The accuracy of endometrial cytology in the diagnosis of endometrial adenocarcinoma

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Abstract
Tajima m., inamura m., nakamura m., sudo y. and yamagishi k. (1998) Cytopathology9, 369–380The accuracy of endometrial cytology in the diagnosis of endometrial adenocarcinomaWe have examined 62 234 cytological samples of endometrium to establish the accuracy and false‐positive rate for the diagnosis of endometrial adenocarcinoma. The patients were either attending the gynaecological out‐patients clinic with symptoms or were asymptomatic women attending for routine population screening as part of our cancer detection programme, the numbers from these two sources being equal. Out of 138 cases identified as endometrial adenocarcinoma by cytology 126 (91.3%) were confirmed histologically in our hospital. Twelve cases (8.7%) were shown to be false‐positives. Re‐examination of these led to the same false‐positive diagnosis in all 12 cases. This was attributable to similarities of nucleo–cytoplasmic ratio, irregular arrangement of nuclei, variation in nuclear shape and in the numbers of nucleoli in repair cells and hyperplastic cells compared with the carcinoma cases. Most of the false‐negative reports were due to insufficient material, pale staining in malignant cells or diagnostic error. Refraction measurement of the density of nuclei of cancer cells using equipment for which the patent is pending enabled objective measurement of nuclear density which indicated that the nuclei were not stained darkly enough in false‐negative cases.

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