engleski

Utility of Direct Endometrial Cytology in One Day Gynaecology Clinic

Objectives:The aim of this study was to evaluate the role ofdirect endometrial cytology (DEC) for triage of patients with border-line ultrasound findings in one-day gynaecology clinic. In addition, we calculated the value of DEC in diagnosis of endometrial cancer.Methods:We analysed 694 patients with DEC taken withendometrial brush. Out of the total number, 80 were taken in one-day clinic in patients who did not have clear indication for curettage.Endometrial brush was taken by gynaecologist and samples wereanalysed within two hours. Depending of the DEC findings, finaldecision of further procedure was made.DEC findings were divided into five categories: inadequate, negative, atypical glandular cells, suspicious for malignancy and malignant.Age, menstrual status and cytological-histological correlation wereanalysed. Cytological findings were compared with pathohistologicaland / or clinical follow-up for 6 to 36 months.Results:The average age of the patient was 60 years (27–88), ofwhich 586 (84%) were postmenopausal, 73 (11%) perimenopausaland 35 (5%) premenopausal women.There were 59 (8.5%) inadequate samples. Cytologically negativefindings were found in 597 (86%), atypical glandular cells in 22 (3.2%), suspicious for malignancy in 5 (0.7%) and positive finding ofmalignant cells in 11 (1.6%) patients.By comparing DEC with histology sensitivity was 73.9%, specificitywas 95.3%, positive predictive value was 50% and negative predic-tive value was 98.3%.For patients in one-day gynaecology clinic (N=85) DEC eliminatedthe need for exploratory curettage in 60 (70.6%) patients, in 25(29.4%) indicated the curettage.Conclusions:Our results are showing that direct endometrialcytology is reliable in diagnosis of endometrial changes. The negativepredictive value of 98.3% indicates a high percentage of findingsthat do not require invasive procedures.

direct endometrial cytology ; endometrial changes ; triage of patients ; predictive value ;

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