子宮内膜サンプリング装置とSurePath製剤を組み合わせて子宮内膜がんのスクリーニングを行う：検証研究

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Chin. Med. J..2015 Mar;128(5):648-53. ChinMedJ_2015_128_5_648_151664. doi: 10.4103/0366-6999.151664.

子宮内膜サンプリング装置とSurePath製剤を組み合わせて子宮内膜がんのスクリーニングを行う：検証研究

Combining endometrium sampling device and SurePath preparation to screen for endometrial carcinoma: a validation study.

Jia Wen
Rui Chen
Jian Zhao
Yin Dong
Xi Yang
Qin-Ping Liao

PMID: 25698198 PMCID: PMC4834777. DOI: 10.4103/0366-6999.151664.

抄録

背景:

BACKGROUND: The aim of this study was to compare specimen adequacy of SAP-1 provided for cytology with that of dilation and curettage (D & C) or hysteroscopy for histology, and evaluate the accuracy of combining endometrium sampling by SAP-1 and liquid-based cytology using SurePath preparation for screening endometrial carcinoma and its precursor.

方法:

METHODS: Endometrial specimens from women (n = 1514) with risk factors were obtained using an SAP-1 device for cytological analysis; histological samples were obtained from 375 of these women who underwent D & C or hysteroscopy. Cytological specimens were prepared to liquid-based smear using SurePath technology and stained by Papanicolaou. Histological samples were processed in routine pathology and stained by hematoxylin and eosin.

結果:

細胞診の適切な検体は1458/1541人（96.3％）から得られ、病理検査の適切な検体は285/375人（76％）から得られた。しかし、閉経後の女性では、細胞診では1045人中1006人（86.3％）が適切な検体、組織診では238人中153人（64.3％）が適切な検体であったため、組織診よりも細胞診の方が採取しやすかった（P＜0.05）。子宮内膜細胞診による子宮内膜癌とその前駆体の検出精度は92.4％（感度73％、特異度95.8％、陽性予測値75％、陰性予測値95.3％）であった。

RESULTS: Adequate specimens for cytology were obtained from 1458/1541 patients (96.3%), while adequate samples for pathology were obtained from 285/375 patients (76%). However, for postmenopausal women, 1006 of 1045 cytology (86.3%) were adequate, 153 of 238 histology (64.3%) were adequate, it was easier to collect cytological specimens than histological specimens (P < 0.05). The accuracy of endometrial cytology for detecting endometrial carcinoma and its precursor was 92.4% (sensitivity, 73%; specificity, 95.8%; positive predictive value, 75%; and negative predictive value, 95.3%).

結論:

SAP-1サンプリングとSurePath製剤を用いた子宮内膜細胞診は、子宮内膜癌とその前駆体の患者のスクリーニングに信頼性の高いアプローチである可能性があります。

CONCLUSIONS: Endometrial cytology using SAP-1 sampling and SurePath preparation may be a reliable approach for screening patients with endometrial carcinoma and its precursor.