Cytological and Histological Diagnosis
The sections examined and reviewed by two pathologists had no
disagreement finally. In histological diagnosis, there were 60 positive
cases containing 4 atypical hyperplasia and 56 endometrial cancers. The
negative cases contained proliferative endometrium (1 case), secretory
endometria (10 cases), atrophic endometria (7 cases), mixed endometria
(26 cases), simple hyperplasia (69 cases), complex hyperplasia (5
cases), and endometrial polyps (2 cases).
The cytological diagnosis included proliferative endometrial cells (49
cases by H-E stain, 57 cases by Papanicolaou stain), secretory
endometrial cells (17 cases by H-E stain, 9 cases by Papanicolaou
stain), atrophic endometrial cells (3 cases by H-E stain, 4 cases by
Papanicolaou stain), simple hyperplasia endometrial cells (41 cases by
H-E stain, 44 cases by Papanicolaou stain), complex hyperplasia
endometrial cells (2 cases by H-E stain, 2 cases by Papanicolaou stain),
atypical hyperplasia endometrial cells (30 cases by H-E stain, 23 cases
by Papanicolaou stain), endometrial cancer endometrial cells (28 cases
by H-E stain, 30 cases by Papanicolaou stain), and no endometrial cells
(10cases by H-E stain, 11 cases by Papanicolaou stain). Endometrial
atypical hyperplasia and carcinoma were considered as positive results.
The positive results of H-E stain were 58, and those of Papanicolaou
stain were 53.
The characteristics of the endometrial cytological diagnosis by H-E and
Papanicolaou stain were showed in Table S2 . There were 135
cases with completely consistent results (distinguished by benign and
malignant endometrial lesions). The simple hyperplasia diagnosed by both
methods were in the majority (33 cases), followed by proliferative
endometria (32 cases). Total 7.32% (12/164) of the samples were
positive in H-E stain and negative in Papanicolaou stain. And 4.27%
(7/164) of them were positive in Papanicolaou stain and negative in H-E
stain.
All participants were stratified based on histological and cytological
results by H-E and Papanicolaou stain (Figure 1 ). Taking the
histological results as gold standard, we compared the cytological
diagnoses of H-E and Papanicolaou stain respectively (Table
S3 ). The Cohen’s kappa value was 0.78, which indicated a high
consistency between them.
The Se, LR+, r, PPV and NPV of H-E stain were higher than those of
Papanicolaou stain, while the FNR, LR- of H-E stain were lower than
those of Papanicolaou stain. The Sp and FPR of them were same
(Table 2 ). The difference of Se between them was statistically
significant(χ2 = 9.068, P = 0.003). Therefore, H-E
stain is considered more accurately than Papanicolaou stain.