Liquid-based endometrial cytology associated with curettage in the investigation of endometrial carcinoma in postmenopausal women

Ma, Ke; Yang, Xi; Chen, Rui; Zhao, Jian; Dong, Ying; Zhang, Naiyi; Ma, Xiuhua; Liao, Qinping

doi:10.1016/j.tjog.2015.09.006

Cited by 10 publications

(7 citation statements)

References 16 publications

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“…The endometrial sampler SAP-1 used in this study is composed of a ring-shaped burr like structure (6 toothed scraps), which can be used for 360degree circular curettage to obtain small-amount but enough endometrial tissue samples for pathological diagnosis [23] . The status of ovarian failure and low serum estrogen level in postmenopausal women, leads to endometrial atrophy and thinning, which often, in turn, results in failure of endometrial sampling or insufficient specimens, even in the circumstances of conventional D&C. In this study, the sample satisfaction rate by method of SAP-1 in postmenopausal women was more than 90%, which was consistent with the literature [24] , and also similar to other different types of endometrial sampling devices [22] . It was reported that incidence rate of EC increased significantly with age.…”

Section: Discussionsupporting

confidence: 89%

“…It was reported that incidence rate of EC increased significantly with age. The onset peak age was 50~59 ys, and the average age of diagnosis was 55 ys, with over 90% occurring in women over 50ys [24,25] . So, postmenopausal population was the uppermost priority in EC screening.…”

Section: Discussionmentioning

confidence: 99%

“…So, postmenopausal population was the uppermost priority in EC screening. Ma et al [24] carried out an investigation on the diagnostic accuracy of liquid-based endometrial cytology, performed by brushing the uterus cavity using SAP-1, in comparison with histology among 790 postmenopausal women, who scheduled for hysteroscopy. SAP-1 was found to provide more sufficient material for cytology than D&C can for histology.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The application of endometrial sampler SAP-1 to screening of endometrial cancer in postmenopausal women: A diagnostic test study

Yu¹,

Xie²,

Chun-ke³

2021

Int. J. Clin. Obstet. Gynaecol.

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With cytology for screening cervical cancer providing a successful reference, endometrial cancer screening has attracted more attentions recently. The objective of this study is to evaluate the application of endometrial sampler SAP-1 as a screening tool to detect endometrial cancer among postmenopausal women. From August 2018 to February 2021, 54 postmenopausal women were hospitalized for undergoing hysteroscopy examination. Before the procedure, endometrial samples were collected by the method of SAP-1. The histological results were compared with those by hysteroscopy sampling. The satisfactory rate for the endometrial specimen by SAP-1 sampling was 88.9%. The sensitivity, specificity and accuracy rate of SAP-1 sampling for diagnosing the cancer or precancerous lesions of endometrium were 87.5%, 100% and 97.9%, respectively. Among these patients, whether they had bleeding symptoms, endometrial thickening or intrauterine occupying lesions, risk factors for endometrial cancer or not, the diagnostic coincidence rate of SAP-1 sampling was over 96%, and the differences were not statistically significant (P>0.05). In conclusions, in postmenopausal women, SAP-1 sampling is an ideal screening method, regardless of whether the patients have bleeding symptoms, endometrial thickening or intrauterine occupying lesions, endometrial cancer risk factors. The diagnostic coincidence rate is quite high, but it still needs large sample study to verify.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The application of endometrial sampler SAP-1 to screening of endometrial cancer in postmenopausal women: A diagnostic test study

Yu¹,

Xie²,

Chun-ke³

2021

Int. J. Clin. Obstet. Gynaecol.

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“… 5 , 11 It is safe, minimally invasive, and easily preformed. 24 Fujiwara et al 5 analyzed 1,441 endometrial cancer cases and 1,361 control cases. Endometrial cytology detected cancer in 1,279 (916 positive and 363 suspicious) cases, sampled by Soft Cyto sampler/Endocyte sampler/Honest Uterine Brush sampler, with a sensitivity (positive plus suspicious cases) of 88.8% and a specificity of 98.5%.…”

Section: Discussionmentioning

confidence: 99%

<p>A Clinical Comparative Study of Two Different Endometrial Cell Samplers for Evaluation of Endometrial Lesions by Cytopathological Diagnosis</p>

Lv¹,

Wang²,

Li³

et al. 2020

CMAR

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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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“…Diagnostic curettage is widely used in the diagnosis of gynecological diseases, and was the main method used in the diagnosis of endometrial atypical hyperplasia in the past ( 26 ). However, endometrial atypical hyperplasia may often be accompanied by local cancer, and diagnostic curettage may miss the diagnosis of endometrial cancer due to examination blindness typical of this method ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

The value of hysteroscopy and transvaginal ultrasonography in the diagnosis of endometrial hyperplasia: a systematic review and meta-analysis

Yao¹,

Lü²,

Xie³

et al. 2019

Transl. Cancer Res.

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Background The systematic evaluation of the diagnostic value of hysteroscopy and transvaginal ultrasonography for endometrial hyperplasia. Methods A systematic search was performed using China Knowledge Network Database, Wanfang Chinese Database, China Biomedical Literature Database, China Science and Technology Journal Database, PubMed, Medline, The Cochrane Library, and web of science from their dates of inception to December 31, 2017, hysteroscopy and transvaginal ultrasonography were used for the diagnosis of endometrial lesions in those studies. Two researchers screened the literature, extracted data, and evaluated the methodological quality of the included studies independently based on the inclusion criteria. Results A total of 1,354 cases were incorporate into analysis from 9 diagnostic studies meta-analysis showed that the diagnostic accuracy of hysteroscopy for endometrial hyperplasia lesions were: combined sensitivity =0.73 (95% CI: 0.68–0.77), combined specificity =0.92 (95% CI: 0.90–0.93), combined positive likelihood ratio =9.87 (95% CI: 4.08–23.84), combined negative likelihood ratio =0.34 (95% CI: 0.22–0.52), combined diagnostic odds ratio =31.64 (95% CI: 10.34–96.78), area under the summary receiver operating characteristic curve =0.8830. The combined sensitivity of transvaginal ultrasonography for those lesions were 0.69 (95% CI: 0.64–0.74), combined specificity was 0.78 (95% CI: 0.76–0.81), combined negative likelihood ratio was 3.40 (95% CI: 2.46–4.70), combined negative likelihood ratio was 0.41 (95% CI: 0.34–0.50), combined diagnostic odds ratio was 8.94 (95% CI: 5.80–13.79), and area under the summary receiver operating characteristic curve was 0.8180. Conclusions Compared with transvaginal ultrasonography, hysteroscopy have higher sensitivity, specificity, and area under the summary receiver operating characteristic curve for the diagnose of endometrial hyperplasia, hysteroscopy should be selected priority as the auxiliary diagnosis.

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Liquid-based endometrial cytology associated with curettage in the investigation of endometrial carcinoma in postmenopausal women

Abstract: Liquid-based endometrial cytology can be considered a useful method in the detection of endometrial pathology in postmenopausal women.

Cited by 10 publications

References 16 publications

The application of endometrial sampler SAP-1 to screening of endometrial cancer in postmenopausal women: A diagnostic test study

The application of endometrial sampler SAP-1 to screening of endometrial cancer in postmenopausal women: A diagnostic test study

<p>A Clinical Comparative Study of Two Different Endometrial Cell Samplers for Evaluation of Endometrial Lesions by Cytopathological Diagnosis</p>

The value of hysteroscopy and transvaginal ultrasonography in the diagnosis of endometrial hyperplasia: a systematic review and meta-analysis

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