The Value of Papanicolaou Tests in the Diagnosis of Endometrial Carcinoma

Serdy, Kate M.; Yildiz-Aktas, Isil Z.; Li, Zaibo; Zhao, Chengquan

doi:10.1093/ajcp/aqv085

Cited by 24 publications

(23 citation statements)

References 19 publications

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“…[ 3 ] Several studies have scrutinized the value of preoperative cervical cytology in EC in terms of screening, prognostic marker of clinicopathological outcomes, and survival. [ 5 6 7 8 9 10 11 12 13 14 ]…”

Section: Discussionmentioning

confidence: 99%

“…Previous reports showed that preoperative cervical cytology significantly correlated with numerous clinicopathological parameters in patients with EC [ Table 3 ]. [ 5 6 7 8 9 10 11 14 ] Examples of such parameters included tumor histology, tumor grade, tumor stage, depth of MI, lymph node involvement, cervical involvement, peritoneal washing, and LVSI. The findings of our study matched the findings of earlier reports only with regard to tumor grade and cervical involvement.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have endeavored to address the use of cervical cytology in EC. [ 5 6 7 8 9 10 11 12 13 14 ] Overall, these studies showed that cervical cytology could identify abnormal endometrial cells in patients with EC. [ 5 6 7 8 9 10 11 12 13 14 ] Moreover, these studies revealed that abnormal endometrial cells in patients with EC correlated with poor survival and clinicopathological parameters, such as unfavorable histological tumor, high tumor grade, advanced stage disease, deep myometrial invasion (MI), and presence of lymphovascular space involvement (LVSI).…”

Section: Introductionmentioning

confidence: 99%

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Preoperative cervical cytology as a prognostic factor in endometrioid-type endometrial cancer: A single-center experience from Saudi Arabia

et al. 2020

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Objectives: The objectives of this study were (1) to estimate the frequency of preoperative abnormal cervical cytology (CC), (2) to explore correlations between preoperative CC and specific clinicopathological prognostic factors (tumor stage, endometrioid grade, myometrial invasion, lymphovascular space involvement, cervical involvement, and recurrence), and (3) to examine the impact of preoperative CC on disease-free survival (DFS) and overall survival (OS) in Saudi patients with endometrioid-type endometrial cancer (EC). Materials and Methods: A retrospective cross-sectional study was conducted at a tertiary hospital in Saudi Arabia. The study’s inclusion criteria included: (1) patients who underwent staging operation for EC from 2010–2014, (2) patients who had preoperative CC results within 3 months before staging operation, and (3) patients with final histopathological diagnosis of endometrioid-type EC. Results: Hundred and sixteen patients ( n = 116) met the study’s inclusion criteria. CC results were abnormal in 46 patients (39.7%). Patients with abnormal CC had statistically significant higher rates of unfavorable Grades II–III tumor and cervical involvement than patients with normal CC ( P = 0.004, chi-square test). There were no statistically significant differences (log-rank test) between patients with normal and abnormal CC with regard to DFS ( P = 0.525) and OS ( P = 0.166). Multivariate analyses of DFS and OS (Cox proportional hazards model) failed to show preoperative CC as a significant independent prognostic factor of DFS and OS ( P > 0.05). Conclusion: The frequency of abnormal preoperative CC in patients with endometrioid-type EC is not uncommon. Abnormal CC correlates with poor prognostic factors, namely high tumor grade and cervical involvement. Preoperative CC is not a significant independent prognostic factor of survival.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Preoperative cervical cytology as a prognostic factor in endometrioid-type endometrial cancer: A single-center experience from Saudi Arabia

et al. 2020

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“…[4][5][6][7] Upon review of current English literature, only rare case reports of metastatic EMCA and a single case series of endometrial cancers which included 3 endometrioid adenocarcinoma subtypes sampled by FNA [8][9][10][11][12] have been reported. 17 In extremely rare instances, evidence of EMCA has been found on urine cytology. 13,14 Studies describing endometrial adenocarcinoma on cervical pap smears (generally without mention of the histologic subtype) have reported glandular structures with nuclear enlargement, conspicuous nucleoli, scant vacuolated cytoplasm, and occasional squamous differentiation.…”

Section: Introductionmentioning

confidence: 99%

“…15,16 Interestingly, endometrial carcinomas with serous or clear cell histologies have a higher likelihood of having abnormal Pap smears than EMCAs. 17 In extremely rare instances, evidence of EMCA has been found on urine cytology. 18 Cytologic endometrial sampling by endometrial aspiration via catheters or cannula 19,20 has been described, but these reports are limited in number and do not provide detailed cytomorphologic features of encountered malignancies.…”

Section: Introductionmentioning

confidence: 99%

Cytomorphologic features of metastatic endometrioid carcinoma by fine needle aspiration

Johnson

Barroeta

Antic

et al. 2017

Diagnostic Cytopathology

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Detection rates and factors affecting thereof in endometrial hyperplasia, endometrial carcinoma, and cervical glandular lesions on cervical smear

Cheung

Lee

et al. 2023

Cancer Medicine

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IntroductionEndometrial lesions are morphologically diverse and uncommon on cervical smears, with its detection rate and associated diagnostic categories uncharacterized. In this study, cervical smears matched to histologically proven endometrial hyperplasias and carcinomas were reviewed and compared with cervical in‐situ‐carcinomas/carcinomas, aiming to detail the diagnostic performance of cervical smears for upper tract and glandular lesions.MethodsPathology reports of cervical smears, hysterectomies, endometrial and cervical biopsies from 1995 to 2021 were retrieved. Diagnoses of cervical smears were matched to endometrial hyperplasias and carcinomas, or cervical carcinomas and reviewed.ResultsTotally 832 cervical smears (272 cervical carcinomas, 312 endometrial carcinomas, and 248 hyperplasias) were included. Considering all cytologic glandular diagnosis as positive, the detection rate of cervical adenocarcinoma‐in‐situ was the highest (64.3%), followed by cervical adenocarcinoma (63.8%), endometrial carcinoma (31.7%), and hyperplasia (with atypia–8.5%; without atypia–2.3%) (p < 0.001). Endometrial hyperplasia was most often diagnosed as atypical squamous cells of undetermined significance (ASCUS) (5.0%) or atypical glandular cells, not otherwise specified (3.6%) without indication of endometrial origin. For endometrial carcinomas, higher FIGO grading and endocervical involvement were associated with higher detection rates across all diagnostic categories (p = 0.002–0.028). High FIGO grade was associated with suspicious/favor neoplastic (C4) (31.1%vs10.3%, p < 0.001) and carcinoma (C5) (17.8% vs. 5.6%, p = 0.005) categories, but not for all glandular diagnoses combined (33.3% vs. 31.0%, p = 0.761).ConclusionDetection rates for endometrial lesions are lower than cervical lesions but not insignificant. Endometrial hyperplasia should be recognized as a differential of human papilloma virus‐negative ASCUS and prompt consideration of investigation of the upper genital tract.

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The Value of Papanicolaou Tests in the Diagnosis of Endometrial Carcinoma

Abstract: The Pap test may play a role in the detection of endometrial carcinoma, especially for those with cervical involvement, lymphovascular invasion, and/or advanced stage.

Cited by 24 publications

References 19 publications

Preoperative cervical cytology as a prognostic factor in endometrioid-type endometrial cancer: A single-center experience from Saudi Arabia

Preoperative cervical cytology as a prognostic factor in endometrioid-type endometrial cancer: A single-center experience from Saudi Arabia

Cytomorphologic features of metastatic endometrioid carcinoma by fine needle aspiration

Detection rates and factors affecting thereof in endometrial hyperplasia, endometrial carcinoma, and cervical glandular lesions on cervical smear

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