Effectiveness of Pap Smears as Predictor in the Diagnosis of Carcinoma Endometrium at a Tertiary Oncology Centre in India

Abstract

Endometrial carcinoma is the commonest malignancy of female genital tract in the developed world. No widely accepted screening test exists for endometrial cancer. However, cervical cytology may be useful in predicting endometrial disease. The aim of this study was to review the Pap smears of endometrial carcinoma patients for normal/ abnormal cytology and then correlate with clinico-pathological parameters. This was a retrospective study from January 2008 to December 2013. A total of 226 patients underwent surgery for endometrial cancer at this centre in this duration. Of these, medical records were available in 204 cases. Pap smear reports within previous 6 months of surgery were available in 180 cases. The relevant data of these patients were statistically analysed using standard statistical tests. A p value of ≤ 0.05 was considered significant. The patients were in the age group of 32 to 85 years. A total of 38 (21.1%) cases showed abnormal cytology on Pap test. The cervical cytology of carcinoma endometrium patients was then correlated and statistically analysed with various parameters like age, stage, grade of the disease, histology type and depth of myometrial invasion. The association was significant for higher histologic grade, advanced stage, deeper myometrial invasion and non-endometrioid histology. In our study, the rate of detection of abnormal cervical cytology in carcinoma endometrium is less in early stages but high in advanced stages and in the presence of poor prognostic factors, like higher histologic grade, deeper myometrial invasion and non-endometrioid histology.