The Yokohama system for reporting directly sampled endometrial cytology: The quest to develop a standardized terminology

Fulciniti, Franco; Yanoh, Kenji; Karakitsos, Petros; Watanabe, Jun; Lorito, Alessia Di; Margari, Niki; Maeda, Yoshinobu; Kihara, Maki; Norimatsu, Yoshiaki; Kobayashi, Tadao K.; Hirai, Yasuo

doi:10.1002/dc.23916

Cited by 38 publications

(43 citation statements)

References 29 publications

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“…Although endometrial hysteroscopy and/or curettage may be used for the diagnosis, this intervention is difficult to apply for screening because it is invasive, time‐consuming, and expensive. Endometrial cytology by brush sampling has been widely applied for the screening of endometrial neoplasms . This method is a simple, painless, inexpensive and relatively accurate strategy to obtain materials for cancer detection, showing a sensitivity of 79% and a specificity of 99% .…”

Section: Introductionmentioning

confidence: 99%

“…Endometrial cytology by brush sampling has been widely applied for the screening of endometrial neoplasms. 3 This method is a simple, painless, inexpensive and relatively accurate strategy to obtain materials for cancer detection, showing a sensitivity of 79% and a specificity of 99%. 4 However, there are some factors that interfere with conventional smear quality, and the presence of excess blood is one of the main factors.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of liquid‐based genetic diagnosis of endometrial cancer

et al. 2018

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Although liquid‐based cytology (LBC) has increased the sensitivity of cytological diagnosis of endometrial cancer (EC) compared with conventional smear cytology, the sensitivity of LBC for the detection of EC is between 70% and 96% and remains unsatisfactory. In the present study, we compared the efficacy of LBC with liquid‐based genetic diagnosis (LBGDx) by amplicon sequencing of five genes including PTEN,PIK3CA,CTNNB1,KRAS, and TP53 in 48 LBC subjects who underwent endometrial screening. Consequently, LBC classified 15 samples as “positive or suspicious for malignancy” and the 15 were later confirmed as EC. However, LBC failed to identify five cases who were diagnosed as EC by additional transvaginal ultrasound and endometrial curettage, indicating that the sensitivity of cytology alone was 75% (15/20). LBGDx identified 11 pathogenic PTEN variants in 10 subjects, six PIK3CA variants in nine, three CTNNB1 variants in five, two KRAS variants in four, and three TP53 variants in three. Collectively, at least one pathogenic variant was identified in 19 subjects, which included 17 EC (15 endometrioid carcinoma and 2 endometrial carcinosarcomas), and one cervical adenocarcinoma. However, LBGDx did not identify any pathogenic mutations in three of the 20 EC, indicating that the sensitivity of LBGDx alone was 85% (17/20). Although five EC were negative for malignancy by LBC and three were negative for pathogenic mutations by LBGDx, the combination of LBC and LBGDx would successfully diagnose all 20 EC. These data suggested that LBGDx is a useful strategy to improve the sensitivity of screening of EC by LBC.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy of liquid‐based genetic diagnosis of endometrial cancer

et al. 2018

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“…This target was reached through the serious and fruitful discussion in the symposium in the ICC2016 at Yokohama, Japan, when internationally gathered experts on endometrial cytology developed a globally acceptable descriptive reporting system for endometrial cytology; named "The Yokohama system (TYS) for Reporting Endometrial Cytology (TYS reporting format)" [76]. The diagnostic categories of "TYS reporting format" and the "Algorithmic Interpretational Approach for TYS" are shown in Table 1 and Figure 5, respectively.…”

Section: The Yokohama System For Reporting Endometrial Cytologymentioning

confidence: 99%

A Diagnostic Approach to Endometrial Cytology by Means of Liquid-Based Preparations

Norimatsu¹,

Yanoh²,

Hirai³

et al. 2019

Acta Cytologica

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The adoption of endometrial cytology as a diagnostic procedure has been hampered in the past by difficulties arising in interpreting the cellular findings due to a number of factors (such as excess blood, cellular overlapping, and the complex physiology of endometrium). Recently, the use of liquidbased cytology (LBC), with its ability to remove blood and mucus and to distribute cells uniformly in a thin layer on the slide, has provided an opportunity to reevaluate the role of endometrial cytology. LBC samples are easier to screen compared to conventional ones, due to a smaller screening area and an excellent quality of cell preparations. LBC by using peculiar cytoarchitectural features is a useful tool in the cellular diagnosis and follow-up of abnormalities, which, how-ever, remains complementary to histopathology and to the emerging molecular diagnostic cytopathology. This review discusses these various entities and takes into consideration the ancillary techniques that may be useful in the diagnostic procedure. Herein, we also summarize the process and rationale by which updates were made to the standardized terminology in 2018 and outline the contents of the new Bethesda-style classification (the Yokohama system) for the endometrial cytology.

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“…Very recently, through fruitful discussion in the symposium at the ICC2016 in Yokohama, Japan, international experts on endometrial cytology agreed to develop a globally acceptable descriptive reporting system for endometrial cytology, The Yokohama System for Reporting Endometrial Cytology (TYS reporting format) ).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of cellular adequacy in endometrial liquid‐based cytology

et al. 2019

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Objective This study evaluated cellular adequacy in endometrial liquid‐based cytology (LBC) specimens. Methods In total, 1267 cases were obtained and the rate of unsatisfactory specimen and diagnostic accuracy for malignancy were assessed. If ≥10 cellular clusters composed of ≤30 endometrial cells were found per specimen, then the sample was provisionally considered adequate. Results The unsatisfactory rate (with fewer than 10 clusters) was 15.4%. Diagnostic accuracy in specimens with ≥10 clusters was significantly higher (90.5% vs 36.4%) than that in specimens with fewer than10 clusters. Moreover, the unsatisfactory rate in patients aged ≥60 years was significantly higher (33.8% vs 13.2%) than that in patients younger than 60 years. Although the unsatisfactory rate was decreased, significant differences were not found between cases with fewer than five clusters (22.6%) and fewer than 10 clusters (33.8%) in patients aged ≥60 years. Diagnostic accuracy in cases with five or more clusters was significantly higher (90.3% vs 0%) than that in cases with fewer than five clusters. Conclusions We propose that ≥10 clusters with ≥30 endometrial cells per cluster could be used as a specimen adequacy criterion for endometrial LBC. If ≥10 clusters cannot be found in patients aged ≥60 years, then the use of the alternative criterion of five or more clusters may yield satisfactory specimen adequacy.

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The Yokohama system for reporting directly sampled endometrial cytology: The quest to develop a standardized terminology

Cited by 38 publications

References 29 publications

Efficacy of liquid‐based genetic diagnosis of endometrial cancer

Efficacy of liquid‐based genetic diagnosis of endometrial cancer

A Diagnostic Approach to Endometrial Cytology by Means of Liquid-Based Preparations

Evaluation of cellular adequacy in endometrial liquid‐based cytology

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