ABSTRACT
Despite remarkable progress in understanding and treating gastrointestinal stromal tumors (GISTs) during the past two decades, the pathological characteristics of GISTs have not been made clear yet. Furthermore, concrete diagnostic criteria of malignant GISTs are still uncertain. We collected pathology reports of 1,227 GISTs from 38 hospitals in Korea between 2003 and 2004 and evaluated the efficacy of the NIH and AFIP classification schemes as well as the prognostic factors among pathologic findings. The incidence of GISTs in Korea is about 1.6 to 2.2 patients per 100,000. Extra-gastrointestinal GISTs (10.1%) are more common in Korea than in Western countries. In univariate analysis, gender, age, tumor location, size, mitosis, tumor necrosis, vascular and mucosal invasions, histologic type, CD34 and s-100 protein expression, and classifications by the NIH and AFIP criteria were found to be significantly correlated with patient's survival. However, the primary tumor location, stage and classification of the AFIP criteria were prognostically significant in predicting patient's survival in multivariate analysis. The GIST classification based on original tumor location, size, and mitosis is more efficient than the NIH criteria in predicting patient's survival, but the mechanism still needs to be clarified through future studies.
ABSTRACT
The significance of endometrial cells on cervicovaginal smears is underestimated. The aim of this study is to evaluate the detection rate of endometrial cells on cervicovaginal smears. The materials consisted of two groups. Group I was 701 cervicovaginal smears from patients with no gynecological problems. Group II was 208 cervicovaginal smears from patients with abnormal uterine bleeding followed by endometrial curettage; 31 cases of endometrial adenocarcinoma(CA), 19 cases of endometrial hyperplasia(HP), 83 cases of dysfunctional uterine bleeding(DUB), and 75 cases of normal endometrium. Cervicovaginal smears were reviewed according to the criteria of The Bethesda System. Endometrial cells were identified in 15 of 701 cases(2.1%) in group I and 64 of 208 cases(30.8%) in group II. Among group II, detection rate of endometrial cells was the highest in CA (51.6%) compared to HP(26.3%), DUB(41.0%), and normal endometrium(12.0%) ( p<0.05). Cytologic atypia of endometrial cells was not found in group I, but was more frequently identified in CA(87.5%) than in HP(10.5%) or DUB(14.7%) ( p<0.05). Exfoliation of endometrial cells might be related to abnormal endometrial lesion, and reporting of endometrial cells in the cervicovaginal smear may increase a chance to detect endometrial lesions especially in patients with abnormal uterine bleeding.
Subject(s)
Female , Humans , Curettage , Endometrium , Uterine HemorrhageABSTRACT
The significance of endometrial cells on cervicovaginal smears is underestimated. The aim of this study is to evaluate the detection rate of endometrial cells on cervicovaginal smears. The materials consisted of two groups. Group I was 701 cervicovaginal smears from patients with no gynecological problems. Group II was 208 cervicovaginal smears from patients with abnormal uterine bleeding followed by endometrial curettage; 31 cases of endometrial adenocarcinoma(CA), 19 cases of endometrial hyperplasia(HP), 83 cases of dysfunctional uterine bleeding(DUB), and 75 cases of normal endometrium. Cervicovaginal smears was reviewed according to the criteria of The Bethesda System. Endometrial cells were identified in 15 of 701 cases(2.1%) in group I and 64 of 208 cases(30.8%) in group II. Among group II, detection rate of endometrial cells was the highest in CA (51.6%) compared to HP(26.3%), DUB(41.0%), and normal endometrium(12.0%) (p<0.05). Cytologic atypia of endometrial cells was not found in group I, but was more frequently identified in CA(87.5%) than in HP(10.5%) or DUB(14.7%) (p<0.05). Exfoliation of endometrial cells might be related to abnormal endometrial lesion, and reporting of endometrial cells in the cervicovaginal smear may increase a chance to detect endometrial lesions especially in patients with abnormal uterine bleeding.