The diagnostic value of the thinprep pap test in endometrial carcinoma: A prospective study with histological follow‐up

Tomashefski, Joseph F.; Sawady, Joram; Ferrer, Héctor Luis Mustelier; Khiyami, Amer

doi:10.1002/dc.22841

Cited by 13 publications

(6 citation statements)

References 24 publications

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“…With the development of the 2001 Bethesda System [10], cytopathologists and cytotechnologists became more familiar with the cytomorphological features of endometrial cancers. Beside our previous reports [5,6,7], some other papers reporting liquid-based preparations [11,12,13] have revealed improved sensitivity in recent years. Similar to the results of Zhou et al [13], we found that abnormal cells tend to be present more often in patients with type II cancers, a higher grade/stage and cervical involvement.…”

Section: Discussionmentioning

confidence: 80%

The Diagnostic Value of Routine Papanicolaou Smears for Detecting Endometrial Cancers: An Update

et al. 2015

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Objective: The presence of degenerative endometrial debris and abnormal endometrial cells is considered to be the hint for endometrial pathology. The purpose of this study was to evaluate the efficacy of Papanicolaou (Pap) smears in detecting endometrial cancers. Study Design: There were 146 cases of endometrial cancer diagnosed at our institute in 2000-2002 and 271 in 2010-2012. Among them, 57 and 95 relevant reports of Pap smears 6 months prior to the histology diagnosis were retrieved for this study, respectively. In the first time period, new criteria for detecting endometrial lesions had not yet been incorporated into routine screening. Results: Twenty cases (21%) of adenocarcinoma, 12 (13%) of atypical glandular cells, 4 (4%) of endometrial debris and 59 (62%) negative reports were found among the more recent 95 relevant Pap smears. The overall efficacy of the Pap smear for detecting endometrial malignancy was 38%, higher than 10 years previously (30%). Conclusion: Although the Pap smear was originally designed to screen cervical lesions, more effective detection of endometrial lesions could be achieved by adding new criteria to the routine screening.

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Section: Discussionmentioning

confidence: 80%

The Diagnostic Value of Routine Papanicolaou Smears for Detecting Endometrial Cancers: An Update

et al. 2015

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“…have shown that in Pap tests, enlarged nuclei and the presence of nucleoli are reliable diagnostic criteria to make distinctions among normal, atypical, and endometrial adenocarcinoma cells. [ 28 ] The set of criteria we used in our study are relatively objective and have demonstrated a reliable distinction among atypical endometrial cells, atypical endocervical cells, and ASC-H cells.…”

Section: Discussionmentioning

confidence: 99%

Atypical endometrial cells and atypical glandular cells favor endometrial origin in Papanicolaou cervicovaginal tests: Correlation with histologic follow-up and abnormal clinical presentations

et al. 2014

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The 2001 Bethesda system recommends further classifying atypical glandular cells (AGCs) as either endocervical or endometrial origin. Numerous studies have investigated the clinical significance of AGC. In this study, we investigated the incidence of clinically significant lesions among women with liquid-based Papanicolaou cervicovaginal (Pap) interpretations of atypical endometrial cells (AEMs) or AGC favor endometrial origin (AGC-EM). More importantly, we correlated patients of AEM or AGC-EM with their clinical presentations to determine if AEM/AGC-EM combined with abnormal vaginal bleeding is associated with a higher incidence of significant endometrial pathology. All liquid-based Pap tests with an interpretation of AEM and AGC-EM from July, 2004 through June, 2009 were retrieved from the database. Women with an interpretation of atypical endocervical cells, AGC, favor endocervical origin or AGC, favor neoplastic were not included in the study. The most severe subsequent histologic diagnoses were recorded for each patient. During this 5-year period, we accessioned 332,470 Pap tests of which 169 (0.05%) were interpreted as either AEM or AGC-EM. Of the 169 patients, 133 had histologic follow-up within the health care system. The patients ranged in age from 21 to 71 years old (mean 49.7). On follow-up histology, 27 (20.3%) had neoplastic/preneoplastic uterine lesions. Among them, 20 patients were diagnosed with adenocarcinoma (18 endometrial, 1 endocervical, and 1 metastatic colorectal), 3 with atypical endometrial hyperplasia, and 4 with endometrial hyperplasia without atypia. All patients with significant endometrial pathology, except one, were over 40 years old, and 22 of 25 patients reported abnormal vaginal bleeding at the time of endometrial biopsy or curettage. This study represents a large series of women with liquid-based Pap test interpretations of AEM and AGC-EM with clinical follow-up. Significant preneoplastic or neoplastic endometrial lesions were identified in 20.3% of patients. Patients with Pap test interpretations of AEM or AGC-EM and the clinical presentation of abnormal vaginal bleeding should be followed closely.

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“…Cervicovaginal smears are not a dependable method in the detection of endometrial malignancies. However, many studies have investigated the importance of histiocytes, BEC, and AEC in pre-/postmenopausal smears for the detection of endometrial pathologies [2,3,4,5,6,7,10,11,12,13]. According to the literature, the detection rate of EC using the Pap test ranges from 20% to as high as 90% [7].…”

Section: Discussionmentioning

confidence: 99%

Significance of Foamy Histiocytes in Cervical Smears from Postmenopausal Women

Kır

Yılmaz²,

Çetiner³

et al. 2013

Acta Cytologica

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Objective: To determine the significance of the presence of foamy histiocytes (FH) in postmenopausal cervicovaginal smears for the detection of endometrial carcinomas (EC). Study Design: Endometrial sampling was performed over 6 months in 53 of 102 cases that presented with postmenopausal FH, benign endometrial cells (BEC), FH with BEC (FH + BEC), and atypical endometrial cells (AEC), resulting in a total of 41,150 cervicovaginal smears. The control group consisted of 58 cases with a cytologic diagnosis of a normal smear (NS). Results: There were 0 (0%), 1 (4.54%), 2 (13.33%), 2 (33.33%), and 5 (50.00%) cases of EC diagnosed on histopathologic evaluation in patients with NS (n = 58), BEC (n = 22), FH (n = 15), FH + BEC (n = 6), and AEC (n = 10), respectively. The sensitivities and specificities of the cytologic diagnoses of FH, FH + BEC, and AEC for the detection of EC were 81.7 and 100%, 93.6 and 100%, and 92.1 and 100%, respectively. Conclusion: The cytologic diagnoses of FH and FH + BEC had reasonably high sensitivities and specificities for the diagnosis of EC by cervicovaginal smear. Additional studies are needed.

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The diagnostic value of the thinprep pap test in endometrial carcinoma: A prospective study with histological follow‐up

Cited by 13 publications

References 24 publications

The Diagnostic Value of Routine Papanicolaou Smears for Detecting Endometrial Cancers: An Update

The Diagnostic Value of Routine Papanicolaou Smears for Detecting Endometrial Cancers: An Update

Atypical endometrial cells and atypical glandular cells favor endometrial origin in Papanicolaou cervicovaginal tests: Correlation with histologic follow-up and abnormal clinical presentations

Significance of Foamy Histiocytes in Cervical Smears from Postmenopausal Women

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