Liquid-based Papanicolaou test (SurePath) interpretations before histologic diagnosis of endometrial hyperplasias and carcinomas
✍ Scribed by Thrall, Michael ;Kjeldahl, Klint ;Gulbahce, H. Evin ;Pambuccian, Stefan E.
- Book ID
- 102105663
- Publisher
- John Wiley and Sons
- Year
- 2007
- Tongue
- English
- Weight
- 96 KB
- Volume
- 111
- Category
- Article
- ISSN
- 0008-543X
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✦ Synopsis
Background:
In addition to the reporting of atypical glandular cells (agc) and adenocarcinoma (adca), the 2001 bethesda system requires the reporting of benign-appearing endometrial cells in women aged >40 years (baemc). in this study, the authors evaluated the contribution of each of these reporting categories to the sensitivity and specificity of a liquid-based papanicolaou test for endometrial carcinoma or hyperplasia.
Methods:
Over the 3-year study period, in the setting of a large, multihospital health care system, the authors analyzed the results from liquid-based papanicolaou tests that were performed within the 6 months that preceded a histologic diagnosis of endometrial carcinoma or hyperplasia and that were reported according to the 2001 bethesda system.
Results:
Two hundred seventy-two women had a histologic diagnosis of endometrial hyperplasia (n = 199) or malignancy (n = 73) within 6 months after a papanicolaou test. in total, 188,594 papanicolaou tests (91,385 from women aged >40 years) were interpreted during the study period and resulted in 3810 diagnoses of baemc, 326 diagnoses of agc, and 30 diagnoses of adca. only 28 of 73 women (38.4%) with endometrial carcinoma had cytologically agc or adca reported on a previous papanicolaou test. the reporting of baemc increased this sensitivity by only 5.5% (4 additional tests) but decreased the specificity of the papanicolaou test for endometrial malignancy from 99.8% to 96%. for endometrial hyperplasias, the sensitivity of the papanicolaou test was even lower (39 of 198 tests; 19.7%), but baemc represented the majority of endometrial-type cells reported (36 of 39 tests).
Conclusions:
The reporting of baemc led to an only marginal increase in sensitivity that had to be weighed against the significant loss in specificity of the papanicolaou test for endometrial neoplasia.