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  • Title: Transvaginal ultrasonography and endometrial cytology as a diagnostic schema for endometrial cancer.
    Author: Minagawa Y, Sato S, Ito M, Onohara Y, Nakamoto S, Kigawa J.
    Journal: Gynecol Obstet Invest; 2005; 59(3):149-54. PubMed ID: 15637434.
    Abstract:
    OBJECTIVE: To determine whether the combined use of transvaginal ultrasonography and endometrial cytology is an effective diagnostic schema for endometrial cancer and hyperplasia of the uterus. METHODS: Five hundred fifty-two women were enrolled in this study. For all subjects, endometrial thickness was evaluated by transvaginal ultrasonography. Endometrial cytology was carried out according to the following criteria: all women with atypical uterine bleeding, for asymptomatic postmenopausal women with endometrial thickness >or=5 mm, and for asymptomatic premenopausal women with endometrial thickness >or=20 mm. When the cytological findings were abnormal, we performed a hysteroscopy-guided biopsy within 2 weeks. Women who received transvaginal ultrasonography alone, or those who showed negative cytology, underwent repeated gynecological examination and transvaginal ultrasonography 3, 6, and 12 months after the first examination. RESULTS: Endometrial cytology was done on 129 women (23.4% of all subjects), of whom 14 were diagnosed as 'positive' cytology, 20 as 'suspicious positive', and 95 as 'negative'. A total of 34 women with 'positive' or 'suspicious positive' cytological result underwent hysteroscopy-guided endometrial biopsy. The histological diagnosis of the endometrium included 13 endometrial cancers, 9 endometrial hyperplasias (one atypical hyperplasia and 3 hyperplastic polyps), and 10 normal endometria. As a diagnostic schema for endometrial cancer, this combined method resulted in 100% sensitivity, 99.1% specificity, 92.9% positive predictive value, and 100% negative predictive value. For endometrial hyperplasia, the method resulted in 100% sensitivity, 89.6% specificity, 40.0% positive predictive value, and 100% negative predictive value. CONCLUSION: A combination of transvaginal ultrasonography and endometrial cytology may be an effective diagnostic schema for endometrial cancer and hyperplasia.
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