[446] Liquid-Based Papanicolaou Tests in Endometrial Carcinoma Diagnosis

Isil Z Yildiz-Aktas, Chengquan Zhao. UPMC, Pittsburgh, PA

Background: Currently, there is no cost effective screening tool for endometrial carcinoma. Conventional Pap smear is considered suboptimal for detection of endometrial carcinoma. However, morphology is superior in liquid-based Pap tests and their utility in detection of endometrial carcinoma has not been well studied. The aim of this study was to retrospectively examine the Pap test results of histologically diagnosed endometrial carcinoma patients prior to diagnosis.
Design: A retrospective search of our database was conducted (2006 to 2011) for women with histological endometrial carcinoma diagnoses. These cases were evaluated for the presence of previous Pap tests up to 36 months prior to diagnosis. The cases were evaluated for further clinicopathologic information (patient age, tumor type, FIGO grade, tumor size, myometrial invasion, angiolymphatic invasion, cervical invasion, FIGO stage, and previous Pap tests when present).
Results: A total of 222 cases of endometrial carcinoma were identified, including 186 endometrioid (83.8%), 14 mixed (5.9%), 8 serous (3.6%), 6 clear cell (2.7%), 2 mucinous (0.9%) carcinoma, and 5 MMMT (2.3%). Average patient age was 62 years (range= 33-91).126 patients (57.3%) had at least one Pap test up to 36 months prior to diagnosis. 84 of these 126 women had a Pap test in 4 months prior to histological diagnosis (Pap test results are summarized in Table 1): 28 (33.3%) had at least glandular abnormality, 8 (9.5%) had benign endometrial cells (all >40 years old), and 43 (51.2%) had negative results.

Pap test results prior to histopathological diagnoses of endometrial carcinoma (<5 months)
CategoriesCase# (n=84)%
Suspicious/malignant1315.5
AGC1315.5
AGC/SIL22.4
Endometrial cells in >40 years old89.5
ASC-US56.0
Negative4351.2


The remaining 67 of 126 women had at least one Pap test in 5-36 months prior to carcinoma diagnosis: 53 (79.1%) had at least one negative Pap test, 8 (11.9%) had ASC-US, 5 (7.5%) had AGC, and 1 (1.5%) had ASC-H.
Conclusions: In our patient population of biopsy-proven endometrial carcinoma, 42.8% of cases had a Pap test with a diagnosis of at least AGC or endometrial cells over 40 years of age. This result demonstrates that Pap test plays a role in the detection of endometrial carcinoma. However, 51.2% of women had negative Pap tests up to 4 months before the malignancy diagnosis. Therefore, we conclude that Pap test is not a sensitive method for detection of endometrial carcinoma.
Category: Cytopathology

Tuesday, March 5, 2013 1:00 PM

Poster Session IV # 105, Tuesday Afternoon

 

Close Window