Peritoneal lavage cytology in the diagnosis of pelvic endometriosis

Abstract

Background We aimed to assess the sensibility, specificity, and predictive values of cytology of the fluid sediment in patients with pelvic endometriosis diagnosed based on laparoscopic‐guided biopsy. Methods Between January 2017 and September 2018, 71 specimens of peritoneal fluid collected by laparoscopy were evaluated. Fifty‐three patients were diagnosed laparoscopically and histologically with endometriosis, and 18 were considered controls (without suspicious endometriosis lesions). We calculated the sensitivity, specificity, the positive and negative predictive value, and the accuracy of endometrial‐like cells (ELC) and hemosiderin‐laden macrophages (HLM) in the fluid sediment. Results Of the 50 patients with endometriosis, 32 (64%) had HLM, 9 (18%) had ELC, and 7 (14%) had both elements. Of the 18 patients without endometriosis, 3 (16%) had HLM, 2 (11%) had ELC, and 1 (5%) had both ELC and HLM. The sensitivity of the cytology of peritoneal fluid sediment for the diagnosis of endometriosis, based on the presence of ELC, was 18%, the specificity was 83%, the positive predictive value was 82%, the negative predictive value was 28.7%, and the accuracy was 36.8%. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy based on the presence of HLM were 64%, 83%, 91%, 45.5%, and 69.1%, respectively. Conclusion The study of peritoneal fluids obtained laparoscopically from women undergoing evaluation for endometriosis may identify patients with the disease.

Prognostic Impact of Positive Peritoneal Lavage Cytology on Resectable Pancreatic Body and Tail Cancer: A Retrospective Study

“…The detection rate is reportedly higher when peritoneal lavage cytology is performed at multiple locations [48]. In addition, many reports use 100-200 ml of saline solution for pancreatic cancer [11][12][13]16], compared to 10-1000 ml or more for other cancers [49,50], which may also affect the detection rate. In addition, reverse-transcription polymerase chain reaction reportedly increases detection sensitivity [51].…”

MicroRNAs in Endometriosis: Insights into Inflammation and Progesterone Resistance

“…Elevated IL-10 levels may contribute to polarization of M1 to M2 macrophages, as evidenced by an increase in CD163+ biomarkers expressed by M2 macrophages and a decrease in CD86+ biomarkers expressed by M1 macrophages [35]. Macrophages are not only present in ectopic endometriotic lesions but also in the eutopic endometrium and peritoneal fluid of patients with endometriosis [36,37]. In endometriosis, macrophages showed increased secretion of prostaglandins (PG), proinflammatory cytokines, and hydrolytic enzymes with increased levels of PG observed in peritoneal fluid [10,38].…”