A reporting system for endometrial cytology: Cytomorphologic criteria-Implied risk of malignancy
Background There have been various attempts to assess endometrial lesions on cytological material obtained via direct endometrial sampling. The majority of efforts focus on the description of cytological criteria that lead to classification systems resembling histological reporting formats. These sy...
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| Veröffentlicht in: | Diagnostic cytopathology 2016-11, Vol.44 (11), p.888-901 |
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| creator | Margari, Niki Pouliakis, Abraham Anoinos, Dionysios Terzakis, Emmanouil Koureas, Nikolaos Chrelias, Charalampos Marios Makris, George Pappas, Assimakis Bilirakis, Evripidis Goudeli, Christina Damaskou, Vasileia Papantoniou, Nicolaos Panayiotides, Ioannis Karakitsos, Petros |
| description | Background
There have been various attempts to assess endometrial lesions on cytological material obtained via direct endometrial sampling. The majority of efforts focus on the description of cytological criteria that lead to classification systems resembling histological reporting formats. These systems have low reproducibility, especially in cases of atypical hyperplasia and well differentiated carcinomas. Moreover, they are not linked to the implied risk of malignancy.
Methods
The material was collected from women examined at the outpatient department of four participating hospitals. We analyzed 866 consecutive, histologically confirmed cases. The sample collection was performed using the EndoGyn device, and processed via Liquid Based Cytology, namely ThinPrep technique. The diagnostic categories and criteria were established by two cytopathologists experienced in endometrial cytology; performance of the proposed reporting format was assessed on the basis of histological outcome; moreover, the implied risk of malignancy was calculated.
Results
The proposed six diagnostic categories are as follows: (i) nondiagnostic or unsatisfactory; (ii) without evidence of hyperplasia or malignancy; (iii) atypical cells of endometrium of undetermined significance; (iv) atypical cells of endometrium of low probability for malignancy; (v) atypical cells of endometrium of high probability for malignancy; and (vi) malignant. The risk of malignancy was 1.42% ± 0.98%, 44.44% ± 32.46% (nine cases), 4.30% ± 4.12%, 89.80% ± 8.47%, and 97.81% ± 2.45%, respectively.
Conclusion
We propose a clinically oriented classification scheme consisting of diagnostic categories with well determined criteria. Each diagnostic category is linked with an implied risk of malignancy; thus, clinicians may decide on patient management and eventually reduce unnecessary interventional diagnostic procedures. Diagn. Cytopathol. 2016;44:888–901. © 2016 Wiley Periodicals, Inc. |
| doi_str_mv | 10.1002/dc.23605 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1837295945</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1835388306</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3355-3b69f259b8dd238763676aa4b226e0118bd253174a04fbffe3f5005e1c0d52e3</originalsourceid><addsrcrecordid>eNqN0VFr1TAUB_Agirubgp9AAr740nmS06SJb9udzrGhCAN9i2maXrO1TU16cf32du5ugiD4lBP48ecc_oS8YHDIAPibxh1ylCAekRUDXRWAqB-TlaqEKBig3iP7OV8BgOZMPiV7vJICy1KuyLcjmvwY0xSGDc1znnxP25ioH5rY-ykF21E3T7GLm_ktXS9TH9P4_fYfHHUpTH4xxVk_dsE3NIV8TWNLe9uFzWAHNz8jT1rbZf989x6Qy_fvLtcfiotPp2fro4vCIS5bYi11y4WuVdNwVJVEWUlry5pz6YExVTdcIKtKC2Vbt63HVgAIzxw0gns8IK_vYscUf2x9nkwfsvNdZwcft9kwhRXXQpfif6hApRDkQl_9Ra_iNg3LHYviCqRGUH8CXYo5J9-aMYXeptkwMLf9mMaZ3_0s9OUucFv3vnmA94UsoLgDP0Pn538GmZP1feDOh6W6mwdv07WRFVbCfPl4avT58frr5_MTo_AXTWym6g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1828069308</pqid></control><display><type>article</type><title>A reporting system for endometrial cytology: Cytomorphologic criteria-Implied risk of malignancy</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Margari, Niki ; Pouliakis, Abraham ; Anoinos, Dionysios ; Terzakis, Emmanouil ; Koureas, Nikolaos ; Chrelias, Charalampos ; Marios Makris, George ; Pappas, Assimakis ; Bilirakis, Evripidis ; Goudeli, Christina ; Damaskou, Vasileia ; Papantoniou, Nicolaos ; Panayiotides, Ioannis ; Karakitsos, Petros</creator><creatorcontrib>Margari, Niki ; Pouliakis, Abraham ; Anoinos, Dionysios ; Terzakis, Emmanouil ; Koureas, Nikolaos ; Chrelias, Charalampos ; Marios Makris, George ; Pappas, Assimakis ; Bilirakis, Evripidis ; Goudeli, Christina ; Damaskou, Vasileia ; Papantoniou, Nicolaos ; Panayiotides, Ioannis ; Karakitsos, Petros</creatorcontrib><description>Background
There have been various attempts to assess endometrial lesions on cytological material obtained via direct endometrial sampling. The majority of efforts focus on the description of cytological criteria that lead to classification systems resembling histological reporting formats. These systems have low reproducibility, especially in cases of atypical hyperplasia and well differentiated carcinomas. Moreover, they are not linked to the implied risk of malignancy.
Methods
The material was collected from women examined at the outpatient department of four participating hospitals. We analyzed 866 consecutive, histologically confirmed cases. The sample collection was performed using the EndoGyn device, and processed via Liquid Based Cytology, namely ThinPrep technique. The diagnostic categories and criteria were established by two cytopathologists experienced in endometrial cytology; performance of the proposed reporting format was assessed on the basis of histological outcome; moreover, the implied risk of malignancy was calculated.
Results
The proposed six diagnostic categories are as follows: (i) nondiagnostic or unsatisfactory; (ii) without evidence of hyperplasia or malignancy; (iii) atypical cells of endometrium of undetermined significance; (iv) atypical cells of endometrium of low probability for malignancy; (v) atypical cells of endometrium of high probability for malignancy; and (vi) malignant. The risk of malignancy was 1.42% ± 0.98%, 44.44% ± 32.46% (nine cases), 4.30% ± 4.12%, 89.80% ± 8.47%, and 97.81% ± 2.45%, respectively.
Conclusion
We propose a clinically oriented classification scheme consisting of diagnostic categories with well determined criteria. Each diagnostic category is linked with an implied risk of malignancy; thus, clinicians may decide on patient management and eventually reduce unnecessary interventional diagnostic procedures. Diagn. Cytopathol. 2016;44:888–901. © 2016 Wiley Periodicals, Inc.</description><identifier>ISSN: 8755-1039</identifier><identifier>EISSN: 1097-0339</identifier><identifier>DOI: 10.1002/dc.23605</identifier><identifier>PMID: 27653446</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Carcinoma - classification ; Carcinoma - pathology ; classification ; classification system ; diagnosis ; endometrial cytology ; Endometrial Neoplasms - classification ; Endometrial Neoplasms - pathology ; Female ; Humans ; Middle Aged ; Papanicolaou Test - methods ; Papanicolaou Test - standards ; risk of malignancy ; Severity of Illness Index ; ThinPrep</subject><ispartof>Diagnostic cytopathology, 2016-11, Vol.44 (11), p.888-901</ispartof><rights>2016 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3355-3b69f259b8dd238763676aa4b226e0118bd253174a04fbffe3f5005e1c0d52e3</citedby><cites>FETCH-LOGICAL-c3355-3b69f259b8dd238763676aa4b226e0118bd253174a04fbffe3f5005e1c0d52e3</cites><orcidid>0000-0002-0074-3619</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fdc.23605$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fdc.23605$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27653446$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Margari, Niki</creatorcontrib><creatorcontrib>Pouliakis, Abraham</creatorcontrib><creatorcontrib>Anoinos, Dionysios</creatorcontrib><creatorcontrib>Terzakis, Emmanouil</creatorcontrib><creatorcontrib>Koureas, Nikolaos</creatorcontrib><creatorcontrib>Chrelias, Charalampos</creatorcontrib><creatorcontrib>Marios Makris, George</creatorcontrib><creatorcontrib>Pappas, Assimakis</creatorcontrib><creatorcontrib>Bilirakis, Evripidis</creatorcontrib><creatorcontrib>Goudeli, Christina</creatorcontrib><creatorcontrib>Damaskou, Vasileia</creatorcontrib><creatorcontrib>Papantoniou, Nicolaos</creatorcontrib><creatorcontrib>Panayiotides, Ioannis</creatorcontrib><creatorcontrib>Karakitsos, Petros</creatorcontrib><title>A reporting system for endometrial cytology: Cytomorphologic criteria-Implied risk of malignancy</title><title>Diagnostic cytopathology</title><addtitle>Diagn. Cytopathol</addtitle><description>Background
There have been various attempts to assess endometrial lesions on cytological material obtained via direct endometrial sampling. The majority of efforts focus on the description of cytological criteria that lead to classification systems resembling histological reporting formats. These systems have low reproducibility, especially in cases of atypical hyperplasia and well differentiated carcinomas. Moreover, they are not linked to the implied risk of malignancy.
Methods
The material was collected from women examined at the outpatient department of four participating hospitals. We analyzed 866 consecutive, histologically confirmed cases. The sample collection was performed using the EndoGyn device, and processed via Liquid Based Cytology, namely ThinPrep technique. The diagnostic categories and criteria were established by two cytopathologists experienced in endometrial cytology; performance of the proposed reporting format was assessed on the basis of histological outcome; moreover, the implied risk of malignancy was calculated.
Results
The proposed six diagnostic categories are as follows: (i) nondiagnostic or unsatisfactory; (ii) without evidence of hyperplasia or malignancy; (iii) atypical cells of endometrium of undetermined significance; (iv) atypical cells of endometrium of low probability for malignancy; (v) atypical cells of endometrium of high probability for malignancy; and (vi) malignant. The risk of malignancy was 1.42% ± 0.98%, 44.44% ± 32.46% (nine cases), 4.30% ± 4.12%, 89.80% ± 8.47%, and 97.81% ± 2.45%, respectively.
Conclusion
We propose a clinically oriented classification scheme consisting of diagnostic categories with well determined criteria. Each diagnostic category is linked with an implied risk of malignancy; thus, clinicians may decide on patient management and eventually reduce unnecessary interventional diagnostic procedures. Diagn. Cytopathol. 2016;44:888–901. © 2016 Wiley Periodicals, Inc.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Carcinoma - classification</subject><subject>Carcinoma - pathology</subject><subject>classification</subject><subject>classification system</subject><subject>diagnosis</subject><subject>endometrial cytology</subject><subject>Endometrial Neoplasms - classification</subject><subject>Endometrial Neoplasms - pathology</subject><subject>Female</subject><subject>Humans</subject><subject>Middle Aged</subject><subject>Papanicolaou Test - methods</subject><subject>Papanicolaou Test - standards</subject><subject>risk of malignancy</subject><subject>Severity of Illness Index</subject><subject>ThinPrep</subject><issn>8755-1039</issn><issn>1097-0339</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqN0VFr1TAUB_Agirubgp9AAr740nmS06SJb9udzrGhCAN9i2maXrO1TU16cf32du5ugiD4lBP48ecc_oS8YHDIAPibxh1ylCAekRUDXRWAqB-TlaqEKBig3iP7OV8BgOZMPiV7vJICy1KuyLcjmvwY0xSGDc1znnxP25ioH5rY-ykF21E3T7GLm_ktXS9TH9P4_fYfHHUpTH4xxVk_dsE3NIV8TWNLe9uFzWAHNz8jT1rbZf989x6Qy_fvLtcfiotPp2fro4vCIS5bYi11y4WuVdNwVJVEWUlry5pz6YExVTdcIKtKC2Vbt63HVgAIzxw0gns8IK_vYscUf2x9nkwfsvNdZwcft9kwhRXXQpfif6hApRDkQl_9Ra_iNg3LHYviCqRGUH8CXYo5J9-aMYXeptkwMLf9mMaZ3_0s9OUucFv3vnmA94UsoLgDP0Pn538GmZP1feDOh6W6mwdv07WRFVbCfPl4avT58frr5_MTo_AXTWym6g</recordid><startdate>201611</startdate><enddate>201611</enddate><creator>Margari, Niki</creator><creator>Pouliakis, Abraham</creator><creator>Anoinos, Dionysios</creator><creator>Terzakis, Emmanouil</creator><creator>Koureas, Nikolaos</creator><creator>Chrelias, Charalampos</creator><creator>Marios Makris, George</creator><creator>Pappas, Assimakis</creator><creator>Bilirakis, Evripidis</creator><creator>Goudeli, Christina</creator><creator>Damaskou, Vasileia</creator><creator>Papantoniou, Nicolaos</creator><creator>Panayiotides, Ioannis</creator><creator>Karakitsos, Petros</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><orcidid>https://orcid.org/0000-0002-0074-3619</orcidid></search><sort><creationdate>201611</creationdate><title>A reporting system for endometrial cytology: Cytomorphologic criteria-Implied risk of malignancy</title><author>Margari, Niki ; Pouliakis, Abraham ; Anoinos, Dionysios ; Terzakis, Emmanouil ; Koureas, Nikolaos ; Chrelias, Charalampos ; Marios Makris, George ; Pappas, Assimakis ; Bilirakis, Evripidis ; Goudeli, Christina ; Damaskou, Vasileia ; Papantoniou, Nicolaos ; Panayiotides, Ioannis ; Karakitsos, Petros</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3355-3b69f259b8dd238763676aa4b226e0118bd253174a04fbffe3f5005e1c0d52e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Carcinoma - classification</topic><topic>Carcinoma - pathology</topic><topic>classification</topic><topic>classification system</topic><topic>diagnosis</topic><topic>endometrial cytology</topic><topic>Endometrial Neoplasms - classification</topic><topic>Endometrial Neoplasms - pathology</topic><topic>Female</topic><topic>Humans</topic><topic>Middle Aged</topic><topic>Papanicolaou Test - methods</topic><topic>Papanicolaou Test - standards</topic><topic>risk of malignancy</topic><topic>Severity of Illness Index</topic><topic>ThinPrep</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Margari, Niki</creatorcontrib><creatorcontrib>Pouliakis, Abraham</creatorcontrib><creatorcontrib>Anoinos, Dionysios</creatorcontrib><creatorcontrib>Terzakis, Emmanouil</creatorcontrib><creatorcontrib>Koureas, Nikolaos</creatorcontrib><creatorcontrib>Chrelias, Charalampos</creatorcontrib><creatorcontrib>Marios Makris, George</creatorcontrib><creatorcontrib>Pappas, Assimakis</creatorcontrib><creatorcontrib>Bilirakis, Evripidis</creatorcontrib><creatorcontrib>Goudeli, Christina</creatorcontrib><creatorcontrib>Damaskou, Vasileia</creatorcontrib><creatorcontrib>Papantoniou, Nicolaos</creatorcontrib><creatorcontrib>Panayiotides, Ioannis</creatorcontrib><creatorcontrib>Karakitsos, Petros</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>Diagnostic cytopathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Margari, Niki</au><au>Pouliakis, Abraham</au><au>Anoinos, Dionysios</au><au>Terzakis, Emmanouil</au><au>Koureas, Nikolaos</au><au>Chrelias, Charalampos</au><au>Marios Makris, George</au><au>Pappas, Assimakis</au><au>Bilirakis, Evripidis</au><au>Goudeli, Christina</au><au>Damaskou, Vasileia</au><au>Papantoniou, Nicolaos</au><au>Panayiotides, Ioannis</au><au>Karakitsos, Petros</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A reporting system for endometrial cytology: Cytomorphologic criteria-Implied risk of malignancy</atitle><jtitle>Diagnostic cytopathology</jtitle><addtitle>Diagn. Cytopathol</addtitle><date>2016-11</date><risdate>2016</risdate><volume>44</volume><issue>11</issue><spage>888</spage><epage>901</epage><pages>888-901</pages><issn>8755-1039</issn><eissn>1097-0339</eissn><abstract>Background
There have been various attempts to assess endometrial lesions on cytological material obtained via direct endometrial sampling. The majority of efforts focus on the description of cytological criteria that lead to classification systems resembling histological reporting formats. These systems have low reproducibility, especially in cases of atypical hyperplasia and well differentiated carcinomas. Moreover, they are not linked to the implied risk of malignancy.
Methods
The material was collected from women examined at the outpatient department of four participating hospitals. We analyzed 866 consecutive, histologically confirmed cases. The sample collection was performed using the EndoGyn device, and processed via Liquid Based Cytology, namely ThinPrep technique. The diagnostic categories and criteria were established by two cytopathologists experienced in endometrial cytology; performance of the proposed reporting format was assessed on the basis of histological outcome; moreover, the implied risk of malignancy was calculated.
Results
The proposed six diagnostic categories are as follows: (i) nondiagnostic or unsatisfactory; (ii) without evidence of hyperplasia or malignancy; (iii) atypical cells of endometrium of undetermined significance; (iv) atypical cells of endometrium of low probability for malignancy; (v) atypical cells of endometrium of high probability for malignancy; and (vi) malignant. The risk of malignancy was 1.42% ± 0.98%, 44.44% ± 32.46% (nine cases), 4.30% ± 4.12%, 89.80% ± 8.47%, and 97.81% ± 2.45%, respectively.
Conclusion
We propose a clinically oriented classification scheme consisting of diagnostic categories with well determined criteria. Each diagnostic category is linked with an implied risk of malignancy; thus, clinicians may decide on patient management and eventually reduce unnecessary interventional diagnostic procedures. Diagn. Cytopathol. 2016;44:888–901. © 2016 Wiley Periodicals, Inc.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>27653446</pmid><doi>10.1002/dc.23605</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-0074-3619</orcidid></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Carcinoma - classification Carcinoma - pathology classification classification system diagnosis endometrial cytology Endometrial Neoplasms - classification Endometrial Neoplasms - pathology Female Humans Middle Aged Papanicolaou Test - methods Papanicolaou Test - standards risk of malignancy Severity of Illness Index ThinPrep |
| title | A reporting system for endometrial cytology: Cytomorphologic criteria-Implied risk of malignancy |
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