Liquid based endometrial cytology in diagnosis of high-grade endometrial carcinoma with emphasis in recent advances and tissue correlation

Abstract

Background: Invasive endometrial cancer is the most common cancer of the female genital tract and from clinico-pathologic standpoint endometrial serous carcinoma as a prototype of type II endometrial carcinomas, has poor prognosis and 46% of these tumors are going to be diagnose in metastatic and high stages. The aims of this research is comparison of endometrial cytological findings in high grade endometrial carcinoma with tumor histology and achieve accuracy, sensitivity, specificity, positive predictive value and negative predictive value of this method in diagnosis of high grade endometrial tumors. Methods: Seventy patients, who had been candidate for hysterectomy, underwent for endometrial brush cytology before surgery. The prepared liquid based cytology smears examined by gynecological pathologist and the cytologic findings compared with histologic results and stages in a blind fashion. Results: All 12 cases of high- grade malignant lesions diagnosed by permanent histologic sections were diagnosed by cytological smears except one. There was complete correlation between cytologic and histologic findings regarding to tumor type and nuclear grades. The accuracy, sensitivity, specificity, PPV and NPV of endometrial brush cytology were calculated as 98%, 91%, 100%, 100% and 98% respectively. Conclusion: Endometrial cytology is a simple and feasible method for diagnosing of endometrial malignant lesions and if this high sensitivity and specificity be achieved in diagnosis of endometrial premalignant lesions such as endometrial intraepithelial neoplasia (EIN) and endometrial glandular dysplasia (EmGD) in large studies, it may be useful in early diagnosis and screening of endometrial lesions.