0009: LIQUID-BASED ENDOMETRIAL CYTOLOGY: A NEW DIAGNOSTIC TOOL FOR CLINICIANS

Literature data on quality assurance of cytological diagnosis of endometrial anomalies are quite a few, in contrast of what happens for the cervix. Furthermore, the majority of authors have often only highlighted problems of diagnostic accuracy of endometrial cytology in the recognition of atypical endometrial cells together with the lack of well established diagnostic criteria of this method. Basing on the evidence of improvements brought by liquid-based technique to cervical cytology reducing false positives through its capacity to lower shadowing factors and to provide easy-to-read thin layer specimens, we planned a study to assess the utility of this method in improving accuracy of endometrial cytology. Nine hundred seventeen women have been consecutively enrolled, after a previous informed consent, to submit at the time of their indicated hysteroscopy both bioptical endometrial sampling and cytology. In 519 cases both samplings were obtained and sent to pathologists. From the comparison of cytological and histological results, endometrial cytology showed to have an estimated sensitivity of 96%, a specificity of 98%, a positive predictive value of 86% and a negative one of 99% with a much lower rate of inadequate sampling than endometrial biopsy (4% compared to 41%). These results may be considered a leading step to prove the effective accuracy and consequent applicability of liquid-based endometrial cytology alone or combined to other diagnostic methods in the triage endometrial pathology. Promising applicability fields may be the assessment of ultrasonographic endometrial thickening, evaluation of tamoxifen users and management of asymptomatic endometrial polyps.