Endometrial Cells: The How and When of Reporting

Cibas, Edmund S.; Chelmow, David; Waxman, Alan G.; Moriarty, Ann

doi:10.1007/978-3-319-11074-5_3

Cited by 5 publications

(5 citation statements)

References 19 publications

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“…However, menopausal status is often unclear or unknown to the laboratory, and therefore the subsequent 2001 Bethesda System recommended to report these abnormalities in women ≥40 years of age 70 . Therefore, the level of reporting benign endometrial cells increased with the transition from the 1991 to 2001 Bethesda System, and predictive values of this abnormality dropped from 6% to 1% 71 . The current recommendations are to report malignant, atypical, and benign‐appearing endometrial cells in women ≥45 years of age, although the former category is still a subject of debate 72 …”

Section: Discussionmentioning

confidence: 99%

Sensitivity of cervico‐vaginal cytology in endometrial carcinoma: A systematic review and meta‐analysis

Frias-Gomez

Benavente

Ponce

et al. 2020

Cancer Cytopathology

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Cervico‐vaginal cytology is primarily a cervical cancer screening test. The anatomical continuity of the uterine cavity with the cervix makes the Papanicolaou (Pap) test accessible to evaluate signs of disease shed from the endometrium. Our aim was to determine the sensitivity of routine Pap test in endometrial carcinoma detection and its relationship with clinico‐pathologic factors. We performed a systematic review of studies reporting Pap test results prior to diagnosis of or surgery for endometrial carcinoma between 1990 and 2018 in PubMed or Web of Science. Two independent reviewers extracted data and assessed study quality using an adapted Newcastle‐Ottawa Quality Assessment Scale and Quality Assessment of Diagnostic Accuracy Studies tool. We identified 45 studies including a total of 6599 women with endometrial cancer. Abnormal Pap test results prior to diagnosis of or surgery for endometrial carcinoma were observed in 45% (95% CI, 40%‐50%) of study participants. This percentage was significantly higher among those of non‐endometrioid histology compared with endometrioid subtypes (77% [95% CI, 66%‐87%] vs 44% [95% CI, 34%‐53%], respectively; P heterogeneity <.001). Several clinico‐pathologic factors were related to a higher percentage of abnormal Pap test results, including high‐stage, myometrial invasion >50%, high histological grade, positive peritoneal cytology, presence of lymph node metastasis, cervical involvement, and lymphovascular invasion (P heterogeneity <.05 for all variables). Routine cervical cytology can detect endometrial cancer in almost half of patients, whereas sensitivity is higher among individuals with non‐endometrioid histology or more advanced cancers. This review summarizes the current clinical and prognostic value of cervical cytology in endometrial carcinoma. Recent technological developments using molecular biomarkers may improve accuracy for early cancer detection.

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Section: Discussionmentioning

confidence: 99%

Sensitivity of cervico‐vaginal cytology in endometrial carcinoma: A systematic review and meta‐analysis

Frias-Gomez

Benavente

Ponce

et al. 2020

Cancer Cytopathology

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“…A total of 80 subjects were recruited and gave their formal consent. Five of these subjects had their sample excluded from the study due to unsatisfactory cellularity and/or absence of endocervical/metaplastical cells ( 43 ) for cytology evaluation or presence of confirmed carcinoma through histology. Tables S3, S4 in Supplementary Material present detailed information on each sample diagnosis.…”

Section: Resultsmentioning

confidence: 99%

Molecular Signatures of High-Grade Cervical Lesions

et al. 2018

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Cervical cancer is the fourth most common neoplasia in women and the infection with human papilloma virus (HPV) is its necessary cause. Screening methods, currently based on cytology and HPV DNA tests, display low specificity/sensitivity, reducing the efficacy of cervical cancer screening programs. Herein, molecular signatures of cervical cytologic specimens revealed by liquid chromatography-mass spectrometry (LC-MS), were tested in their ability to provide a metabolomic screening for cervical cancer. These molecules were tested whether they could clinically differentiate insignificant HPV infections from precancerous lesions. For that, high-grade squamous intraepithelial lesions (HSIL)-related metabolites were compared to those of no cervical lesions in women with and without HPV infection. Samples were collected from women diagnosed with normal cervix (N = 40) and from those detected with HSIL from cytology and colposcopy (N = 40). Liquid-based cytology diagnosis, DNA HPV-detection test, and LC-MS analysis were carried out for all the samples. The same sample, in a customized collection medium, could be used for all the diagnostic techniques employed here. The metabolomic profile of cervical cancer provided by LC-MS was found to indicate unique molecular signatures for HSIL, being two ceramides and a sphingosine metabolite. These molecules occurred independently of women’s HPV status and could be related to the pre-neoplastic phenotype. Statistical models based on such findings could correctly discriminate and classify HSIL and no cervical lesion women. The results showcase the potential of LC-MS as an emerging technology for clinical use in cervical cancer screening, although further validation with a larger sample set is still necessary.

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“…The 2014 Bethesda System recommends reporting benign-appearing endometrial cells for women aged 45 years and older, and endometrial assessment is recommended for postmenopausal women. 132,133 In a systematic review of 22 studies, the prevalence of normal endometrial cells on cervical cytology was 0.7% (95% CI 0.4-1.4%) in women aged 40 years and older. Seven percent (95% CI 4-10%) of patients with normal endometrial cells on cytology had endometrial hyperplasia or cancer.…”

Section: Cervical Cytology Findings Prompting Uterine Cancer Evaluationmentioning

confidence: 99%

Executive Summary of the Uterine Cancer Evidence Review Conference

Chelmow

Brooks

Cavens

et al. 2022

Obstetrics &Amp; Gynecology

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receives a stipend as the editor-in-chief of the Medscape Obstetrics and Gynecology Clinical Reference Book, and was on the American Board of Obstetrics and Gynecology Board of Directors during the evidence review and manuscript writing period. David Chelmow is a member of the United States Preventive Services Task Force (USPSTF). This article does not necessarily represent the views and policies of the USPSTF. Rebecca Brooks is a member of an AstraZeneca speakers' bureau related to ovarian cancer, a past advisory board member and consultant for GSK and Merck & Co., Inc., and a past non-branded speaker for Clinical Care Options. Sangini Sheth is a past consultant for Merck & Co., Inc., and a research study grant recipient (drug only: HPV vaccine) from Merck & Co., Inc. She was paid costs of travel and meeting registration (paid directly) and received honoraria payment for an education course from the ASCCP. She also has research grants from the NIH and CDC for studies unrelated to the submitted work.

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Endometrial Cells: The How and When of Reporting

Cited by 5 publications

References 19 publications

Sensitivity of cervico‐vaginal cytology in endometrial carcinoma: A systematic review and meta‐analysis

Sensitivity of cervico‐vaginal cytology in endometrial carcinoma: A systematic review and meta‐analysis

Molecular Signatures of High-Grade Cervical Lesions

Executive Summary of the Uterine Cancer Evidence Review Conference

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