Endoscann cell sampling for cytological assessment of endometrial pathology

Cytological samples of the endometrium obtained by Endoscann were compared with histological preparations from conventional curettage of the uterine cavity (D & C) in 275 women. Indications of D & C were irregular menstrual bleeding, postmenopausal bleeding, or suspected ovarian or cervical neoplasia in women of 50 years or more. The women were consecutively enrolled in the study and had an average age of 60.2 years (range 50-87). The cytological investigation detected all 16 cases of endometrial cancer but none of 6 cases of atypical hyperplasia. Insertion of the Endoscann cell sampler was easily performed in 87% of the patients in whom cervical dilatation was unnecessary. The cytological technique had 11 cases of insufficient material (4%). By D & C, sufficient material for histological evaluation could not be obtained in 32 cases (12%). The predictive value of a positive test with respect to endometrial carcinoma was 0.38, the corresponding sensitivity was 1.00, and the specificity 0.90. A positive cytology should lead to immediate further investigation.