Liquid-based endometrial cytology associated with curettage in the investigation of endometrial carcinoma in postmenopausal women

Abstract

ObjectiveThe aim of this study was to investigate the diagnostic accuracy of liquid-based endometrial cytology in postmenopausal women, in comparison with histology. Materials and methodsThere were 790 postmenopausal women scheduled for hysteroscopy enrolled in this study. After providing informed consent, all patients proceeded sequentially through endometrial cytology, hysteroscopy, and then dilatation and curettage (D&C). Cytology sampling was performed by brushing the uterus cavity using SAP-1 and the sample was prepared to liquid-based smear using SurePath technology. The slides were stained by Papanicolaou method. All cytological diagnoses were correlated with the D&C histological diagnoses. ResultsCytohistological correlations were possible in 567 (71.8%) patients: the D&C was inadequate in 204 (25.8%) patients; the cytology was inadequate in 32 (4.1%) patients; and both were inadequate in 13 (1.6%) patients. SAP-1 provided more sufficient material for cytology than D&C can for histology (p < 0.001). Taking atypical hyperplasia and endometrial carcinoma as a positive result, the diagnostic accuracy of liquid-based endometrial cytology was 81.5%; sensitivity was estimated at 75.9%, specificity at 83.3%, positive predictive value at 59.1% and negative predictive value at 91.6%. ConclusionLiquid-based endometrial cytology can be considered a useful method in the detection of endometrial pathology in postmenopausal women.