Diagnostic Usefulness of Endometrial Aspiration Cytology for Endometrial Cancer Cases with Normal Curettage Findings

Objective To determine whether endometrial aspiration cytolopy is useful for endometrial cancer cases with normal endmetrial curettage findings. Study Design Eleven cases in which endinnetrial cancer could be detected by endometrial aspiration cytology but not endometrial curettage were classified into 2 groups by cancer locus. on the endometrial surface (A) or in the mymetrium (B). A clinicopathologic and cytologic analysis was performed to cinoare the 2 groups. Results Five cases had cancer lesions localized at the fundus and one at the isthmus (group A). The other 5 bad lesions localized in the myometrium (group B). The myometrium invasion was beyond half the myometrium in group B and within half in group A. it required > 2 cytologic examinations for a definitive diagnosis in 33.3% of group A and 80.0% of group B. The endometrial cytology differed clearly between the groups: large clusters of malignant cells with a dirty background (group A) vs. small clusters with a clean background (group B). The log-rank test revealed that group B had significantly poorer prognoses than did group A despite nearly the same rate of stage 1/11 cases in the 2 groups (p = 0.004). Conclusion Endometrial aspiration cytology was useful for endometrial cancer cases with normal curettage findings as part of early detection. However, the cytologic diagnosis did not indicate good prognoses in the cases of cancer localized in the myometrium.