[394] Histologic Follow-Up Results in Patients with Pap Test Findings of Endometrial Cells: Results from a Large Academic Women Hospital Laboratory

Zaibo Li, Huaitao Yang, Baoying Weng, Chengquan Zhao. Magee-Womens Hospital of UPMC, Pittsburgh, PA; Conemaugh Valley Memorial Hospital, Johnstown, PA

Background: TBS 2001 recommendation to report normal endometrial cells (nEMC) in women ages ≥40 years. nEMC in women ages ≥40 years and atypical endometrial cells (aEMC) of Pap remain challenges for interpretation and management. We reported the largest histopathologic follow-up findings for women with endometrial cells (both nEMC and aEMC) in Pap testing.
Design: We searched our pathology databases (a large academic medical center) from 2005 to 2011 to retrieve cases with Pap tests of nEMC in women ages ≥40 years, aEMC or endometrial carcinoma cells (EMCC). Pap tests were liquid-based cytology (LBC) specimens screened using computer-assisted screening. Follow-up diagnoses were correlated with cytology and stratified into age groups.
Results: During a period of 6 years, 1,183 cases with a cytology report of endometrial cells (nEMC, aEMC and EMCC) were documented with histopathologic follow-up. Significant endometrial lesions (precancerous and malignant) were found in women with aEMC (18.3%) or with EMCC (100%) Pap testing (Table 1).

1183 patients with a Pap testing of endometrial cells and histologic follow-up
 Negative (%)Benign (%)Precancerous (%)Malignant (%)Totalp value
nEMC532 (72%)187 (25%)13 (1.8%)7 (0.95%)739 (100%) 
aEMC227 (54%)118 (28%)18 (4.3%)60 (14%)423 (100%)<0.01
EMCC00021 (100%)21 (100%)<0.01
Total759 (64%)305 (26%)31 (26%)88 (7.4%)1183 (100%) 

More importantly, significant endometrial lesions were also found in women ≥50 years with nEMC after Day 12 of menstrual period (5.19%). However, no significant endometrial lesions were found in women with nEMC either before Day 12 (0.51%) or women younger than 50 years after Day 12 (1.58%) (Table 2).

Histologic follow-up in 739 patients with nEMC
 Precancerous/malignant lesion # (%)Total case #p value
nEMC ≤12 d1 (0.51)197 
nEMC >12 d, <50 yr4 (1.58)2530.16
nEMC >12 d, ≥50 yr15 (5.19)289<0.01
total nEMC >12 d19 (3.51)542<0.01

Conclusions: Our data indicated that endometrial sampling has no clinical benefit in women (regardless of ages) with a nEMC before Day 12 of menstrual cycle or women younger than 50 years with a nEMC after Day 12. Endometrial sampling should be routinely performed in women with aEMC and women older than 50 years with nEMC.
Category: Cytopathology

Tuesday, March 20, 2012 9:30 AM

Poster Session III # 44, Tuesday Morning


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