Value of Cervical Cytology in Diagnosing Endometrial Carcinoma in Women with Postmenopausal Bleeding

Doorn, Helena C. van; Opmeer, Brent C.; Kooi, G.S.; Ewing-Graham, Patrica C.; Kruitwagen, Roy F.P.M.; Mol, Ben Willem J.

doi:10.1159/000325308

Cited by 11 publications

(10 citation statements)

References 32 publications

(33 reference statements)

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“…Many researchers reported a high risk of endometrial cancer with positive cervical cytology (42, 43). Abnormal cervical cytology was associated with high-grade endometrial cancer, worse 5-year median recurrence-free survival and worse disease-specific survival (44).…”

Section: Discussionmentioning

confidence: 99%

Endometrial Cytology as a Method to Improve the Accuracy of Diagnosis of Endometrial Cancer: Case Report and Meta-Analysis

Wang

Zhao

et al. 2019

Front. Oncol.

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More and more researchers have reported that dilatation and curettage (D&C) or Pipelle had low accuracy, high misdiagnosis, and insufficient rate. Endometrial cytology is often compared with histology and seems to be an efficient method for the diagnosis of endometrial disorders, especially endometrial cancer. We report a case of misdiagnosed endometrial cancer by D&C, but with a positive cytopathological finding. Following that, a meta-analysis including 4,179 patients of endometrial diseases with cyto-histopathological results was performed to assess the value of the endometrial cytological method in endometrial cancer diagnosis. The pooled sensitivity and specificity of the cytological method in detecting endometrial atypical hyperplasia or cancer was 0.91[95% confidence interval (CI) 0.74–0.97] and 0.96 (95% CI 0.90–0.99), respectively. The pooled positive likelihood ratio and negative likelihood ratio was 25.4 (95% CI 8.1–80.1) and 0.10 (95% CI 0.00–0.30), respectively. The diagnostic odds ratio which was usually used to evaluate the diagnostic test performance reached 260 (95% CI 36–1905). So we recommend that D&C and Pipelle are still practical procedures to evaluate the endometrium, cytological examinations should be utilized as an additional endometrial assessment method.

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Section: Discussionmentioning

confidence: 99%

Endometrial Cytology as a Method to Improve the Accuracy of Diagnosis of Endometrial Cancer: Case Report and Meta-Analysis

Wang

Zhao

et al. 2019

Front. Oncol.

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“…Many of these women are referred to a gynaecologist, and investigation started, without cervical cytology 29 . The value of cervical cytology in diagnosing endometrial carcinoma in women with postmenopausal bleeding was assessed and the authors concluded that a combined approach of cervical cytology and endometrial thickness could detect incidental endometrial cancers that are missed by transvaginal sonography alone, with a cut‐off less than 5 mm 30 . A recent report by Patel et al.…”

Section: Discussionmentioning

confidence: 99%

“…29 The value of cervical cytology in diagnosing endometrial carcinoma in women with postmenopausal bleeding was assessed and the authors concluded that a combined approach of cervical cytology and endometrial thickness could detect incidental endometrial cancers that are missed by transvaginal sonography alone, with a cut-off less than 5 mm. 30 A recent report by Patel et al 31 suggested that 77% of women with endometrial cancers identified on cytology were asymptomatic. In our study, endometrial cancer was diagnosed in ten women, who were all above the age of 50; seven were symptomatic and three asymptomatic.…”

Section: Discussionmentioning

confidence: 99%

Risk of significant gynaecological pathology in women with ?glandular neoplasia on cervical cytology

Talaat¹,

Brinkmann²,

Dhundee

et al. 2011

Cytopathology

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“…Park et al [4] identified a high incidence of Pap smear tests with cancer cells (75%) in 12 subjects diagnosed with UPSC. Further, Van Doom et al [5] suggested that adding the results of a cervical smear to endometrial thickness could detect incidental endometrial cancers that are missed by transvaginal sonography (<5 mm). Early detection of these particularly poor prognostic variants of endometrial carcinoma is of clinical relevance; however, few studies have assessed the utility of Pap smears in the diagnosis of high-grade endometrial adenocarcinomas.…”

Section: Introductionmentioning

confidence: 99%

Abnormal Cervical Cytology in the Diagnosis of Uterine Papillary Serous Carcinoma: Earlier Detection of a Poor Prognostic Cancer Subtype

et al. 2011

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Objective: Early detection of uterine papillary serous (UPSC), clear cell (CCC), and grade 3 endometrioid carcinomas (G3EC) – all poor prognostic variants of endometrial carcinoma (EC) – is of particular clinical relevance. The study objective was to assess the utility of liquid-based cytology (Pap) in the detection of high-grade EC. Study Design: A retrospective, two-institution analysis of patients diagnosed with UPSC, CCC, or G3EC with a preoperative Pap from 1999 to 2010 was conducted. Results: One hundred and one patients were evaluated; 51.5% had UPSC, 27.7% had CCC, and 20.8% had G3EC. Stage I/II disease was found in 69.3% of patients, and 46/101 patients (45.5%) had abnormal Paps. Significantly more patients with UPSC had abnormal Paps (65.7%) than those with CCC (25%) or G3EC (23.8%; p < 0.001). An abnormal Pap was the only presenting clinical finding in a significant number of asymptomatic UPSC patients (26.9%) compared with 4% of patients with CCC and G3EC (p = 0.005). On multivariate analysis, UPSC histology was the only variable associated with an abnormal Pap. Conclusions: A high incidence of abnormal cervical cytology was observed in women with high-grade EC, particularly in UPSC patients. Although hypothesis generating, a proportion of asymptomatic UPSC patients had abnormal cytology, signifying that Pap smear screening may help detect the disease before the patient develops symptoms.

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Value of Cervical Cytology in Diagnosing Endometrial Carcinoma in Women with Postmenopausal Bleeding

Cited by 11 publications

References 32 publications

Endometrial Cytology as a Method to Improve the Accuracy of Diagnosis of Endometrial Cancer: Case Report and Meta-Analysis

Endometrial Cytology as a Method to Improve the Accuracy of Diagnosis of Endometrial Cancer: Case Report and Meta-Analysis

Risk of significant gynaecological pathology in women with ?glandular neoplasia on cervical cytology

Abnormal Cervical Cytology in the Diagnosis of Uterine Papillary Serous Carcinoma: Earlier Detection of a Poor Prognostic Cancer Subtype

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