Objective. Determination of the significance of cytological methods in the diagnosis of non-tumor lesions and endometrial tumors.   Materials and Methods. 69 patients who underwent surgical treatment of hysterectomy or hysteroscopy with separate diagnostic scraping of the cervical mucosa and uterine cavity. The endometrial surface was scraped by Cytobrush. Part of the material was applied to a slide for conventional cytology (CC); the remaining material was placed into the vial for liquid-based cytology (LBC). The results were analyzed using SPSS Statistical Package (SPSS: An IBM Company).   Results. Histological examination of biopsy material revealed endometrial hyperplasia without atypia (20), atypical hyperplasia (2) and adenocarcinoma (11). The sensitivity of CC and LBC for hyperplasia without atypia was estimated at 100 %, the specificity at 88 % and 94 %, respectively; the positive predictive value at 77 % and 87 %, respectively, and the negative predictive value at 100 %. The sensitivity of CC and LBC for atypical hyperplasia and adenocarcinoma was estimated at 100 %, specificity at 96 %; positive predictive value at 87 % and negative predictive value at 100 %.   Conclusions. Exfoliative cytology of material from the uterine cavity can be used as an informative method for detecting endometrial cancer and hyperplasia.

A cytological examination of uterine cavity material has proven to be the effective method of detecting and clarifying the diagnosis of cancer and non-tumor endometrial diseases. However, sometimes there are difficulties in interpreting the results in a traditional (classical) cytological examination, due to high level of inadequate samples: the presence of mucus, a large number of blood elements, structures of poorly visible cells in the wrong preparation of the smear. At present, the method of liquid cytology, based on the technology of preparation of standard thin-layer cytological preparations from liquid cell suspension, is increasingly developed and widespread. These slides, if necessary, can be used for morphometry, cytochemical, immunocytochemical studies etc. It is also possible to prepare cell blocks from this material, and to obtain information about the histological structure if small pieces of tissue are presented in cytological material, moreover, to use these blocks for immunohistochemical reactions. Material from the uterine cavity may contain tumor cells from ovarian, tubal or other non- endometrial carcinoma, and it is necessary to obtain information about their origin, to verify the morphological diagnosis and to determine the management and treatment of patients, as a lot of problems concerning ovarian and endometrial cancer remains unclear. Examination of aspirates and scrapes from the uterine cavity using advanced molecular techniques, together with existing examination methods, can help to form risk groups for uterine, tubal, ovarian and even peritoneal tumors. The review of literature contains comparative characteristics of different methods and their combinations, which allow improving diagnostics of non-tumor lesions and endometrial tumors.

BACKGROUND: Morphological examination of materials obtained during endometrial aspiration biopsy or diagnostic curettage is an integral part in the diagnosis of endometrial pathologies; however, these manipulations are invasive and have additional surgical and anesthetic risks. Therefore, the improvement of endometrial cytological examination is of great interest to minimize associated risks with high diagnostic potential. Currently, traditional cytology (TC) and liquid-based cytology (LBC) are employed for the morphological diagnosis of diseases of various localizations, but the possibilities of their combined use are insufficiently explored. AIMS: To improve the cytological diagnosis of endometrial tumors and non-tumor lesions. MATERIALS AND METHODS: The study enrolled 101 patients aged 2279 years with endometrial pathologies and indications for surgical treatment and routine histological examination of operative specimen. Endometrial surface scrapings obtained during hysteroscopy (n=73) and postoperative specimen (n=28) were used for cytological examination. A portion of the obtained specimen was immediately applied to a TC slide, and the rest was placed in a vial with preserving medium for LBC. Statistical processing of the results was performed according to conventional methods using StatTech v. 2.8.8 (Stattech LLC, Russia). RESULTS: Uninformative data were obtained in 9.9% of the cases in the TC and in 14.9% of cases in LC of uterine cavity specimens. The combined use of TC and LC reduced the number of observations with inadequate specimen to 6.9%. The presence of atypia in the cytological specimen (threshold value of atypical hyperplasia) correlated with the results of the histological examination (p0.001). CONCLUSIONS: The combined use of TC and LC allows increasing the number of observations with adequate specimens, improving the accessible and minimally invasive diagnosis of proliferative conditions and tumors.