Endocervical cell collection using cytobrush, liquid-fixation, and cytocentrifugation: A feasibility study using 455 hysterectomy specimens

Differential uterine curettage may be performed for the evaluation of`abnor mal uterine bleeding. The purpose of this study was to test the Sensibility of substituting cytological methods Sor differential uterine curettage to evaluate the entire glandular axis of the uterus and the transformation zon e. In order to simulate differential uterine sampling, the endocervix was b rushed in 455 uteruses from which all endometrial cytology sample had been previously collected Twenty-five percent of the brushes' cell-sample was ex amined using two 17.5 min circle-slides prepared with a Hettich cytocentrif uge. The resulting slides were homogeneous and cellular: They were compared to tissue sections of matched hysterectomy specimens. Endometrial adenucar cinoma was overrepresented in the endocervical cytology preparations. This was ascribed either to prior endometrial collection with "drop-down contami nation" of the endocervix and/or to entry of the cytobrush into the endomet rial cavity. Otherwise, cytological and histological diagnoses were compara ble for squamous and endocervical-adenomatous lesions. Under the conditions of this simulation, endometrial and endocervical brushings appeared to com plement each other as case-finding techniques for evaluating abnormal uteri ne bleeding. (C) 1999 Wiley-Liss, Inc.