Diagnostic value of the thin-layer, liquid-based Pap test in endometrialcancer: a retrospective study with emphasis on cytomorphologic features
OBJECTIVE: To examine the diagnostic value (sensitivity and specificity ofthe ThinPrep Pap test in the detection of endometrial cancer and assess the morphologic features ofendometrial cancer in ThinPrep tests. STUDY DESIGN: In a retrospective, case-controlled study, weidentified 60 Pap slides performed within 12 months of the tissue diagnosis of endometrial carcinomaand 56 comparison slides from patients without known carcinoma. The slides were blindly reviewed bythe authors without knowledge of the surgical diagnosis. An independent diagnosis was given for thetests based on 14 diagnostic criteria from the 2001 Bethesda System and 6 additional criteriaproposed by the authors. RESULTS: The sensitivity of detecting endometrial carcinoma was 88.3% (95%CI 77.8-94.2%) and specificity was 87.5% (95% CI 76.4-93.8%). The positive likelihood ratio was7.067 (95% CI 3.513-14.217) and negative likelihood ratio was 0.133 (95% CI 0.066-0.269). Enlargednuclei and the presence of nucleoli in endometrial cells were the most reliable indicators ofendometrial cancer or atypical endometrial cells. CONCLUSION: The ThinPrep Pap test has highsensitivity and specificity in detecting or suggesting the presence of endometrial cancer. Certaincytomorphologic features are helpful in distinguishing benign and malignant endometrial lesions.
Zhou,J　Tomashefski-J,Jr　Khiyami,A
Department of Pathology, MetroHealth Medical Center, Cleveland, Ohio 44109,USA. jzhou@metrohealth.org
Adenocarcinoma　 Adult　 Aged　 Aged, 80 and over　 Cell Nucleus Chi-SquareDistribution
