Abstract
Objective: We believe that the presence of arborescent clusters is indicative of endometrial cancer in endometrial cytology.
Study Design: We compared the accuracy of endometrialcytological diagnosis in 183 patients examined from 1979 to 1988 based mainly on cellular atypia and 294 patients examined from 1989 to 1997 based on structural abnormalities, and clinical staging of endometrial cancer. Using specimens from other institutions, we also assessed the diagnostic accuracy of direct (44 patients) and washout / crushed (44 patients) smear in endometrial cancer.
Results: 1) Of 183 patients whose diagnosis was interpreted based mainly on cellular atypia, 51 were diagnosed as class V. Of these, 29 (56.9%) were diagnosed with endometrial cancer and 13 (25.5%) showed no marked histological change. 29 of 33 diagnosed with endometrial cancer were diagnosed as class V. Of 294 patients whose diagnosis was based mainly on structural abnormalities, 110 were diagnosed as class V. Of these, 91 (82.7%) were diagnosed with endometrial cancer and 5 (4.5%) showed no marked histological change. All 95 of those with endometrial cancer were diagnosed as class IV or V.
2) Of 33 patients diagnosed with endometrial cancer detected when interpretation was based mainly on cellular atypia, clinical staging was stage 0 or I A in 4 (12.2%). Of 95 detected after the focus was changed to structural abnormalities, clinical staging was stage 0 or I A in 24 (25.3%).
3) Diagnostic accuracy of direct smear in endometrial cancer was 54.6% (24 of 44 patients) and that of washout was 79.6% (35 of 44 patients).
Conclusion: Based on these results, we believe that focusing on structural abnormalities effectively raises the accuracy of endometrial cytological diagnosis.
