Evaluation of cellular adequacy in endometrial liquid‐based cytology

Nimura, Azusa; Ishitani, Ken; Norimatsu, Yoshiaki; Okada, Kazuko; Akizawa, Yoshika; Yanoh, Kenji; Hirai, Yasuo; Nagashima, Yoji; Irino, Satoshi; Kobayashi, Tadao K.; Tabata, Tsutomu

doi:10.1111/cyt.12716

Cited by 6 publications

(5 citation statements)

References 24 publications

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“…Regarding the number of clusters, it has been reported that 10 or more clusters comprising 30 or more cells collected by brushing and prepared by LBC are sufficient to make a cytologic diagnosis [16]. In our study, the numbers of clusters converted to that per preparation using a smear area of 133 mm 2 were 514 in G1 and 140 in G3 in LBC, and 55 and 50 in CP, respectively, showing that a sufficient amount to make a diagnosis was collected by both procedures.…”

Section: Discussionmentioning

confidence: 99%

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Morphological Differences between Liquid-Based Cytology and Conventional Preparation in Endometrial Endometrioid Carcinoma Grade 1 and Grade 3, and the Differentiation of Grades in Each Method

et al. 2021

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Introduction: Direct smearing preparation (conventional preparation [CP]) has been widely used for endometrial cytology in Japan. In CP, sampling and screening errors are problematic. In liquid-based cytology preparation (LBC), the problems of CP can be solved. But there is a problem that cytological findings of LBC are different from those of CP. The purpose of this study was to evaluate the differences of morphological findings of endometrial cytology between LBC and CP, and the usefulness of the endometrial LBC to differentiate endometrioid carcinoma grade 1 (G1) from grade 3 (G3). Methods: Thirteen cases of endometrioid carcinoma G1, and 5 cases of G3 collected by the Softcyte device and prepared by LBC and CP (split specimen) were used. We focused on the following items: (1) the number of clusters per cm2, (2) the number of layers of clusters, (3) area of clusters, (4) perimeter of clusters, (5) roundness of clusters, (6) complexity of clusters, (7) area of nucleus, (8) perimeter of nucleus, (9) roundness of nucleus, (10) complexity of nucleus, (11) area of nucleolus, and (12) nucleolus-nucleus ratio (N/N). Results: Compared with CP, the number of clusters and layers of the clusters in LBC were significantly larger in G1. The area and perimeters of the clusters and the nucleus were significant smaller, and the N/N ratio was greater in LBC than that in CP in both G1 and G3. Regarding morphological differences between G1 and G3 in LBC and CP, the number of layers was significantly larger in G1 than in G3 in LBC and CP. The area of the clusters in LBC was significantly larger in G1 than in G3. The area and perimeters of the nucleus in CP and the area of the nucleolus and N/N ratio in LBC and CP were significantly smaller in G1 than in G3. Conclusion: In the endometrial cytology, it became clear that the cell image was different between LBC and CP and between G1 and G3. By microscopic examination understanding the characteristics of the cell image in LBC, endometrial LBC could be useful to diagnose endometrial carcinoma.

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Section: Discussionmentioning

confidence: 99%

“…For staining of the cytology preparations, Papanicolaou staining was used. Cell clusters were defined as those comprising 30 or more cells with a longitudinal diameter of the cluster within 300 μm [16]. This study was approved by the Ethics Committee of Hirosaki University Graduate School of Medicine (No.…”

Section: Methodsmentioning

confidence: 99%

Morphological Differences between Liquid-Based Cytology and Conventional Preparation in Endometrial Endometrioid Carcinoma Grade 1 and Grade 3, and the Differentiation of Grades in Each Method

et al. 2021

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“…The cytological specimens were stained by the Papanicolaou method. Cell clusters were defined as aggregates 300 μm or less in longitudinal dimension consisting of 30 or more cells [21]. This study was approved by the Ethics Committee of Hirosaki University Graduate School of Medicine (No.…”

Section: Methodsmentioning

confidence: 99%

Morphometrical Differences among Endometrial Endometrioid Carcinoma Grade 1, Grade 3, and Serous Carcinoma in Endometrial Liquid-Based Cytology Preparations

et al. 2022

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Introduction: In Japan, the direct smearing preparation (conventional preparation) has been widely used for cytological examination of the endometrium. Problems with the conventional preparation can be dissolved by liquid-based cytology (LBC) preparation. The Yokohama System is a method for reporting endometrial cytology, but the system lumps cancers together and does not distinguish between histological types. The objective of this study was to clarify morphometrical differences among endometrial endometrioid carcinoma grade 1 (G1), grade 3 (G3), and serous carcinoma (Serous) by image analysis of endometrial LBC. Methods: Using Papanicolaou smears prepared by LBC after sampling with a brush from 32 G1, 16 G3, and 16 Serous patients, image analysis was performed concerning the following 11 items: (1) number of layers of cluster, (2) area of cluster, (3) perimeter of cluster, (4) roundness of cluster, (5) complexity of cluster, (6) area of nucleus, (7) perimeter of nucleus, (8) roundness of nucleus, (9) complexity of nucleus, (10) area of nucleolus, and (11) nucleolus/nucleus (N/N) ratio. The data were statistically compared among G1, G3, and Serous. Results: Significant differences were observed in the number of layers of cluster (G1<G3<Serous), area of cluster (G1>G3<Serous), area of nucleus (G1<G3<Serous), area of nucleolus (G1<G3<Serous), roundness of cluster (G1>G3, G1>Serous), complexity of cluster (G1<G3, G1<Serous), roundness of nucleus (G1<Serous), complexity of nucleus (G1>Serous), and N/N ratio (G1>G3, G3<Serous). Conclusion: The number of layers and area of cluster, complexity of cluster, area and complexity of nucleus, area of nucleolus, and N/N ratio were suggested to be useful for the differentiation of histological types among G1, G3, and Serous. Particularly, differences in the number of layers of cluster, size of nucleus, and size of nucleolus among histological types were large and are considered to be potentially effective points of differential diagnosis.

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“…In order to assess adequacy of endometrial specimen, the evaluation specimen cellularity (numerical criterion) is among the most important issues. The study conducted by Nimura et al (19) demonstrated the ≥10 clusters with ≥30 endometrial cells per cluster could be used as a specimen adequacy criterion for endometrial liquid based cytology in non-menopausal patients, while presence of 5 or more cell clusters was satisfactory in post-menopausal patients.…”

Section: Methodsmentioning

confidence: 99%

Cytological and histological examination of the endometrium based on menstruation age groups

et al. 2022

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Introduction: Abnormal uterine bleeding (AUB) is one of the most common symptoms of endometrial cancer that necessitates endometrial biopsy. Objectives: This study aimed to compare the cytological and histological findings in endometrial specimens among women with AUB in three different menstrual groups (pre-menopause, perimenopause, and post-menopause) and to evaluate the statistical accuracy of cytology compared to histopathology (gold standard). Patients and Methods: This descriptive study was conducted on 78 women with AUB admitted to the gynecology and obstetrics unit of Shahid Beheshti hospital, Isfahan, Iran from 2018 to 2020. Patients were divided into three groups (pre-menopause, perimenopause, and post-menopause) based on their menstrual condition. Samples were obtained using endometrial curettage and cytobrush and were analyzed by two surgical pathologists. The results were described in four categories: negative, atypical endometrial cells of undetermined significance (AEC-US), atypical endometrial cells encompassing the spectrum of precursors to the malignant endometrial tumor (AEC-PEMT), and positive. Results: Out of 78 samples, 36 (46.2%) were reported negative for epithelial abnormality, 15 (19.2%) were AEC-US, 9 (11.5%) were AEC-PEMT, and 18 (23.1%) were positive for epithelial lesions. There was a significant association between cytological findings and menstrual groups (P = 0.004). Positive results were more frequently reported in the post-menopausal group, whereas negative results were most common in the pre-menopause group. The sensitivity and specificity of cytological evaluation in the pre-menopause, perimenopause and post-menopause groups were 100% and 95% (accuracy: 100%, 95% CI: 0.94-1), 77% and 53%, (accuracy: 62%, 95% CI: 0.40-0.85), and 100% and 34% (accuracy: 41%, 95% CI: 0.20-0.61), respectively. Conclusion: Cytological examination of the endometrium demonstrated high sensitivity in the pre-menopausal and post-menopausal women with AUB and can therefore be used as an efficient and valuable method of screening for endometrial neoplasia.

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Evaluation of cellular adequacy in endometrial liquid‐based cytology

Cited by 6 publications

References 24 publications

Morphological Differences between Liquid-Based Cytology and Conventional Preparation in Endometrial Endometrioid Carcinoma Grade 1 and Grade 3, and the Differentiation of Grades in Each Method

Morphological Differences between Liquid-Based Cytology and Conventional Preparation in Endometrial Endometrioid Carcinoma Grade 1 and Grade 3, and the Differentiation of Grades in Each Method

Morphometrical Differences among Endometrial Endometrioid Carcinoma Grade 1, Grade 3, and Serous Carcinoma in Endometrial Liquid-Based Cytology Preparations

Cytological and histological examination of the endometrium based on menstruation age groups

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