Τίτλος:
A reporting system for endometrial cytology: Cytomorphologic criteria—Implied risk of malignancy
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: There have been various attempts to assess endometrial lesions on cytological material obtained via direct endometrial sampling. The majority of efforts focus on the description of cytological criteria that lead to classification systems resembling histological reporting formats. These systems have low reproducibility, especially in cases of atypical hyperplasia and well differentiated carcinomas. Moreover, they are not linked to the implied risk of malignancy. Methods: The material was collected from women examined at the outpatient department of four participating hospitals. We analyzed 866 consecutive, histologically confirmed cases. The sample collection was performed using the EndoGyn device, and processed via Liquid Based Cytology, namely ThinPrep technique. The diagnostic categories and criteria were established by two cytopathologists experienced in endometrial cytology; performance of the proposed reporting format was assessed on the basis of histological outcome; moreover, the implied risk of malignancy was calculated. Results: The proposed six diagnostic categories are as follows: (i) nondiagnostic or unsatisfactory; (ii) without evidence of hyperplasia or malignancy; (iii) atypical cells of endometrium of undetermined significance; (iv) atypical cells of endometrium of low probability for malignancy; (v) atypical cells of endometrium of high probability for malignancy; and (vi) malignant. The risk of malignancy was 1.42% ± 0.98%, 44.44% ± 32.46% (nine cases), 4.30% ± 4.12%, 89.80% ± 8.47%, and 97.81% ± 2.45%, respectively. Conclusion: We propose a clinically oriented classification scheme consisting of diagnostic categories with well determined criteria. Each diagnostic category is linked with an implied risk of malignancy; thus, clinicians may decide on patient management and eventually reduce unnecessary interventional diagnostic procedures. Diagn. Cytopathol. 2016;44:888–901. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
Συγγραφείς:
Margari, N.
Pouliakis, A.
Anoinos, D.
Terzakis, E.
Koureas, N.
Chrelias, C.
Marios Makris, G.
Pappas, A.
Bilirakis, E.
Goudeli, C.
Damaskou, V.
Papantoniou, N.
Panayiotides, I.
Karakitsos, P.
Περιοδικό:
Diagnostic Cytopathology
Εκδότης:
John Wiley and Sons Inc
Λέξεις-κλειδιά:
adult; aged; area under the curve; Article; cancer classification; cancer risk; cell structure; cytopathology; diagnostic test accuracy study; diagnostic value; endometrium cancer; endometrium cytology; endometrium hyperplasia; female; histopathology; human; information processing; major clinical study; medical decision making; outpatient department; predictive value; priority journal; probability; receiver operating characteristic; risk assessment; sensitivity and specificity; unnecessary procedure; vagina smear kit; very elderly; carcinoma; classification; endometrium tumor; middle aged; Papanicolaou test; pathology; procedures; severity of illness index; standards, Adult; Aged; Aged, 80 and over; Carcinoma; Endometrial Neoplasms; Female; Humans; Middle Aged; Papanicolaou Test; Severity of Illness Index
