Diagnostic Efficacy of Endometrial Cytology with the Abradul Cell Sampler Supplemented by Laser Scanning Confocal Microscopy

OBJECTIVE: To study the diagnostic efficacy of endometrial cytology with the Abradul cell sampler and the effect of supplementing it, in cases with overly thick smears, with laser scanning confocal microscopy. STUDY DESIGN: Sampling was performed on 1,684 women. All patients underwent subsequent histology. In eight cases with overly thick smears the original smears were restained to allow confocal microscopy. RESULTS: Efficacy was high, with 1,593 good samples. Thirty-one endometrial carcinomas were signed out as cytologically positive and 10 as atypia. In addition, 10 squamous cell carcinomas of the cervix and 1 ovarian carcinoma were diagnosed with this method. Only one case (endocervical adenocarcinoma) was not detected in the sample. In the eight cases in which confocal microscopy was performed, the images were high quality, allowing a correct diagnosis. In addition, the transition from hyperplasia to carcinoma could be visualized in the cytologic smear. CONCLUSION: Endometrial cytology in an outpatient setting is highly effective, and confocal microscopy in selected cases is not only helpful but also highly instructive.