Endometrial Adenocarcinoma in SurePath™ Cervical Samples: Cytological Features Revisited

Area of Science:

• Cytopathology
• Gynecologic Oncology

Background:

• Endometrial lesion cytomorphology in cervical samples is less understood than cervical lesions.
• Accurate differentiation of endometrial cells in cervical samples is crucial for patient management.

Purpose of the Study:

• To identify cytomorphological features in SurePath™ liquid-based cytology samples that distinguish benign from malignant endometrial cells.
• To improve the accuracy of diagnosing endometrial pathology from cervical cytology.

Main Methods:

• A two-phase study evaluated 12 cytological features in SurePath™ samples.
• Phase 1 (training set, n=42) identified significant features.
• Phase 2 (test set, n=125) validated these features for predicting histological outcome.

Main Results:

• Granular nuclear chromatin, apoptotic bodies, and tingible body macrophages were significant indicators of malignancy in phase 1.
• In phase 2, these features were re-evaluated in 125 cases (54 benign, 71 malignant/premalignant).
• The study achieved a positive predictive value of 56.8% for malignancy.

Conclusions:

• Granular nuclear chromatin, tingible body macrophages, and background apoptosis are key indicators of endometrial malignancy in cervical samples.
• These cytological features enable relatively accurate predictions of endometrial pathology.
• The findings enhance diagnostic capabilities for endometrial lesions detected in cervical cytology.