Abnormal cervical cytology in the diagnosis of uterine papillary serous carcinoma: Earlier detection of a poor prognostic cancer subtype?

Malgorzata E. Skaznik-Wikiel, Stefanie M. Ueda, Heidi E. Frasure, Peter G. Rose, Aimee Fleury, Francis C. Grumbine, Amanda Nickles Fader

Research output: Contribution to journalArticle

Abstract

Objective: Early detection of uterine papillary serous (UPSC), clear cell (CCC), and grade 3 endometrioid carcinomas (G3EC) - all poor prognostic variants of endometrial carcinoma (EC) - is of particular clinical relevance. The study objective was to assess the utility of liquid-based cytology (Pap) in the detection of high-grade EC. Study Design: A retrospective, two-institution analysis of patients diagnosed with UPSC, CCC, or G3EC with a preoperative Pap from 1999 to 2010 was conducted. Results: One hundred and one patients were evaluated; 51.5% had UPSC, 27.7% had CCC, and 20.8% had G3EC. Stage I/II disease was found in 69.3% of patients, and 46/101 patients (45.5%) had abnormal Paps. Significantly more patients with UPSC had abnormal Paps (65.7%) than those with CCC (25%) or G3EC (23.8%; p < 0.001). An abnormal Pap was the only presenting clinical finding in a significant number of asymptomatic UPSC patients (26.9%) compared with 4% of patients with CCC and G3EC (p = 0.005). On multivariate analysis, UPSC histology was the only variable associated with an abnormal Pap. Conclusions: A high incidence of abnormal cervical cytology was observed in women with high-grade EC, particularly in UPSC patients. Although hypothesis generating, a proportion of asymptomatic UPSC patients had abnormal cytology, signifying that Pap smear screening may help detect the disease before the patient develops symptoms.

Original languageEnglish (US)
Pages (from-to)255-260
Number of pages6
JournalActa cytologica
Volume55
Issue number3
DOIs
StatePublished - Apr 2011

Keywords

  • Cervical cytology
  • Endometrial cancer
  • Papanicolaou smear
  • Uterine papillary serous carcinoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

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