Nuclear characteristics of the endometrial cytology: Liquid‐based versus conventional preparation

Abstract

The aim of this study was to assess the utility of liquid-based cytologic preparation (LP) compared with conventional preparation (CP) for the assessment of nuclear findings in endometrial glandular and stromal breakdown (EGBD) which may be misdiagnosed as carcinoma in EGBD cases. The material consists of cytologic smears including 20 cases of proliferative endometrium (PE), 20 cases of EGBD, and 20 cases of endometrioid adenocarcinoma grade1 (G1) for which histopathological diagnosis was obtained by endometrial curettage at the JA Suzuka General Hospital. Nuclear findings were examined in PE cells, EGBD-stromal cells, EGBD-metaplastic cells, and G1 cells, respectively. It was examined about the following items; (1) nuclear shape; (2) A long/minor axis ratio in cell nuclei; (3) an area of cell nuclei; (4) overlapping nuclei. Results are as follows: (1) nuclear shape; as for the reniform shape of EGBD-stromal cells and spindle shape of EGBD-metaplastic cells, the ratio of the LP method was a higher value than the CP method. (2) The long axis and area of cell nuclei; LP in all groups was a recognizable tendency for nuclear shrinkage. (3) The long/minor axis ratio in cell nuclei; only EGBD-metaplastic cells recognize a significant difference between CP and LP. (4) Overlapping nuclei; LP was a higher value in comparison with CP in the other groups except PE cells, and the degree of overlapping nuclei was enhanced about three times. Therefore, although a cell of LP has a shrinking tendency, (1) it is excellent that LP preserves a characteristic of nuclear shape than CP; (2) a cellular characteristic becomes clearer, because three-dimensional architecture of LP is preserved of than CP. As for the standard preparation method for endometrial cytology samples, we considered that a concrete introduction of the LP method poses no problems.

The Role of Liquid-Based Preparation in the Evaluation of Endometrial Cytology

“…However, the nuclear shape features appear to be more useful in the discrimination between EGBD and G1 on LBPs. In the differential assessment of nuclear features in LBP versus conventional cytologic preparation (CCP) in EGBD cases, considering the spindle shape of the nucleus, only MCIP showed significantly higher values in LBP than in CCP, and as for the reniform shape of the nucleus, only CCSC showed significantly higher values in LBP compared with CCP [59]. …”

Evaluation of the benefit and use of the new terminology in endometrial cytology reporting system

“…Endometrial cytology using liquid-based preparation (LP) of specimens has been reported. [11][12][13] We have also reported that the inadequate specimen rate of LP is lower than that of the CP method. 14 Regarding the diagnostic system in endometrial cytology, traditionally, a "three-tier reporting (TTR) system," which consists of "negative," "suspicious positive," and "positive" categories, has been widely used.…”

“…Endometrial cytology using liquid‐based preparation (LP) of specimens has been reported . We have also reported that the inadequate specimen rate of LP is lower than that of the CP method .…”

“…5,9,10 The preparation method of endometrial cytology adopted in many institutions is that an obtained endometrial sample is directly smeared onto a glass slide (conventional preparation; CP). Endometrial cytology by CP has two problems: a high inadequate specimen rate due to the presence of protein, mucus, and blood components in the background, 11 and no diagnostic format, such as the Bethesda system (TBS), has been defined for this method.…”

Cytological Characteristics of Endometrial Phasing Using the Specimens Prepared with the Liquid-Based Procedure: Comparison with the Conventional Procedure

“…This may be due to the clear cytological specimens obtained by the automated processing system in the limited field of glass slides. In the field of endometrial cytology, LBP has started to be utilized for detecting endometrial neoplasia [14,15,16,17,18,19,20]. However, endometrial phasing using LBP specimens has not yet been analyzed, and the results obtained with this method may differ from the knowledge acquired using conventional specimens.…”