Liquid-based endometrial cytology using SurePath™ is not inferior to suction endometrial tissue biopsy for detecting endometrial malignancies: Midterm report of a multicentre study advocated by Japan Association of Obstetricians and Gynecologists

Cytopathology. 2019 Mar;30(2):223-228. doi: 10.1111/cyt.12657. Epub 2019 Jan 17.

Abstract

Objective: We conducted a prospective, multicentre study to compare the clinical performance of liquid-based endometrial cytology (LBEC) using SurePath™ with that of suction endometrial tissue biopsy (SETB). This study is officially advocated and reported by the Japan Association of Obstetricians and Gynecologists. By publishing our midterm data, we intend to disseminate the benefits of LBEC system, using the descriptive reporting format and algorithmic interpretational approach.

Methods: From April 2014 to December 2015, we consecutively assessed 1116 LBEC specimens and 1044 SETB specimens in our five outpatient clinics.

Results: The sensitivity of suction tissue biopsies was 85.2%, whereas the sensitivity of LBEC was 92.2%. The specificity of suction tissue biopsies was 98.9% and that of LBEC was 98.5%. The negative predictive value of LBEC (99.1%) was higher than that of SETB (98.1%), although the difference between these values was not significant.

Conclusions: The clinical performance of LBEC for detecting endometrial malignancies was almost identical to the performance of SETB. This indicates that LBEC was not inferior to SETB for the detection of endometrial cancer. The LBEC is appropriate for various clinical situations as the first-step detecting tool. In addition, it could be used for cancer surveillance for women with signs highly suggestive of endometrial malignancies and in Lynch syndrome patients, on a larger scale.

Keywords: SurePath™; endometrial suction tissue biopsy; intrauterine sampling; liquid-based endometrial cytology; multicentre study.

MeSH terms

  • Cytodiagnosis*
  • Endometrial Neoplasms / diagnosis*
  • Endometrial Neoplasms / pathology
  • Endometrium / pathology
  • Female
  • Humans
  • Japan / epidemiology
  • Liquid Biopsy*
  • Uterine Neoplasms / diagnosis*
  • Uterine Neoplasms / pathology