Experience with the EndoPap device for the cytologic detection of uterine cancer and its precursors: A comparison of the EndoPap with fractional curettage or hysterectomy

LaPolla, James P.; Nicosia, Santo V.; McCurdy, Charles M.; Songster, Curtis L.; Ruffolo, Eugene H.; Roberts, William S.; Hoffman, Mitchel S.; Fiorica, James V.; Cavanagh, Denis

doi:10.1016/0002-9378(90)91125-v

Cited by 21 publications

(23 citation statements)

References 7 publications

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“…Analogously, in 2005 Tsuda et al documented that the prevalence of endometrial disease in asymptomatic and symptomatic women whit thickened endometrium was 2.3% and 21%. 17 Regarding traditional endometrial cytology, despite several encouraging results have been reported with sensibility and specificity reaching 96%, [20][21][22][23][24] its diffusion has been hampered because of technical and diagnostic difficulties.…”

Section: Discussionmentioning

confidence: 99%

Liquid‐based endometrial cytology in the management of sonographically thickened endometrium

Buccoliero

Gheri

Castiglione

et al. 2007

Diagnostic Cytopathology

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Liquid-based cytology represents an opportunity to re-evaluate endometrial cytology. We evaluated the accuracy of liquid-based endometrial cytology as compared to biopsy in 670 women scheduled for histeroscopy because of thickened endometrium (>4 mm), as evaluated by transvaginal sonography. Endometrial biopsy detected pathology in 41 (6%) of cases (21 of which were adenocarcinomas). Cytologic study found pathology in 62 (9%) cases (19 of which were adenocarcinomas). Two hundred ninety-one biopsies (43%) and 28 (4%) cytologies were inadequate. The sensitivity and the specificity were estimated, respectively, at 95% and 98%; the positive and negative predictive values were estimated, respectively, at 83% and 99%. Cytology provided sufficient material more often than biopsy (P < 0.01). We consider endometrial cytology an efficacious diagnostic opportunity. It could be usefully applied in association with transvaginal sonography. The combination of these procedures might reduce more invasive and expensive diagnostic procedures. Diagn. Cytopathol. 2007;35:398-402. ' 2007 Wiley-Liss, Inc.Key Words: thin-layer; liquid-based; endometrial cytology; endometrial adenocarcinoma; endometrial hyperplasia Endometrial adenocarcinoma is the most common malignancy of the female genital tract. A significant increase in its frequency, both absolute and relative, has been observed during the last decades. This increase is considered the consequence of the extended life expectancy of women, the increase in the incidence of risk factors, and of the reduction of invasive cervical carcinomas. Nowadays, more than 1 in 20 female cancers in Europe are of the endometrium. [1][2][3][4][5][6][7][8][9][10] Contrary to cervical carcinoma, no screening programs have been organized for the early detection of endometrial adenocarcinoma. The lack of screening programs may be related to the precocious presenting symptoms and to the relative good prognosis of the majority of endometrial adenocarcinomas. Early abnormal uterine bleeding, the commonest presenting symptom for the 95% of women, allows diagnosis at stage I in 73% of cases. 11 Moreover, there has not been an endometrial test comparable to cervicovaginal cytology for diagnostic reliability, tolerability, and low cost.Several diagnostic procedures are used for investigating the endometrium, but there is no common agreement for the optimum approach in each circumstance (i.e. symptomatic vs. asymptomatic; with risk factors vs. without risk factors).Endometrial cytology has been hampered in its dissemination by the difficulty in its interpretation due to the common presence of excess blood and overlapping cells. Liquid-based cytology represents an opportunity to reexamine endometrial cytology. We conducted the current study to correlate the results of liquid-based endometrial cytology with the results of endometrial biopsy in a group of 670 women scheduled for hysteroscopy because of thick endometrium (>4 mm), as evaluated by transvaginal sonography (TVS). Our purpose was preliminarily to asce...

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Section: Discussionmentioning

confidence: 99%

Liquid‐based endometrial cytology in the management of sonographically thickened endometrium

Buccoliero

Gheri

Castiglione

et al. 2007

Diagnostic Cytopathology

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“…We found the sensitivity of Suresample ™ to be 84%, which is lower than that of the Pipelle ® device, as mentioned above. In the present study, the inadequate sample (no specimen obtained or insufficient specimen for adequate assessment for histological or cytological diagnosis) at the outpatient examination was regarded as 'negative' for the calculation of the sensitivity, in contrast to some previous studies where inadequate diagnoses were excluded from the calculations [4,8,[10][11][12]. Had we calculated sensitivity by excluding inadequate samples, the sensitivity of Suresample ™ for detecting endometrial carcinoma would be 91%, which is similar to the values reported in previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, no patient with carcinoma was falsely diagnosed as having a normal endometrium by outpatient tissue biopsy. Other reports have showed that the sensitivity of cytologic examination for diagnosing endometrial carcinoma is 74.1-100% [8][9][10][11][12][13][14]. One study evaluated and compared the accuracy of sampling using Endopap ® and Pipelle ® for diagnosing postmenopausal disease.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the diagnostic rate is not always high because of the lack of cellular atypia. In fact, it has been reported that hyperplasia can be detected in only 32.3-80.5% of cases [8][9][10][11][12]14]. A meta-analysis shows that the sensitivity of the Pipelle ® device in detecting atypical hyperplasia is 81% [5].…”

Section: Discussionmentioning

confidence: 99%

“…This procedure is easy to perform, associated with minimal patient discomfort, and reported to be highly sensitive in detecting endometrial carcinoma [4][5][6][7][8][9][10][11][12][13][14]. The Pipelle de Cornier ® device (Laboratoire CCD, Paris, France) is an endometrial biopsy sampler that is seemingly better tolerated by patients than most other endometrial biopsy devices [15,16].…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Two Sampling Procedures for Diagnosing Endometrial Carcinoma and Hyperplasia: Outpatient Tissue Biopsy Versus Cytologic Examination

Motegi¹,

Tanaka²,

Tada³

et al. 2011

J Cytol Histol

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IntroductionEach year, there are about 142,000 new cases of endometrial carcinoma worldwide, and an estimated 42,000 women die because of this type of cancer [1]. The surgical stage, determined according to the criteria of the International Federation of Gynecology and Obstetrics, reflects the 5-year survival, which is around 85% for stage I, 75% for stage II, 45% for stage III, and 25% for stage IV disease [1]. Endometrial cancer is often preceded by endometrial hyperplasia, which is a spectrum of morphologic and biologic alterations of the endometrial glands and stroma and is often secondary to hyperestrogenism. It has been shown that progression to carcinoma occurs in 1% of patients with simple hyperplasia, 3% of patients with complex hyperplasia, 8% of patients with simple hyperplasia with atypia, and 29% of patients with complex hyperplasia with atypia [2].The Japanese Ministry of Health and Welfare investigated the effectiveness of mass endometrial carcinoma screening. During the 9-year study, 126 cases were detected by mass screening and 1,069 cases were diagnosed in outpatient clinics. Early-stage cases were significantly more frequent in the screening group (p < 0.001): 88.1% of the patients in the screening group had stage I disease, as compared to 65.3% of the patients in the outpatient group. The 5-year survival rate was also significantly higher in the screening group than in the outpatient group (94.7% vs 84.3%; p = 0.041) [3]. These statistics suggest that early detection of endometrial carcinoma and hyperplasia is necessary to improve the prognosis of these diseases. AbstractBackground: We compared the sensitivity of 2 diagnostic procedures-tissue biopsy and cytologic examinationfor detecting endometrial carcinoma and hyperplasia in outpatients. The patients' degree of acceptance of these methods was also evaluated.

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Screening tests for endometrial cancer in the general population

Njoku

O’Flynn

Jones

et al. 2021

Cochrane Database of Systematic Reviews

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This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows:To assess the diagnostic accuracy of potential screening tests for the detection of atypical hyperplasia (pre-cancer) and endometrial cancer of all stages and grades in asymptomatic (healthy) women in the general population. Secondary objectives• To determine the optimal endometrial thickness cut-o value using transvaginal ultrasound scan for the screening of asymptomatic women for endometrial cancer and atypical hyperplasia. • To investigate sources of heterogeneity in endometrial cancer screening studies, including: * characteristics of the studied population including age, menopausal status (pre-and postmenopausal), country of study and risk status (body mass index (BMI) categories, diabetes mellitus, polycystic ovary syndrome (PCOS)); * characteristics of index test such as cytological classification used and sampling device; * methodological quality (low risk of bias compared to high risk of bias); * disease factors (endometrioid versus non-endometrioid, low grade versus high grade).

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Experience with the EndoPap device for the cytologic detection of uterine cancer and its precursors: A comparison of the EndoPap with fractional curettage or hysterectomy

Cited by 21 publications

References 7 publications

Liquid‐based endometrial cytology in the management of sonographically thickened endometrium

Liquid‐based endometrial cytology in the management of sonographically thickened endometrium

Comparison of Two Sampling Procedures for Diagnosing Endometrial Carcinoma and Hyperplasia: Outpatient Tissue Biopsy Versus Cytologic Examination

Screening tests for endometrial cancer in the general population

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