, The University of Manchester; Manchester UK
| | - Neal C Ramchander
- Division of Cancer Sciences; Faculty of Biology, Medicine and Health, The University of Manchester; Manchester UK
| | - Helen White
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health; The University of Manchester ; Manchester UK
| | - Richard Macey
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS); University of Oxford; Oxford UK
| | - Emma J Crosbie
- Division of Cancer Sciences; Faculty of Biology, Medicine and Health, The University of Manchester; Manchester UK
- Manchester Academic Health Science Centre; Manchester University NHS Foundation Trust; Manchester UK
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8
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Lukanović D, Matjašič M, Kobal B. Accuracy of preoperative sampling diagnosis for predicting final pathology in patients with endometrial carcinoma: a review. Transl Cancer Res 2020; 9:7785-7796. [PMID: 35117381 PMCID: PMC8798103 DOI: 10.21037/tcr-20-2228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 07/31/2020] [Indexed: 11/30/2022]
Abstract
Endometrial cancer (EC) is the most common gynecologic cancer. The most frequent symptom of this disease is postmenopausal bleeding. Diagnosis of EC must be histologically confirmed, and there are several methods for endometrial sampling to obtain cells or endometrial tissue. The first step in diagnosis should be ultrasound measurement of endometrial thickness, followed by endometrial sampling, which can be performed by office endometrial biopsy, hysteroscopic biopsy, or dilatation and curettage (D&C). The review in this article was carried out to present previously published studies, comprehensively evaluate method performance (i.e., overall accuracy of preoperative sampling in patients with endometrial carcinoma, and overall agreement on grade and histological subtype between preoperative endometrial sampling and final diagnosis), and determine which sampling method is most accurate on the basis of the statistical data in the studies analyzed. From the literature analyzed and examined, it can be concluded that preoperative endometrial sampling is not always the best predictor of final histology in EC and has its limitations. In surgical decisions based only on preoperative sampling, a biopsy should be made with caution, and it is necessary to take other parameters into account. Inadequate grading leads to suboptimal clinical management, mainly in early-stage tumors. This review showed that, although hysteroscopic biopsy was mainly associated with the highest tumor grade agreement, and although D&C showed the highest overall accuracy in detecting endometrial carcinoma, the data do not therefore reliably indicate which method yields the most precise results. The results of this review indicate that further studies on larger samples and with greater statistical power are needed to accurately define the role and type of preoperative sampling methods.
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Affiliation(s)
- David Lukanović
- Department of Gynecology, Division of Gynecology and Obstetrics, Ljubljana University Medical Center, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Miha Matjašič
- Center for Social Informatics, Faculty of Social Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - Borut Kobal
- Department of Gynecology, Division of Gynecology and Obstetrics, Ljubljana University Medical Center, Ljubljana, Slovenia
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Lv S, Wang Q, Li Y, Zhao L, Wang Y, Feng X, Han L, Zhang K, Yin P, Hou H, Shi G, Li Q. A Clinical Comparative Study of Two Different Endometrial Cell Samplers for Evaluation of Endometrial Lesions by Cytopathological Diagnosis. Cancer Manag Res 2020; 12:10551-10557. [PMID: 33122953 PMCID: PMC7591233 DOI: 10.2147/cmar.s272755] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 09/17/2020] [Indexed: 12/24/2022] Open
Abstract
Purpose Cytopathology detecting for endometrial cancer is becoming accepted, and Tao Brush is the most widely used sampler for endometrial cells. This study aims to compare the effectiveness between Li brushes and Tao brushes for the diagnosis of endometrial lesions and to evaluate the diagnostic accuracy of endometrial cytology compared with histology. Methods There were 109 patients needing dilation and curettage (D&C) and 21 patients needing hysterectomies included from November 2017 to April 2018. Every patient was sampled by Tao brush and Li brush before D&C or hysterectomy performed. The cytological results were compared based on the gold standard histological results of D&C or hysterectomy. Results The sensitivity of Li brush cytology for detecting endometrial cancer and atypical hyperplasia was estimated at 83.33%, specificity at 100%, positive predictive value (PPV) at 100%, and negative predictive value (NPV) at 98.02%, respectively. While for the Tao brush, it was 91.67% of sensitivity, 96.04% of specificity, 73.33% of PPV, and 98.98% of NPV, respectively. The kappa value was 0.767, which indicated a substantial agreement. Cytology by both two brushes had a lower insufficient sample rate (2.75% of Tao brush, 4.59% of Li brush) than did D&C (11.93%). Discussion Endometrial cytology is a reliable approach for evaluating endometrium with a lower insufficient sample rate. Cytology sampled by both Li brushes and Tao brushes has a high accuracy with histological diagnosis in detecting endometrial cancer and atypical hyperplasia. Combining social and economic benefits, the Li brush may be a better endometrial cell collector.
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Affiliation(s)
- Shulan Lv
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Qing Wang
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yan Li
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,Department of Obstetrics and Gynecology, Yan'an People's Hospital, Yan'an, Shaanxi, China
| | - Lanbo Zhao
- Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yiran Wang
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xue Feng
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Lu Han
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Kailu Zhang
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Panyue Yin
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Huilian Hou
- Department of Pathology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Guizhi Shi
- Aviation General Hospital of Beijing, Medical, Pathology Department of Aviation General Hospital of Beijing, Beijing, China
| | - Qiling Li
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
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Kakinuma T, Kakinuma K, Tanaka H, Ohwada M. Considerations for performing microwave endometrial ablation (MEA) - Three cases with abnormal test results of endometrial tissue discovered by chance when performing MEA. Int J Hyperthermia 2020; 37:749-752. [PMID: 32619375 DOI: 10.1080/02656736.2020.1781267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Introduction: Microwave endometrial ablation (MEA) is beginning to be used widely in Japan as a minimally invasive alternative to conventional total hysterectomy for functional hypermenorrhea, uterine fibroids, hypermenorrhea due to organic diseases such as uterine adenomyosis, and acute heavy uterine bleeding. Method: MEA was introduced in our hospital in January 2016. It is performed after a screening via cytodiagnosis and histodiagnosis to ensure that there are no malignant diseases in the uterus. Histopathological examination by endometrial curettage during MEA revealed three cases of endometrial abnormalities. In all cases, radical surgery was performed, the postoperative course was good, and no recurrence was observed. Here, we report three cases in which abnormal endometrial tissue findings were observed in histopathologic examinations via total endometrial curettage during MEA. Conclusion: When performing MEA, it is important to perform detailed examinations and careful monitoring of post-operative progress bearing in mind potential malignant uterine diseases.
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Affiliation(s)
- Toshiyuki Kakinuma
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara-City, Japan
| | - Kaoru Kakinuma
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara-City, Japan
| | - Hirokazu Tanaka
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara-City, Japan
| | - Michitaka Ohwada
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara-City, Japan
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11
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Tuo X, Zhao L, Wang Q, Han L, Wang Y, Ma S, Feng X, Li Q, Sun C, Wang Q, Shi G, Hou H, Zhang G, Li Q. Validation of Molecular Typing for Endometrial Screening Test That Predicts Benign and Malignant Lesions. Front Oncol 2019; 9:561. [PMID: 31338322 PMCID: PMC6629861 DOI: 10.3389/fonc.2019.00561] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 06/10/2019] [Indexed: 12/24/2022] Open
Abstract
The aim of this study is to examine the immunocytochemical expression of p53, Ki-67, and CA125 in endometrial brush samples for endometrial cancer. Forty-four patients were recruited with liquid-based cytology preparations during a 5-month period. Both the histological and cytological samples were assessed by histology based on hematoxylin and eosin (H&E), and the expression of p53, CA125, and Ki-67 in endometrial cells was examined by immunocytochemistry. The percentage and intensity of endometrial cells were scored on a scale of 0-3. The final score was calculated by the addition of all partial scores, and then Probit model was used to predict the possibility for malignant lesions. The mean immunoreactivity score of the three immunocytochemical biomarkers (p53, CA125, and Ki-67) in the positive group (including atypical hyperplastic cells and malignant cells) was significantly higher than in the negative group (benign cells and non-atypical hyperplastic cells). The possibility value of the positive group was also significantly higher than the negative group (P < 0.05). The cutoff value of the possibility value was 0.754, the sensitivity and specificity of which were 86.4 and 95.5%. The assessment of p53, CA125, and Ki-67 combined with the prediction model is valuable for the detection of endometrial cancer and atypical hyperplasia in endometrial cytology.
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Affiliation(s)
- Xiaoqian Tuo
- Department of Gynecology and Obstetrics, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Lanbo Zhao
- Guipei 77, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Qi Wang
- Department of Gynecology and Obstetrics, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Lu Han
- Department of Gynecology and Obstetrics, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Yiran Wang
- Department of Gynecology and Obstetrics, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Sijia Ma
- Department of Gynecology and Obstetrics, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Xue Feng
- Department of Gynecology and Obstetrics, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Qing Li
- Department of Gynecology and Obstetrics, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Chao Sun
- Department of Gynecology and Obstetrics, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Qing Wang
- Department of Gynecology and Obstetrics, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Guizhi Shi
- Aviation General Hospital of Beijing, Medical University and Beijing Institute of Translational Medicine, University of Chinese Academy of Sciences, Beijing, China
| | - Huilian Hou
- Department of Pathology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Guanjun Zhang
- Department of Pathology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Qiling Li
- Department of Gynecology and Obstetrics, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
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12
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Wang Q, Wang Q, Zhao L, Han L, Sun C, Ma S, Hou H, Song Q, Li Q. Endometrial Cytology as a Method to Improve the Accuracy of Diagnosis of Endometrial Cancer: Case Report and Meta-Analysis. Front Oncol 2019; 9:256. [PMID: 31069167 PMCID: PMC6491702 DOI: 10.3389/fonc.2019.00256] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 03/21/2019] [Indexed: 12/16/2022] Open
Abstract
More and more researchers have reported that dilatation and curettage (D&C) or Pipelle had low accuracy, high misdiagnosis, and insufficient rate. Endometrial cytology is often compared with histology and seems to be an efficient method for the diagnosis of endometrial disorders, especially endometrial cancer. We report a case of misdiagnosed endometrial cancer by D&C, but with a positive cytopathological finding. Following that, a meta-analysis including 4,179 patients of endometrial diseases with cyto-histopathological results was performed to assess the value of the endometrial cytological method in endometrial cancer diagnosis. The pooled sensitivity and specificity of the cytological method in detecting endometrial atypical hyperplasia or cancer was 0.91[95% confidence interval (CI) 0.74-0.97] and 0.96 (95% CI 0.90-0.99), respectively. The pooled positive likelihood ratio and negative likelihood ratio was 25.4 (95% CI 8.1-80.1) and 0.10 (95% CI 0.00-0.30), respectively. The diagnostic odds ratio which was usually used to evaluate the diagnostic test performance reached 260 (95% CI 36-1905). So we recommend that D&C and Pipelle are still practical procedures to evaluate the endometrium, cytological examinations should be utilized as an additional endometrial assessment method.
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Affiliation(s)
- Qing Wang
- Center for Single-Cell Biology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Qi Wang
- Center for Single-Cell Biology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Lanbo Zhao
- Guipei 77, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Lu Han
- Center for Single-Cell Biology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Chao Sun
- Center for Single-Cell Biology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Sijia Ma
- Center for Single-Cell Biology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Huilian Hou
- Department of Pathology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Qing Song
- Center for Single-Cell Biology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Qiling Li
- Center for Single-Cell Biology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
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13
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Han L, Du J, Zhao L, Sun C, Wang Q, Tuo X, Hou H, Liu Y, Wang Q, Ulain Q, Lv S, Zhang G, Song Q, Li Q. An Efficacious Endometrial Sampler for Screening Endometrial Cancer. Front Oncol 2019; 9:67. [PMID: 30838173 PMCID: PMC6389657 DOI: 10.3389/fonc.2019.00067] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 01/24/2019] [Indexed: 11/25/2022] Open
Abstract
Recently, the research on early detection of precancerous change and endometrial carcinoma has been focusing on minimally invasive procedures for screening. On this basis, we aim to verify the feasibility of endometrial samplers for screening endometrial cancer using Li Brush. We recruited patients undergoing hysterectomy for different diseases from the Inpatient Department of the Department of Obstetrics and Gynecology. Before surgery, endometrial cells were collected by Li Brush. The cytopathologic diagnosis from Li Brush and the histopathologic diagnosis from hysterectomy in the same patient were compared to calculate sensitivity (Se), specificity (Sp), false-negative rate (FNR), false-positive rate (FPR), positive predictive value (PV+) %, and negative predictive value (PV-). The research enrolled 293 women into this self-controlled trial. According to the hypothesis test of paired four lattices, we obtained the following indicators: Se 92.73, Sp 98.15, FNR 7.27, FPR 1.85, PV+92.73, and PV−98.15%. The endometrial sampler Li Brush is an efficacious instrument for screening endometrial cancer.
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Affiliation(s)
- Lu Han
- Center for Single-Cell Biology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.,Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Jiang Du
- Department of Gynecology and Obstetrics, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Lanbo Zhao
- Guipei 77, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Chao Sun
- Center for Single-Cell Biology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.,Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Qi Wang
- Center for Single-Cell Biology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.,Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Xiaoqian Tuo
- Center for Single-Cell Biology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.,Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Huilian Hou
- Department of Pathology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Yu Liu
- Department of Pathology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Qing Wang
- Center for Single-Cell Biology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.,Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Qurat Ulain
- Center for Single-Cell Biology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.,Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Shulan Lv
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Guanjun Zhang
- Department of Pathology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Qing Song
- Center for Single-Cell Biology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.,Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA, United States
| | - Qiling Li
- Center for Single-Cell Biology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.,Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
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14
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Matsuura M, Yamaguchi K, Tamate M, Satohisa S, Teramoto M, Iwasaki M, Sugita S, Hasegawa T, Koubo R, Takane K, Ikenoue T, Furukawa Y, Saito T. Efficacy of liquid-based genetic diagnosis of endometrial cancer. Cancer Sci 2018; 109:4025-4032. [PMID: 30289582 PMCID: PMC6272085 DOI: 10.1111/cas.13819] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 09/21/2018] [Accepted: 09/26/2018] [Indexed: 12/17/2022] Open
Abstract
Although liquid-based cytology (LBC) has increased the sensitivity of cytological diagnosis of endometrial cancer (EC) compared with conventional smear cytology, the sensitivity of LBC for the detection of EC is between 70% and 96% and remains unsatisfactory. In the present study, we compared the efficacy of LBC with liquid-based genetic diagnosis (LBGDx) by amplicon sequencing of five genes including PTEN, PIK3CA, CTNNB1, KRAS, and TP53 in 48 LBC subjects who underwent endometrial screening. Consequently, LBC classified 15 samples as "positive or suspicious for malignancy" and the 15 were later confirmed as EC. However, LBC failed to identify five cases who were diagnosed as EC by additional transvaginal ultrasound and endometrial curettage, indicating that the sensitivity of cytology alone was 75% (15/20). LBGDx identified 11 pathogenic PTEN variants in 10 subjects, six PIK3CA variants in nine, three CTNNB1 variants in five, two KRAS variants in four, and three TP53 variants in three. Collectively, at least one pathogenic variant was identified in 19 subjects, which included 17 EC (15 endometrioid carcinoma and 2 endometrial carcinosarcomas), and one cervical adenocarcinoma. However, LBGDx did not identify any pathogenic mutations in three of the 20 EC, indicating that the sensitivity of LBGDx alone was 85% (17/20). Although five EC were negative for malignancy by LBC and three were negative for pathogenic mutations by LBGDx, the combination of LBC and LBGDx would successfully diagnose all 20 EC. These data suggested that LBGDx is a useful strategy to improve the sensitivity of screening of EC by LBC.
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Affiliation(s)
- Motoki Matsuura
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Kiyoshi Yamaguchi
- Division of Clinical Genome Research, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Masato Tamate
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Seiro Satohisa
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Mizue Teramoto
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Masahiro Iwasaki
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Shintaro Sugita
- Department of Surgical Pathology, Sapporo Medical University, Sapporo, Japan
| | - Tadashi Hasegawa
- Department of Surgical Pathology, Sapporo Medical University, Sapporo, Japan
| | - Rika Koubo
- Division of Clinical Genome Research, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Kiyoko Takane
- Division of Clinical Genome Research, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Tsuneo Ikenoue
- Division of Clinical Genome Research, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Yoichi Furukawa
- Division of Clinical Genome Research, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Tsuyoshi Saito
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
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15
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Nomura H, Sugiyama Y, Ito T, Furuta N, Komatsu K, Takazawa Y, Aoki Y, Tanigawa T, Matoda M, Okamoto S, Kanao H, Omatsu K, Kato K, Utsugi K, Takeshima N. Clinical management of the status of atypical endometrial cells using the descriptive reporting format for endometrial cytology. Cytopathology 2018; 30:209-214. [DOI: 10.1111/cyt.12638] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 08/21/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Hidetaka Nomura
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Yuko Sugiyama
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Takahiko Ito
- Department of Cytology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Noriyuki Furuta
- Department of Cytology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Kyoko Komatsu
- Department of Cytology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Yutaka Takazawa
- Division of Pathology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Yoichi Aoki
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Terumi Tanigawa
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Maki Matoda
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Sanshiro Okamoto
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Hiroyuki Kanao
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Kohei Omatsu
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Kazuyoshi Kato
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Kuniko Utsugi
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Nobuhiro Takeshima
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
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16
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Munakata S, Sasaki S, Takase M, Okatake R, Suzuki Y, Yamamoto T, Yanoh K. Practical usefulness of atypical endometrial cell categories within the new classification of endometrial cytology when applied to conventional smears. Cytopathology 2016; 28:131-139. [PMID: 27859783 DOI: 10.1111/cyt.12401] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Endometrial cytology has been widely used as a screening tool in Japan. Traditionally, a three-tier reporting system, consisting of 'negative', 'suspicious' and 'positive' categories, has been used. However, a more descriptive system, the New Terminology in Endometrial Cytology (NTEMC), which is based on the Bethesda System for uterine cervical cytology, was introduced recently. The objective of this study was to validate the NTEMC criteria. METHODS Endometrial cytology specimens that had been categorised as 'suspicious' were collected in our hospital between 2003 and 2013, and from these, 106 specimens with corresponding histological results, were re-evaluated according to the NTEMC criteria. Diagnostic categories were assigned based on that chosen by the majority of the examining members. RESULTS Negative, atypical endometrial cells, of undetermined significance (ATEC-US), atypical endometrial cells for which atypical endometrial hyperplasia or worse cannot be excluded (ATEC-A), endometrial hyperplasia, atypical endometrial hyperplasia and malignancy were selected as the diagnostic categories for 9 (8.5%), 34 (32.1%), 17 (16%), 34 (32.1%), 5 (4.7%) and 7 (6.6%) specimens, respectively. Corresponding histological categories of benign, endometrial hyperplasia, atypical endometrial hyperplasia and malignancy were established in 28 (82.4%), 1 (2.9%), 2 (5.9%) and 3 (8.8%) ATEC-US specimens, respectively, and in 6 (35.3%), 3 (17.6%), 2 (11.8%) and 6 (35.3%) ATEC-A specimens, respectively. The histological category distribution differed significantly (P = 0.001), and there was a significant correlation between corresponding cytological and histological categories (P = 0.005). CONCLUSION The ATEC category of NTEMC system works well in a practical setting and resembles the Bethesda reporting system ASC (atypical squamous cells) category for cervical cytology.
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Affiliation(s)
- S Munakata
- Department of Pathology, Sakai City Medical Center, Sakai, Japan
| | - S Sasaki
- Department of Clinical Laboratory, Sakai City Medical Center, Sakai, Japan
| | - M Takase
- Department of Clinical Laboratory, Sakai City Medical Center, Sakai, Japan
| | - R Okatake
- Department of Clinical Laboratory, Sakai City Medical Center, Sakai, Japan
| | - Y Suzuki
- Department of Clinical Laboratory, Sakai City Medical Center, Sakai, Japan
| | - T Yamamoto
- Department of Obstetrics and Gynecology, Sakai City Medical Center, Sakai, Japan
| | - K Yanoh
- Department of Obstetrics and Gynecology, J. A. Suzuka General Hospital, Suzuka, Japan
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