Comparison of Two Sampling Procedures for Diagnosing Endometrial Carcinoma and Hyperplasia: Outpatient Tissue Biopsy Versus Cytologic Examination

Abstract

IntroductionEach year, there are about 142,000 new cases of endometrial carcinoma worldwide, and an estimated 42,000 women die because of this type of cancer [1]. The surgical stage, determined according to the criteria of the International Federation of Gynecology and Obstetrics, reflects the 5-year survival, which is around 85% for stage I, 75% for stage II, 45% for stage III, and 25% for stage IV disease [1]. Endometrial cancer is often preceded by endometrial hyperplasia, which is a spectrum of morphologic and biologic alterations of the endometrial glands and stroma and is often secondary to hyperestrogenism. It has been shown that progression to carcinoma occurs in 1% of patients with simple hyperplasia, 3% of patients with complex hyperplasia, 8% of patients with simple hyperplasia with atypia, and 29% of patients with complex hyperplasia with atypia [2].The Japanese Ministry of Health and Welfare investigated the effectiveness of mass endometrial carcinoma screening. During the 9-year study, 126 cases were detected by mass screening and 1,069 cases were diagnosed in outpatient clinics. Early-stage cases were significantly more frequent in the screening group (p < 0.001): 88.1% of the patients in the screening group had stage I disease, as compared to 65.3% of the patients in the outpatient group. The 5-year survival rate was also significantly higher in the screening group than in the outpatient group (94.7% vs 84.3%; p = 0.041) [3]. These statistics suggest that early detection of endometrial carcinoma and hyperplasia is necessary to improve the prognosis of these diseases. AbstractBackground: We compared the sensitivity of 2 diagnostic procedures-tissue biopsy and cytologic examinationfor detecting endometrial carcinoma and hyperplasia in outpatients. The patients' degree of acceptance of these methods was also evaluated.

Epidemiology and Treatment for Thyroid Cancer

“…Furthermore, clinical response by measurement of tumor size is often discordant with the pathological evaluation, such as the clinically response of approximately 70% in most studies, the partial or complete regression in histopathological biopsy analysis is less than 30% [15]. However, in these studies, the diagnostic sensitivity was not sufficiently evaluated because of the small number of carcinoma [16].…”

3D Imaging of Fine Needle Aspirates Using Optical Projection Tomographic Microscopy

“…Diagnostic accuracy of endoscopically guided FNA is much lowers, between 0.6-0.9 [7][8][9][10]. It had been shown that combining histology with cytology can improve diagnostic accuracy and overcome the limitation in the amount and type of information that cytology alone can provide [11][12][13]. For example, tissue structure shown in histology allows pathologists to identify the organization of neoplastic cells with respect to each other, presence or absence of basement membranes, quality and type of supporting connective tissue, including blood vessels, and the invasive relationship between tumor cells and these structures.…”

“…For example, tissue structure shown in histology allows pathologists to identify the organization of neoplastic cells with respect to each other, presence or absence of basement membranes, quality and type of supporting connective tissue, including blood vessels, and the invasive relationship between tumor cells and these structures. The amount of information gained from histology has often led to a change in the diagnostic outcome [12,14,15]. Unfragmented tissue samples are typically obtained from Core Needle Biopsy (CNB), which uses a larger diameter needle (e.g.…”