Morphological Differences between Liquid-Based Cytology and Conventional Preparation in Endometrial Endometrioid Carcinoma Grade 1 and Grade 3, and the Differentiation of Grades in Each Method

Hirokazu Odashima; Haruhiko Yoshioka; Kasumi Ota; Yuya Goto; Misuzu Noro; Kayo Horie; Jun Watanabe

doi:10.1159/000512867

Morphological Differences between Liquid-Based Cytology and Conventional Preparation in Endometrial Endometrioid Carcinoma Grade 1 and Grade 3, and the Differentiation of Grades in Each Method

Acta Cytol. 2021;65(3):227-234. doi: 10.1159/000512867. Epub 2021 Mar 2.

Authors

Hirokazu Odashima^{1

2}, Haruhiko Yoshioka^{1

3}, Kasumi Ota³, Yuya Goto³, Misuzu Noro³, Kayo Horie^{1

3}, Jun Watanabe^{4

5

6}

Affiliations

¹ Department of Bioscience and Laboratory Medicine, Hirosaki University Graduate School of Health Sciences, Aomori, Japan.
² Anatomic Pathology Laboratory, Hirosaki University l Hospital, Aomori, Japan.
³ Department of Medical Technology, Hirosaki University School of Health Sciences, Aomori, Japan.
⁴ Department of Bioscience and Laboratory Medicine, Hirosaki University Graduate School of Health Sciences, Aomori, Japan, watajun@hirosaki-u.ac.jp.
⁵ Anatomic Pathology Laboratory, Hirosaki University l Hospital, Aomori, Japan, watajun@hirosaki-u.ac.jp.
⁶ Department of Medical Technology, Hirosaki University School of Health Sciences, Aomori, Japan, watajun@hirosaki-u.ac.jp.

PMID: 33652432
DOI: 10.1159/000512867

Abstract

Introduction: Direct smearing preparation (conventional preparation [CP]) has been widely used for endometrial cytology in Japan. In CP, sampling and screening errors are problematic. In liquid-based cytology preparation (LBC), the problems of CP can be solved. But there is a problem that cytological findings of LBC are different from those of CP. The purpose of this study was to evaluate the differences of morphological findings of endometrial cytology between LBC and CP, and the usefulness of the endometrial LBC to differentiate endometrioid carcinoma grade 1 (G1) from grade 3 (G3).

Methods: Thirteen cases of endometrioid carcinoma G1, and 5 cases of G3 collected by the Softcyte device and prepared by LBC and CP (split specimen) were used. We focused on the following items: (1) the number of clusters per cm2, (2) the number of layers of clusters, (3) area of clusters, (4) perimeter of clusters, (5) roundness of clusters, (6) complexity of clusters, (7) area of nucleus, (8) perimeter of nucleus, (9) roundness of nucleus, (10) complexity of nucleus, (11) area of nucleolus, and (12) nucleolus-nucleus ratio (N/N).

Results: Compared with CP, the number of clusters and layers of the clusters in LBC were significantly larger in G1. The area and perimeters of the clusters and the nucleus were significant smaller, and the N/N ratio was greater in LBC than that in CP in both G1 and G3. Regarding morphological differences between G1 and G3 in LBC and CP, the number of layers was significantly larger in G1 than in G3 in LBC and CP. The area of the clusters in LBC was significantly larger in G1 than in G3. The area and perimeters of the nucleus in CP and the area of the nucleolus and N/N ratio in LBC and CP were significantly smaller in G1 than in G3.

Conclusion: In the endometrial cytology, it became clear that the cell image was different between LBC and CP and between G1 and G3. By microscopic examination understanding the characteristics of the cell image in LBC, endometrial LBC could be useful to diagnose endometrial carcinoma.

Keywords: Conventional preparation; Differentiation; Endometrial endometrioid carcinoma; Grade; Liquid-based cytology.

Publication types

Comparative Study

MeSH terms

Adult
Aged
Carcinoma, Endometrioid / pathology*
Diagnosis, Differential
Endometrial Neoplasms / pathology*
Female
Humans
Liquid Biopsy
Microscopy
Middle Aged
Neoplasm Grading
Predictive Value of Tests