Introduction: We aimed to determine the utility of Pipet Curet cytology (PCC) and Pipet Curet biopsy (PCB) for diagnosing uterine endometrial endometrioid carcinoma (EEC). Methods: We divided 77 patients with EEC into two groups per Federation of Gynecology and Obstetrics (FIGO) grades: G1 (n = 44) and G2/3 (n = 33) and compared the diagnostic sensitivity of PCC, PCB, and PCC and PCB combined, retrospectively. Next, we investigated any diagnostic discordance between PCC-based and PCB-based diagnoses per FIGO grade group. Results: The diagnostic sensitivity of PCC, PCB, and the two modalities combined was significantly higher for G2/3 EECs than for G1 EECs (72.7% vs. 45.5%, p = 0.0209; 84.8% vs. 63.6%, p = 0.0434; and 93.9% vs. 65.9%, p = 0.0046, respectively), likely due to more friable cancer cells in higher grade EEC cases. Among our 77 EEC patients, there were 4 patients (5.19%) with PCC-based concordant but PCB-based discordant results against EEC, in the G2/3 group predominantly. Diagnostic sensitivity of all cases increased from 72.7% (56/77) by PCB alone to 77.9% (60/77) by use of both modalities combined. Conclusion: Cytologic evaluation can reduce the number of false-negative histologic diagnoses. By providing complementary information, the two modalities combined from the Pipet Curet procedure would be valuable as a diagnostic method for EEC.

1.
Bosse
T
,
Lortet-Tieulent
J
,
Davidson
B
, et al
.
Endometrioid carcinoma of the uterine corpus
. In:
Kim
K-R
,
Lax
SF
,
Lazar
AJ
,
Longacre
TA
,
Malpica
A
,
Maitias-Guiu
X
, et al
, editors.
WHO classification of tumours: female genital tumours
. 5th ed.
Lyon
:
IARC Press
;
2020
. p.
252
5
.
2.
Piriyev
E
,
Mellin
W
,
Roemer
T
.
Comparison of aspirating pipettes and hysteroscopy with curettage
.
Arch Gyn Obstet
.
2020
;
301
:
1485
92
.
3.
Ozawa
N
,
Ohtomo
K
,
Kame
S
,
Sato
M
,
Suzuka
T
,
Oikawa
H
, et al
.
The comparative study of endometrial cytology, histology in cell block specimens with EndoSearch and Endocyte, and suction biopsy with pipet curet
.
J Jpn Soc Clin Cytol
.
2000
;
39
:
396
401
. (Japanese with English abstract).
4.
Okadome
M
,
Saito
T
,
Nishiyama
N
,
Ariyoshi
K
,
Shimamoto
K
,
Shimada
T
, et al
.
Prediction of histological types of endometrial cancer by endometrial cytology
.
J Obstet Gynaecol Res
.
2014
;
40
(
7
):
1931
9
.
6.
Clark
TJ
,
Gupta
JK
.
Endometrial sampling of gynaecological pathology
.
TOG
.
2002
;
4
(
3
):
169
74
.
7.
Du
J
,
Li
Y
,
Lv
S
,
Wang
Q
,
Sun
C
,
Dong
X
, et al
.
Endometrial sampling devices for early diagnosis of endometrial lesions
.
J Cancer Res Clin Oncol
.
2016
;
142
(
12
):
2515
22
.
8.
Huang
GS
,
Gebb
JS
,
Einstein
MH
,
Shahabi
S
,
Novetsky
AP
,
Goldberg
GL
.
Accuracy of preoperative endometrial sampling for the detection of high grade endometrial tumors
.
Am J Obstet Gynecol
.
2007
;
196
(
3
):
243.e1
2435
.
9.
Fakhar
S
,
Saeed
G
,
Khan
AH
,
Alam
AY
.
Validity of pipelle endometrial sampling in patients with abnormal uterine bleeding
.
Ann Saudi Med
.
2008
;
28
(
3
):
188
91
.
10.
Lukanovic
D
,
Matjasic
M
,
Kobal
B
.
Accuracy of preoperative sampling diagnosis for predicting final pathology in patients with endometrial carcinoma: a review
.
Transl Cancer Res
.
2020
;
9
(
12
):
7785
96
.
11.
Utida
GM
,
Kulak
J
.
Hysteroscopic and aspiration biopsies in the histologic evaluation of the endometrium, a comparative study
.
Medicine
.
2019
;
98
(
40
):
e17183
4
.
12.
Polena
V
,
Mergui
JL
,
Zerat
L
,
Sananes
S
.
The role of Pipelle Mark II sampling in endometrial disease diagnosis
.
Eur J Obstet Gynecol Reprod Biol
.
2007
;
134
(
2
):
233
7
.
13.
Japanese Society of Clinical Cytology (JSCC)
.
Atlas and guidelines for cytopathological diagnosis
. 1 st ed.
Tokyo
:
Kanehara & Co: Ltd
;
2015
; p.
54
70
. (in Japanese).
14.
Fulciniti
F
,
Yanoh
K
,
Karakitsos
P
,
Watanabe
J
,
Di Lorito
A
,
Margari
N
, et al
.
The Yokohama system for reporting directly sampled endometrial cytology: the quest to develop a standardized terminology
.
Diagn Cytopathol
.
2018
;
46
(
5
):
400
12
.
15.
Norimatsu
Y
,
Yanoh
K
,
Hirai
Y
,
Kurokawa
T
,
Kobayashi
T
,
Fulciniti
F
.
A diagnostic approach to endometrial cytology by means of liquid-based preparations
.
Acta Cytol
.
2020
;
64
(
3
):
195
207
.
16.
Batista
TP
,
Cavalcanti
CLC
,
Tejo
AAG
,
Bezerra
ALR
.
Accuracy of preoperative endometrial sampling diagnosis for predicting the final pathology grading in uterine endometrioid carcinoma
.
Eur J Surg Oncol
.
2016
;
42
(
9
):
1367
71
.
17.
Visser
NCM
,
Reijenen
C
,
Massuger
LFAG
,
Nagtegaal
ID
,
Bulten
J
,
Pijnenborg
JMA
.
Accuracy of endometrial sampling in endometrial carcinoma: a systemic review and meta-analysis
.
Obstet Gynecol
.
2017
;
130
:
803
13
.
18.
Phelippeau
J
,
Canlorbe
G
,
Bendifallah
S
,
Naoura
I
,
Lefevre
M
,
Ballester
M
, et al
.
Preoperative diagnosis of tumor grade and type in endometrial cancer by pipelle sampling and hysteroscopy: results of a French study
.
Surg Oncol
.
2016
;
25
(
4
):
370
7
.
19.
Quintana-Berto
R
,
Padilla-Iserte
P
,
Gil-Moreno
A
,
Oliver-Perez
R
,
Coronado
PJ
,
Martín-Salamanca
MB
, et al
.
Preoperative sampling in endometrial cancer: evaluation of the histopathological agreement with definitive surgical specimen
.
Clin Transl Oncol
.
2022
;
24
(
12
):
2388
94
.
20.
Kanda
Y
.
Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics
.
Bone Marrow Transplant
.
2013
;
48
(
3
):
452
8
.
21.
Demirkiran
F
,
Yavuz
E
,
Erenel
H
,
Bese
T
,
Arvas
M
,
Sanioglu
C
.
Which is the best technique for endometrial sampling? Aspiration (pipelle) versus dilatation and curettage (D&C)
.
Arch Gynecol Obstet
.
2012
;
286
(
5
):
1277
82
.
You do not currently have access to this content.