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The Yokohama System for Reporting Endometrial Cytology (TYS) has been proposed by an expert meeting under the auspices of the International Academy of Cytology (IAC) in May 2016 at the IAC in Yokohama. Since its introduction, the TYS has been receiving worldwide acceptance, and this review aims to assess its global impact. The adoption of endometrial cytology as a diagnostic procedure has been hampered in the past by difficulties arising in interpreting the cellular findings due to a number of factors (such as excess blood, cellular overlapping and the complex physiology of endometrium). Recently, the use of liquid‐based cytology (LBC), with its ability to remove blood and mucus and to distribute cells uniformly in a thin layer on the slide, has provided an opportunity to re‐evaluate the role of endometrial cytology. LBC is a useful tool in the cytologic diagnosis and follow‐up of endometrial abnormalities, which remains complementary to the emerging molecular diagnostic cytopathology. The study of LBC from endometrial cytology could be challenging since it is affected by numerous look‐alikes and diagnostic pitfalls. This review discusses these various entities and takes into consideration the ancillary techniques that may be useful in the diagnostic procedure. In conclusion, our review of the published data suggests that the TYS is a valid classification scheme that has been widely accepted by cytopathologists globally, is highly reproducible and makes a valuable contribution to clinical therapeutic management. At present, molecular cytopathology is a rapidly evolving field of modern cytopathology, which underlines the effective interplay between genomics and cytology. This review aims to provide a comprehensive review of the drawbacks of endometrial cytopathology, particularly in terms of endometrial cancer diagnosis and molecular testing. [ABSTRACT FROM AUTHOR]

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Objective: To explore the feasibility of sampling Chinese patients by suction curettage for cytological and histological screening of endometrial cancer related to Lynch syndrome. Methods: This retrospective study enrolled patients who underwent endometrial biopsy at our hospital between May 2018 and January 2019. Endometrial sampling (cytological and micro-histological specimens) was conducted by suction curettage. The gold standard for diagnosis was traditional sharp dilation and curettage (D&C). The sensitivity, specificity, and diagnostic accuracy of cytology, micro-histology, and the combination of cytology and micro-histology were calculated. Additionally, receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic efficiency of three screening methods. Mismatch repair proteins were further detected using immunohistochemistry (IHC) in endometrial cancer. Results: This retrospective finally enrolled 100 patients, which satisfactory samples were obtained from 96 patients for liquid-based cytology and 93 patients for microtissue histology. The concordance rates with D&C, sensitivity, and specificity were 94.8%, 76.9%, and 97.5% for liquid-based cytology, 96.8%, 84.6%, and 98.8% for microtissue histology, and 99.0%, 92.3%, and 100.0% for liquid-based cytology and microtissue histology combined, respectively. The AUC of ROC curves in liquid-based cytology, microtissue histology, and the combined methods for diagnostic ability were 0.873, 0.917, and 0.962, respectively. Absence rates of MLHl, MSH2, MSH6, and PMS2 proteins were 15.3% (2/13), 0% (0/13), 7.7% (1/13), and 15.3% (2/13) in the 13 endometrial cancer samples. Conclusion: Liquid-based cytology and microtissue histology samples from suction curettage combined IHC are useful for endometrial cancer screening.

To estimate the feasibility of diagnosing ovarian cancer, fallopian tube cancer, and primary peritoneal cancer through endometrial cytology, we performed a systematic review and meta-analysis to calculate the pooled positive rate of malignant cells in endometrial cytology samples. We queried PubMed, EMBASE, Medline, and Cochrane Central Register of Controlled Trails from inception to November 12, 2020 for studies estimating positive rates of malignant cells in endometrial cytology samples from patients with ovarian cancer, fallopian tube cancer, and primary peritoneal cancer. The positive rates of the included studies were calculated as pooled positive rate through meta-analyses of proportion. Subgroup analysis based on different sampling methods was conducted. Seven retrospective studies involving 975 patients were included. Pooled positive rate of malignant cells in endometrial cytology specimens of ovarian cancer, fallopian tube cancer, and primary peritoneal cancer patients was 23% (95% CI: 16% - 34%). Statistical heterogeneity between the included studies was considerable (I2 = 89%, P < 0.01). The pooled positive rates of the group of brushes and the group of aspiration smears were 13% (95% CI: 10% - 17%, I2 = 0, P = 0.45) and 33% (95% CI: 25% - 42%, I2 = 80%, P < 0.01), respectively. Although endometrial cytology is not an ideal diagnostic tool for ovarian cancer, fallopian tube cancer, and primary peritoneal cancer, it is a convenient, painless, and easy-to-implement adjunct to other tools. Sampling method is one of the factors that affect the detection rate.

Postpartum diseases of uterus represent a foremost predicament in cattle farms affecting reproductive efficiency. Postpartum (PP) uterine diseases include metritis, endometritis and subclinical endometritis (SCE). Barring SCE, all other diseases project the clinical signs. Diagnosis of SCE at the early stage of PP has been a challenging task for many veterinarians. The present study aimed to validate and correlate the proficiency of transitional changes in uterus and cervix assessed by transrectal ultrasonography (TRUS) and endometrial cytology (EC) in the diagnosis of SCE in PP cattle. The research was carried out in two phases i.e, 30th day postpartum (DPP) (n=74) and first exhibited oestrus after 45th DPP (n=24) (54.63 ± 1.13 d) to emphasise the proficiency of both the diagnostic modalities. Endometrial cytology could discriminate between cows positive and negative for SCE significantly at 30th DPP (20.54 ± 0.48 vs 5.55 ± 0.41). It was potent in diagnosing SCE after 45th DPP also, as a significant reduction in the per cent of PMN cells (20.54 ± 0.48 to 7.56 ± 0.32) was noticed. Uterine parameters assessed by TRUS like cervical and uterine diameter and endometrial thickness in both the phases of assessment did not correlate to the EC changes and also could not discriminate between SCE positive and negative animals. The results of the study signify that EC is efficacious in the diagnosis of SCE in cows, while TRUS is impractical as a sole diagnostic modality for SCE.

Objective: For patients with endometrial cancer, the POLE (polymerase epsilon) mutation (POLEmut)‐subtype, one of four molecular‐analysis‐based categories in the Cancer Genome Atlas (TCGA), has the best prognosis. The following histological characteristics are typically observed in endometroid carcinoma cases with the POLEmut‐subtype: (1) the presence of tumour giant cells, (2) numerous tumour‐infiltrating lymphocytes (TILs) and/or peri‐tumoral lymphocytes, and (3) a high grade. However, in the context of cytology, the morphological characteristics of this subtype remain unknown. Methods: DNA extracted from formalin‐fixed paraffin‐embedded (FFPE) tissues was subjected to next‐generation sequencing analysis and categorised according to the TCGA classifications. Genomic mutation, tumour mutation burden (TMB), and microsatellite instability were also assessed. Cytological specimens of resected uteri obtained using the Papanicolaou method were histologically separated into three types. Results: Seven out of 112 patients (6%) with endometrial cancer were diagnosed with the POLEmut‐subtype between January 2019 and August 2021. Tumour giant cells were observed in three cases (43%) on histology and cytology. TIL and/or peritumoral lymphocytes with inflammatory cells were detected in five cases (71%) on histology and three cases (43%) on cytology. Cases in which these three characteristics were observed on both cytology and histology may have belonged to the POLEmut‐subtype. There were no cases in which these characteristics were absent on histology but present on cytology. TMB tended to be higher in cases when the three characteristics were observed in both cytological and histological findings. Conclusions: Preoperative endometrial cytology highlighted the characteristics of the POLEmut‐subtype in the histological analysis of resected uterine specimens and has the potential to play an important role in treatment decisions. [ABSTRACT FROM AUTHOR]

Background: Because the incidence of endometrial cancer has been increasing every year, it is important to identify an effective screening method for it. The endometrial cytology test (ECT) is considered to be the more acceptable technique compared to invasive endometrial sampling. Methods: The study followed the Priority Reporting Project for Systematic Evaluation and Meta-Analysis (PRISMA-DTA) protocol. This systematic rating searched EMBASE and Web of Science databases for studies on ECT for endometrial cancer from the databases' dates of inception to 30 September 2022. All literature screening and data extraction were performed by two researchers, while the methodological quality of the included studies was assessed against defined inclusion criteria. And a third researcher resolves the disagreements. Results: Twenty-six studies were eventually included in this final analysis. Meta-analysis results showed that the diagnostic accuracy characteristics of ECT for endometrial cancer were as follows: combined sensitivity = 0.84 [95% confidence interval (CI) (0.83–0.86)], combined specificity = 0.98 [95% CI (0.98–0.98)], combined positive likelihood ratio = 34.65 [95% CI (20.90–57.45)], combined negative likelihood ratio = 0.21 [95% CI (0.15–0.30)], and area under the summary receiver operating characteristic curve = 0.9673. Conclusions: ECT had the ability to detect endometrial cancer with strong specificity, although some studies have demonstrated significant differences in sensitivity. [ABSTRACT FROM AUTHOR]

Background. The trend towards an increase in the number of caesarean sections (CS) has led to the fact that many women are more likely to plan a second pregnancy with a caesarean scar niche. According to current data, planning pregnancy with a niche may be associated with a decrease in the likelihood of successful implantation, which is a consequence of the uterine form of secondary infertility. In the context of studying the effect of stagnant contents in the projection of the niche on fertility, it is important to assess the prevalence of chronic endometritis (CE) and use new knowledge to personalize patient management schemes in achieving reproductive goals. Aim. To study the prevalence of CE according to various laboratory diagnostic methods in a group of patients with secondary infertility associated with stagnant contents in the niche projection, compared with a group of fertile patients without stagnant contents in the niche projection; to evaluate the possibilities of the cytological and immunocytochemical (ICC) method for studying the endometrium in the diagnosis of CE in comparison with the histological and immunohistochemical (IHC) method. Materials and methods. The prospective study included 38 patients of reproductive age with a caesarean scar niche, who met the inclusion criteria. After excluding other known factors of secondary infertility, performing ultrasound and/or magnetic resonance imaging of the pelvic organs on the 5th8th day of the menstrual cycle, where the presence/absence of stagnant contents in the projection of the niche was assessed, the patients were divided into 2 groups: group 1 (n=30) patients with secondary infertility in combination with stagnant contents in the niche projection (main group), group 2 (n=8) patients without clinical complaints, without stagnant contents in the projection of a clinically insignificant niche (control group). All patients (n=38) underwent an aspiration pipel biopsy of the endometrium (and, in the presence of stagnant contents in the projection of the niche) under ultrasound control on the 7th10th day of the menstrual cycle. Then a cytological, ICC study (using the CD138 marker), a histological, IHC study of the endometrium (using the CD138 marker) was performed. The statistical study was carried out using the IBM SPSS Statistica v22 program (IBM Corp., USA). Results. In the 1st group (n=30), the prevalence of CE according to cytological and ICC studies was 90% (n=27/30), a normal cytological picture was recorded in 10% (n=3/30); the prevalence of CE according to histological and IHC studies was 80% (n=24/30), of which 37.5% (n=9/24) were diagnosed with an incomplete morphological picture of CE, and 62.5% (n=15/24) a complete morphological picture of CE was revealed, a normal morphological picture was recorded in 20% (n=6/30) of cases. In the 2nd group (n=8), the prevalence of CE according to cytological and ICC studies was 12.5% (n=1/8), a normal cytological picture was recorded in 87.5% (n=7/8); according to histological and IHC studies, CE was not diagnosed, a normal morphological picture was recorded in 100% (n=8/8) of cases. A high degree of consistency of laboratory data was revealed for 2 groups (n=38), p=0.0001. The sensitivity of the cytological method compared with the histological method was 95.83% (95% CI 79.7699.26%), specificity 64.29% (95% CI 38.7683.66%), positive predictive value 82.14% (95% CI 64.4192.12%), negative predictive value 90% (95% CI 59.5898.21%), the accuracy of the cytological method compared to the histological one was 84, 21% (95% CI 68.0693.03%). Conclusion. Secondary infertility in patients with stagnant contents in the projection of caesarean scar niche may be associated with CE. Cytological examination of the endometrium in combination with ICC seems to be a promising method for the laboratory evaluation of CE, given the high correlation with histological and IHC data.

The objectives of this study were to determine the effect of calving to timed artificial insemination (C‐TAI) interval on fertility of Bos taurus and Bos indicus cows and to determine the best C‐TAI interval to include postpartum cows in TAI programs in each genotype (B. taurus and B. indicus). In experiment 1, a retrospective study was performed, with data from 2,709 TAI in Bos taurus and Bos indicus cows with different C‐TAI intervals. There was a positive linear effect of C‐TAI interval on the pregnancy probability (p <.0001). However, there was no effect or interaction with the genotype. When C‐TAI intervals were grouped in classes, pregnancy rate differed in groups (p <.05). Receiver operating characteristic (ROC) analysis was performed, and it was observed that 52 days would be the better C‐TAI interval to maximize fertility in beef cows. According to the previous result, we further stratified into two C‐TAI interval groups (≤ 52 days or > 52 days). Cows with C‐TAI longer than 52 days (C‐TAI > 52) had greater pregnancy rate (56%) than cows with short C‐TAI (46%; p <.01). In experiment 2, 18 postpartum beef cows were subjected to TAI protocol at different C‐TAI intervals (n = 6 cows per group): 40, 60 or 80 days postpartum. Cows with 60 days of C‐TAI had a greater preovulatory follicle diameter than cows with 80 days postpartum (p <.05). The C‐TAI interval did not affect (p >.05) the ovulation rate nor the proportion of endometrial polymorphonuclear leucocytes. We conclude that C‐TAI interval affects pregnancy rate in both Bos taurus and Bos indicus. We recommend a C‐TAI interval longer than 52 days to increase fertility of beef cows included in TAI programs. [ABSTRACT FROM AUTHOR]

Abstract Background Abnormal uterine bleeding requires the investigation of the endometrium. Histology is typically used but there remains room for the improvement and use of cytology. Methods Women presenting for clinically indicated office endometrial biopsy were prospectively enrolled. Tao endometrial brushing and office endometrial biopsy were performed, and surgical procedure if clinically indicated. Tao brush cytology specimens were blindly reviewed by up to three pathologists, consensus obtained, and scored as: benign, atypical (favor benign), suspicious, positive for malignancy, or non‐diagnostic. Cytology and histology were compared to surgical pathology to determine sensitivity, specificity, positive, and negative predictive values to detect AH (atypical hyperplasia) or EC (endometrial cancer). Results Clinical indications of 197 enrolled patients included postmenopausal bleeding (90, 45.7%), abnormal uterine bleeding (94, 47.7%), and abnormal endometrium on ultrasound without bleeding (13, 6.6%). Of the 197 patients, 185 (93.9%) had cytology score consensus and a total of 196 (99.5%) had consensus regarding cytology positivity. Surgical pathology diagnoses (N = 85) were 13 (15.3%) FIGO grade 1 or 2 EC, 3 (3.5%) AH, and 69 (81.2%) benign endometrium. Sensitivity and specificity to detect EC or AH were 93.7% and 100%, respectively, via endometrial biopsy; 87.5% and 63.8%, respectively, via endometrial cytology when scores of malignancy, suspicious, or atypical were considered positive. Conclusions In a high‐risk population, Tao brush endometrial cytology showed high sensitivity to detect AH and EC comparable to biopsy histology when considering scores of malignancy, suspicious, atypical, and non‐diagnostic. Revisiting the potential value of endometrial cytology in the contemporary era of endometrial diagnostic workup is warranted.

Introduction: This study aimed to determine the causes of disruption of the three‐dimensional architecture of endometrial glands prepared using BD SurePath™ liquid‐based cytology (SP‐LBC) reagents. One sample preparation method for endometrial cytology is presented in which this three‐dimensional architecture can be retained. Methods: SP‐LBC specimens were prepared by the following three methods: (1) using the BD PrepMateTM (PrepMate) System after cellular fixation for 1‐6 h (method A); (2) without using the PrepMate System after cellular fixation for 1‐6 h (method B); and (3) using the PrepMate System after cellular fixation for at least 18 h (method C). Size and numbers of endometrial cell clusters and numbers of solitary scattered cells were then evaluated. Results: Significantly higher numbers of cell clusters with a major axis of 200 μm or more were yielded by method C (71.3 ± 57.2) than methods A (9.3 ± 5.9, P < 0.001) or B (44.3 ± 28.8, P < 0.05). Method B yielded significantly higher numbers of cell clusters than method A (P < 0.001). Method A (132.2 ± 107.7, p < 0.001) yielded significantly higher numbers of solitary scattered cells than methods B (29.1 ± 14.8) and C (35.7 ± 23.3). No significant difference in solitary cell numbers was found between methods B and C. Conclusions: Retention of endometrial glandular architecture is rendered possible by allowing sample fixation times of 18 h or more when preparing specimens using the PrepMate System. [ABSTRACT FROM AUTHOR]

The present study sought to evaluate the expression of PD-1 and CTLA-4 in blood T lymphocytes during the periparturient period and their relationship with uterine health in dairy cows, as determined by endometrial cytology and serum concentrations of β-hydroxybutyrate (BHB) and non-esterified fatty acids (NEFAs), which are indicators of a negative energy balance. The second objective of this study was to investigate whether the expression of PD-1 and CTLA-4 in T lymphocytes is associated with the serum acute phase-protein haptoglobin concentration during the periparturient period. To address these objectives, 26 clinically healthy dairy cows were used. Peripheral blood was collected 14 days prepartum (T-14), at calving (T0), and 30 days postpartum (T30) to measure the expression of PD-1 and CTLA-4 in blood T lymphocytes by flow cytometry. In addition, we collected blood at T0, 10 days after parturition (T10), and T30 to obtain serum and determine the serum concentrations of NEFA, BHB, and Hp. Endometrial cytology was performed at T10, 20 days after parturition (T20), and T30. In the present study, we observed higher expression of CTLA-4 and PD-1 in T lymphocytes at parturition and in the prepartum period, which could indicate a relationship between these immune checkpoints and immunological tolerance during gestation in dairy cattle. In addition, a negative association between the expression of these immune checkpoints prepartum or at parturition and endometrial cytology at T20 and T30 was observed, indicating the negative implications of these immune response regulators in susceptibility to infections. This finding was further corroborated by the relationship between the serum concentration of haptoglobin and the expression of CTLA-4 and PD-1 by T lymphocytes. However, we did not observe a relationship between the indicators of negative energy balance, evaluated by the serum concentrations of BHB and NEFA, and the expression of the immune checkpoint markers studied. Thus, our findings represent an initial step that paves the way for the development of new therapeutic alternatives directed by the host with the objective of increasing the resistance of dairy cattle to infections in this critical period of life.

Abstract Background Liquid-based cytology (LBC) is now a widely used method for cytologic screening and cancer diagnosis. Since the cells are fixed with alcohol-based fixatives, and the specimens are stored in a liquid condition, LBC specimens are suitable for genetic analyses. Methods Here, we established a small cancer gene panel, including 60 genes and 17 microsatellite markers for next-generation sequencing, and applied to residual LBC specimens obtained by endometrial cancer screening to compare with corresponding formalin-fixed paraffin-embedded (FFPE) tissues. Results A total of 49 FFPE and LBC specimens (n = 24) were analyzed, revealing characteristic mutations for endometrial cancer, including PTEN, CTNNB1, PIK3CA, and PIK3R1 mutations. Eight cases had higher scores for both tumor mutation burden (TMB) and microsatellite instability (MSI), which agree with defective mismatch repair (MMR) protein expression. Paired endometrial LBC, and biopsied and/or resected FFPE tissues from 7 cases, presented almost identical mutations, TMB, and MSI profiles in all cases. Conclusion These findings demonstrate that our ad hoc cancer gene panel enabled the detection of therapeutically actionable gene mutations in endometrial LBC and FFPE specimens. Endometrial cancer LBC specimens offer an alternative and affordable source of molecular testing materials.

Lynch syndrome (LS) results from pathogenic variants in mismatch repair genes and is the most common hereditary cancer syndrome. Some guidelines or studies recommend restricting screening according to endometrial cancer (EC) using endometrial biopsy. The pooled sensitivity and specificity of endometrial cytology for detecting endometrial atypical hyperplasia or cancer have been reported to be as high as the pooled sensitivity and specificity of endometrial biopsy. We conduct transvaginal ultrasound and endometrial cytology in women with LS every six months as surveillance for gynecological malignancy. Through this surveillance program, we can detect early-stage EC in women with LS. Here, we report the case of a patient with stage IA EC detected by endometrial cytology and treated completely. The patient was a 47-year-old woman under surveillance for gynecological malignancy. She was diagnosed as having LS with a germline pathogenic variant in MSH6 after surgery for rectal cancer. Thereafter, gynecological surveillance was started. She had regular menstruation and never experienced atypical genital bleeding. However, her cytopathological findings indicated grade 1 endometrial carcinoma. Endometrial biopsy was performed and endometrial carcinoma was confirmed pathologically. A laparoscopic modified radical hysterectomy with bilateral salpingo-oophorectomy was performed. The resected specimen was reviewed pathologically, and the tumor was finally diagnosed as grade 1 endometrioid carcinoma confined to the endometrium without lymphovascular space invasion. She has remained asymptomatic and free of cancer for five years without any adjuvant therapy. We achieved successful surveillance using endometrial cytology. Endometrial cytology could replace endometrial biopsy as a screening tool for EC., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Murakami et al.)

Background: Abnormal uterine bleeding requires the investigation of the endometrium. Histology is typically used but there remains room for the improvement and use of cytology. Methods: Women presenting for clinically indicated office endometrial biopsy were prospectively enrolled. Tao endometrial brushing and office endometrial biopsy were performed, and surgical procedure if clinically indicated. Tao brush cytology specimens were blindly reviewed by up to three pathologists, consensus obtained, and scored as: benign, atypical (favor benign), suspicious, positive for malignancy, or non‐diagnostic. Cytology and histology were compared to surgical pathology to determine sensitivity, specificity, positive, and negative predictive values to detect AH (atypical hyperplasia) or EC (endometrial cancer). Results: Clinical indications of 197 enrolled patients included postmenopausal bleeding (90, 45.7%), abnormal uterine bleeding (94, 47.7%), and abnormal endometrium on ultrasound without bleeding (13, 6.6%). Of the 197 patients, 185 (93.9%) had cytology score consensus and a total of 196 (99.5%) had consensus regarding cytology positivity. Surgical pathology diagnoses (N = 85) were 13 (15.3%) FIGO grade 1 or 2 EC, 3 (3.5%) AH, and 69 (81.2%) benign endometrium. Sensitivity and specificity to detect EC or AH were 93.7% and 100%, respectively, via endometrial biopsy; 87.5% and 63.8%, respectively, via endometrial cytology when scores of malignancy, suspicious, or atypical were considered positive. Conclusions: In a high‐risk population, Tao brush endometrial cytology showed high sensitivity to detect AH and EC comparable to biopsy histology when considering scores of malignancy, suspicious, atypical, and non‐diagnostic. Revisiting the potential value of endometrial cytology in the contemporary era of endometrial diagnostic workup is warranted. [ABSTRACT FROM AUTHOR]

The aim of the current study was to determine the levels of acute-phase proteins haptoglobin [Hp], serum amyloid A [SAA] and proinflammatory cytokinesinterleukin-6 [IL-6, and IL-8] in serum of buffaloes that developed subclinical endometritis (SCE) during the early postpartum period. Endometritis, which is one of the most common postpartum diseases in cattle and occurs several weeks postpartum, causes severe economic losses. A total of 72 buffaloes, aged 3 years to 12 years and at 15–24 days post-calving, were enrolled in this study. All the animals were checked by transrectal palpation, ultrasound examination to evaluate degree of uterine involution. Endometrial cytological samples were collected by using cytobrush to determine the proportions of endometrial cells and PMNs and later incidence of cytological endometritis in week 4 postpartum buffaloes. Blood samples (10 ml) were collected weekly from week 4 to week 7 after calving to measure levels of IL-6, IL-8 and acute-phase proteins: Hp and SAA in healthy and buffalo cows that developed cytological endometritis. The experimental group consisted of 12 buffaloes with subclinical endometritis and the control group of 12 buffaloes without cytological endometritis. Analyses in both groups of cows were carried out at weeks 4, 5, 6, and 7 postpartum (DPP). The levels of the following cytokines: IL-6, IL-8 and acute-phase proteins: Hp and SAA were determined using ELISA. Twelve of 72 clinically healthy buffalo cows (16.6%) had subclinical endometritis (= 8 % PMN cows). The levels of IL-6, IL-8, Hp, and SAA significantly (P < 0.05) were higher in buffalo cows with subclinical endometritis than healthy animals. The results indicate that the evaluation of the levels of cytokines and Hp in serum can be an important diagnostic indicator in buffalo cows that developed subclinical endometritis. [ABSTRACT FROM AUTHOR]

This study was carried out in crossbred cows (>60 DIM) to evaluate leukocyte esterase (LE) strip test, protein strip test, pH strip test, white side test (WST) of estrual mucus, in comparison to endometrial cytology (EC) using cytobrush (CB) as reference diagnostic method for subclinical endometritis (SCE). Endometrial cytology was done in 78 cows with =4% PMNs as cut-off value for SCE. Leukocyte esterase strip test was done by contacting estrual mucus with multireagent urinalysis reagent strips and results recorded after 10 min. Similarly, protein and pH strip tests were conducted using the same strips and results recorded after 60 s. White side test of estrual mucus was conducted simultaneously. Leukocyte esterase, protein and pH strip tests were evaluated and analyzed statistically using receiver operator characteristic (ROC). LE strip test at cut-off value = ± acquired from ROC analysis showed sensitivity (Se) of 86.67% and specificity (Sp) of 66.67%. Similarly, protein and pH strip tests showed Se of 53.33%, 66.67% and Sp of 66.67%, 77.78%, respectively. Strip tests were also combined in three combinations (LE + protein, LE + pH and LE + protein + pH) and overall decrease in Se was observed in all three combinations (46.67%, 60% and 33.33%, respectively); while, a slight increase in Sp (77.78%) was also observed. Sensitivity and Sp of WST were 63.33% and 55.56%; respectively, and these values for WST were lower compared to those in LE test. In conclusion, cow side LE test can be used as an economic and easy test with acceptable Se and Sp compared to WST instead of EC for SCE in cattle. However, no improvement in performance of LE strip test was observed when combined with pH and protein strip tests. [ABSTRACT FROM AUTHOR]

A mesonephric-like endometrial adenocarcinoma (ML-EAC) is very rare and has a worse prognosis than other endometrial carcinomas. We describe an ML-EAC and report our endometrial cytological findings. A 76-year-old woman presented with irregular genital bleeding and a uterine mass. Endometrial cytology revealed atypical cylindrical or spindle-shaped cells in the form of small aggregates or solitary cells. The cell aggregates exhibited irregularly stacked papillary structures, small glandular structures, and fenestrated structures. The atypical cells had a nucleus with fine-granular chromatin and a granular cytoplasm, and nuclear grooves and intranuclear pseudo-inclusions were present. Hyaline globules were observed in the glandular lumens and in the background. The presumptive histological type was an adenocarcinoma, but the cytological features were different from those of an endometrioid carcinoma. A histological examination of the endometrial biopsy revealed an adenocarcinoma, and a simple hysterectomy was performed. A grayish-white elevated mass measuring 90 mm × 70 mm × 40 mm was observed on the uterine corpus in the hysterectomy specimen. Histologically, the tumor proliferated as complex tubular structures containing eosinophilic colloid-like materials and trabecular structures. The tumor cells were diffuse and positive for GATA-3 and partially positive for thyroid transcription factor-1. Estrogen and progesterone receptors were negative. An ML-EAC was diagnosed. The tumor was invasive and extended beyond one-half of the muscle layer with a high degree of vascular invasion. In conclusion, we need to focus on the various shapes of the cell aggregate, nuclear grooves, and intranuclear pseudo-inclusions of tumor cells to distinguish an ML-EAC from other endometrial carcinomas in endometrial cytology., (© 2024 The Authors. Diagnostic Cytopathology published by Wiley Periodicals LLC.)

This study was conducted to compare the accuracy of three different techniques of endometrial cytology to diagnose sub-clinical endometritis in dairy cows. Postpartum dairy cows (21) with history of normal calving were selected for obtaining endometrial samples at weekly interval from day 14 to 42 postpartum. In each cow, samples were obtained in a sequential manner, first with the cytotape, then with the cytobrush followed by uterine lavage. Smears were stained with Giemsa stain method. Parameters used to evaluate these techniques were; presence of polymorphoneutophils (%), total cellularity, red blood cell contamination and quality of the smears. No difference was recorded between the three techniques in % polymorphoneutrophils recovered. All techniques provided diagnostic samples; however, cytotape yielded the highest quality sample. On the other hand, cytobrush and cytotape methods yielded similar total cellularity (P=0.3781), uterine lavage yielded significantly (P

Objective: In this study, we aimed to retrospectively investigate and confirm whether atypical nuclear findings in endometrial cytology are useful when assessed by image morphometry in liquid‐based cytology (LBC) and compared with microscopic evaluation. Methods: In total, 53 cases were selected for this study, including 11 presenting proliferative endometrium, 12 with surface papillary syncytial change with endometrial glandular and stromal breakdown (EGBD‐SPSC), 10 endometrioid carcinoma grade 1 (G1‐EEC), 10 EEC grade 3 (G3‐EEC), and 10 endometrial serous carcinomas (ESC). Nuclear image morphometry for nuclear geometric features (area, grey value, aspect ratio, internuclear distance, nucleolar diameter) was performed using ImageJ computer software. For assessing nucleoli, 3861 nuclei were measured, and for nuclear findings, except for nucleoli, 4036 nuclei were measured in total. Results: (a) Compared with G1‐EEC, G3‐EEC and ESC presented a marked increase in all six parameters (nuclear enlargement, anisonucleosis, nuclear shade, nuclear shape, irregularity of nuclear arrangement, and nucleolar size). (b) EGBD‐SPSC presented a marked increase in two parameters (nuclear shade, nuclear shape) when compared with G1/G3‐EEC and ESC. (c) Compared with EGBD‐SPSC, EEC and ESC demonstrated a marked increase in nucleolar size (≥2.0 μm). (d) ESC presented a marked increase in nucleolar size (≥3.0 μm) when compared with G3‐EEC. Conclusions: Here we confirmed that atypical nuclear findings evaluated by image morphometry are as useful as microscopic evaluations in endometrial cytology. We believe that the objective evaluation of nucleolar size could contribute to an accurate diagnosis of endometrial‐LBC samples. This study investigates whether atypical nuclear findings in endometrial cytology are useful when determined by image morphometry in liquid‐based cytology. Image analysis was found to be as useful as microscopical evaluation and was particularly useful for objective evaluation of nucleolar size, contributing to accurate diagnosis. [ABSTRACT FROM AUTHOR]

Background: Liquid-based cytology (LBC) is now a widely used method for cytologic screening and cancer diagnosis. Since the cells are fixed with alcohol-based fixatives, and the specimens are stored in a liquid condition, LBC specimens are suitable for genetic analyses. Methods: Here, we established a small cancer gene panel, including 60 genes and 17 microsatellite markers for next-generation sequencing, and applied to residual LBC specimens obtained by endometrial cancer screening to compare with corresponding formalin-fixed paraffin-embedded (FFPE) tissues. Results: A total of 49 FFPE and LBC specimens (n = 24) were analyzed, revealing characteristic mutations for endometrial cancer, including PTEN, CTNNB1, PIK3CA, and PIK3R1 mutations. Eight cases had higher scores for both tumor mutation burden (TMB) and microsatellite instability (MSI), which agree with defective mismatch repair (MMR) protein expression. Paired endometrial LBC, and biopsied and/or resected FFPE tissues from 7 cases, presented almost identical mutations, TMB, and MSI profiles in all cases. Conclusion: These findings demonstrate that our ad hoc cancer gene panel enabled the detection of therapeutically actionable gene mutations in endometrial LBC and FFPE specimens. Endometrial cancer LBC specimens offer an alternative and affordable source of molecular testing materials. [ABSTRACT FROM AUTHOR]

This study was carried out on 10 infertile barren mares to evaluate the sensitivity, specificity, predictive values and agreement (kappa value) of cytological and microbiological findings of three diagnosing techniques of endometritis, viz., endometrial biopsy (EB), cytobrush (CB) and low volume uterine lavage (LVL) in relation to endometrial histology. When histological examinations from EB were used as "the best standard," the sensitivity of cytology from EB, CB and LVL technique was 0.33, 0.50 and 0.50; specificity 0.75, 1.00 and 0.75; positive predictive value 0.66, 1.00 and 0.75, and negative predictive value was 0.42, 0.57 and 0.50, respectively. The sensitivity of bacteriology from EB, CB and LVL technique was 0.83, 0.83 and 1.00; the specificity was 0.75, 0.75 and 0.50; positive predictive value 0.83, 0.83 and 0.75, and the negative predictive value was 0.75, 0.75 and 1.00, respectively. In all the cases, the sensitivity of the bacteriology was found to be higher than the sensitivity of cytology. When the results of cytological and bacteriological examinations were combined, no any increase in the sensitivity was found. Bacteriology and cytology from CB showed the highest positive predictive value demonstrating that a positive result is an accurate indication of endometritis. Sensitivity values were always higher if smears were evaluated according to PMNs to epithelial cell ratio, and the highest values were observed in specimens collected from CB and LVL. The evaluation of cytological smears based on counting PMNs in relation to epithelial cells was a better method for diagnosis of endometritis than counting the number of PMNs per high power microscopic field (k value 0.07-0.47 vs. 0.00). The agreement of the diagnosis of endometritis between the three techniques of the collection was from fair to poor and between the different criteria adopted to evaluate smears was always poor. However, the agreement of the diagnosis of endometritis by the microbial culture was moderate between the three techniques of the collection (k value 0.55-0.58). [ABSTRACT FROM AUTHOR]

Objective: Cases of pelvic high‐grade serous carcinoma (HGSC) with incidentally detected cancer cells (ICCs) in endometrial and/or cervicovaginal cytology have been reported. This study aimed to clarify the incidence and characteristics of pelvic HGSC with ICCs and to determine whether ICCs have a negative prognostic impact. Methods: Patients with ovarian/tubal/peritoneal HGSC who underwent pre‐treatment uterine (endometrial/cervicovaginal) cytology or biopsy between January 2007 and May 2017 were included. We reviewed the frequencies of ICCs and compared the clinicopathological features and survival outcome between the ICC‐positive and ICC‐negative groups. Results: Of the 160 patients evaluated, 69 (43.2%) had positive ICCs in at least one uterine specimen. There were no significant differences in clinicopathological characteristics, such as age, FIGO stage, serum CA125 level, ascites, and tubal lesion, between the two groups. Moreover, ICCs had no significant survival impact on progression‐free survival or overall survival. Conclusion: Our study showed a high rate of pelvic HGSC with ICCs in pre‐treatment uterine specimens. The ICCs per se had no negative impact on survival outcomes of pelvic HGSC. Furthermore, uterine biopsy and cytology can be useful and less‐invasive methods to obtain tubo‐ovarian/peritoneal cancer cells before treatment. Cancer cells in uterine specimens were detected in 43% of patients with pelvic high‐grade serous carcinoma and had no undesirable impact on survival outcomes. [ABSTRACT FROM AUTHOR]

The objective of this study was to diagnose sub-clinical endometritis (SCE) via endometrial cytology on day 42 after parturition and its impact on milk yield (305 days) of dairy cows (parity 2–4). Endometrial cytology was performed in 20 dairy cows, out of which 6 cows were found positive for sub-clinical endometritis. Mean number of polymorphonuclear cells was significantly higher in sub-clinical endometritis positive cows (22.00±4.77%) when compared to cows found negative for sub-clinical endometritis (2.58±0.76%). Sub–clinical endometritis positive cows had a significantly lower (P

Introduction: This study evaluated the immunocytochemical (ICC) expression of IMP3 in direct endometrial brushings processed as liquid‐based cytology (LBC) samples of endometrioid adenocarcinoma (EAC), serous carcinoma (ESC) and surface papillary syncytial change (SPSC) with endometrial glandular and stromal breakdown (EGBD) to exploit its possible differential diagnostic aid. Methods: In total, 333 samples of LBC samples were obtained from selected outpatients in parallel with Pipelle endometrial sampling. They consisted of 97 EAC (83 grade 1: EAC‐1, 14 EAC‐3), 35 ESC and 201 benign endometrial samples (51 proliferative, 42 secretory, 38 atrophic, 70 SPSC with EGBD). ICC expression of insulin‐like growth factor‐II mRNA‐binding protein 3 (IMP3) was manually performed on Papanicolaou‐stained LBC samples. Results: The ESC samples showed positive staining cells in 100%, EAC‐3 in 28.5%, and EAC‐1 in 2.4% cases. All the benign endometrium samples were negative. Only ESC cases showed strong immunoreactivity (≥3+) in more than 50% of tumour cells with an average frequency of 80%. Conclusions: IMP3 is a helpful immunomarker to distinguish ESC from EAC and SPSC in endometrial cytology. The distinction of high grade endometrial malignancies from functional endometrial atypias and benign endometrial alterations is crucial for appropriate clinical management. In the setting of cytological screening of endometrial carcinomas, IMP3 is a helpful immunomarker to aid separation of serous carcinoma from endometrioid carcinoma and surface papillary syncytial change. [ABSTRACT FROM AUTHOR]

Objective: We aimed to develop and reinforce a clinical management regimen for atypical endometrial cell (ATEC) categories within the descriptive reporting format for endometrial cytology. Methods: Between January 2013 and December 2014, 215 samples, for which histological examination was performed immediately or within 3 months after cytology, were cytologically diagnosed as ATEC. For these samples, the medical records were retrospectively reviewed to identify risk factors for malignancy. Results: Among 152 samples diagnosed as ATEC, of undetermined significance, 19 (12.5%) were malignant. In the younger group (age <55 years), the χ2 values of body mass index (BMI) ≥25 kg/m2 (5.85), gravidity (5.64) and parity (5.15) were relatively high, suggesting that these were risk factors for malignancy. Of the nulligravida patients, those with BMI ≥25 kg/m2, 28% were diagnosed with malignant disease. In the older group (≥55 years), endometrial thickening (6.84), atypical genital bleeding (6.43) and BMI ≥25 kg/m2 (3.79) were found to be risk factors for malignancy. Of the patients with endometrial thickening and atypical genital bleeding, 67% were diagnosed with malignant disease. Among 63 samples diagnosed as ATEC, cannot exclude atypical endometrial hyperplasia or more, 35 (55.6%) samples were positive for malignancy. Conclusions: High‐risk patients diagnosed with ATEC, of undetermined significance were identified. Endometrial biopsy should be considered for nulligravida patients aged <55 years with a BMI ≥25 kg/m2. This study aims to develop a clinical management regimen for atypical endometrial cell (ATEC) categories within the descriptive reporting format for endometrial cytology, as no study, to date, has investigated the involvement of ATEC‐US (ATEC with undetermined significance) or ATEC‐A (ATEC, , cannot exclude atypical endometrial hyperplasia or more) in malignancy. We retrospectively reviewed the medical records of patients with ATEC to determine risk factors for the malignancy. This study suggests that an endometrial biopsy should be considered for patients with ATEC with more than two risk factors. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the diagnostic accuracy of liquid-based endometrial cytology in postmenopausal women, in comparison with histology. Materials and methods: There were 790 postmenopausal women scheduled for hysteroscopy enrolled in this study. After providing informed consent, all patients proceeded sequentially through endometrial cytology, hysteroscopy, and then dilatation and curettage (D&C). Cytology sampling was performed by brushing the uterus cavity using SAP-1 and the sample was prepared to liquid-based smear using SurePath technology. The slides were stained by Papanicolaou method. All cytological diagnoses were correlated with the D&C histological diagnoses. Results: Cytohistological correlations were possible in 567 (71.8%) patients: the D&C was inadequate in 204 (25.8%) patients; the cytology was inadequate in 32 (4.1%) patients; and both were inadequate in 13 (1.6%) patients. SAP-1 provided more sufficient material for cytology than D&C can for histology (p

Since in the mare and other animal species such as bitches and cats, the endometrial cell pattern varies depending on the phase of the estrous cycle, the aim of this study was to describe and quantify the endometrial cytological (EC) findings in cycling jennies. EC of eight nonpregnant jennies by cytobrush (CB) at diestrus (day 1 and day 14) and estrous (day 21) were evaluated. All slides were stained with Wright´s stain and microscopically examined at both 400× and 1000× magnification. Seven high-power fields (400×) were assessed in each smear and the endometrial epithelial cells and neutrophils (PMNs) were counted. Endometrial epithelial cells were classified as intact, distorted or fragmented and, on the basis of the presence of dense groups, in monolayer or single clusters. Cytoplasmic characteristics, such as vacuolation or streaming and size, form, position of nuclear characteristics, including karyorrhexis, were recorded. Background aspect, as clear, proteinaceous, or debris, was also considered. In general, sampling by CB provided a yield of cells and clumped endometrial epithelial cells in many smears, being more abundant in estrus than early and late diestrus. Individual endometrial epithelial cells, during estrous, presented a columnar morphology, ciliated or not ciliated and basal nuclei. During diestrus phase, endometrial epithelial cells presented a more cuboidal ciliated or not ciliated morphology. Moderate amount of proteinacious material and red blood cells (RBC) was also observed. Non variation in the percentage of PMNs during diestrus was obtained, but lower and segmented PMNs in CB smears were shown in estrous. This study provides new insights on the physiological changes of endometrial epithelial cells in cycling jennies during the estrus cycle. The CB technique represents a suitable and adequate method for endometrial evaluation, taking into account cytological and/or cytopathological purposes also in jennies.

Context: Endometrial aspiration is not a popular modality for the study of the endometrium despite its simplicity and potential utility. Aim: The present study was aimed at evaluating the utility of endometrial aspiration in various gynecological disorders. Materials and Methods: In this diagnostic accuracy study, 55 prospectively registered women with various gynecological disorders were evaluated clinically and subjected to endometrial aspiration cytology and study of endometrial histology. Endometrial aspiration was performed by infant feeding tube in 10 cases and intra cath cannula in 45 cases. The slides were stained with rapid Papanicolaou (PAP) stain and Leishman stain. Results: Endometrial aspiration cytology showed 90% and 94.6% sampling adequacy with infant feeding tube and intra cath cannula, respectively. Intra cath cannula was very convenient to handle and superior to infant feeding tube in aspirating the endometrium. Of the two stains used, rapid PAP stain was less time-consuming and superior to Leishman stain in studying the nuclear details. Leishman stain was helpful in detecting cytoplasmic vacuoles of secretory endometrium. Overall diagnostic accuracy of endometrial cytology was 90.4% while that for morphological hormonal evaluation was 97.6%. It enjoyed a sensitivity of 91.66%, a specificity of 88.23%, positive predictive value of 94.28%, and negative predictive value of 83.33%. Conclusion: Intra cath cannula emerged as an inexpensive, effective, and convenient device for endometrial aspiration. Endometrial aspiration proved to be a fairly effective, simple, and informative diagnostic modality.

Highlights • Bayesian estimates of test accuracy for diagnosing reproductive tract disease in dairy cows. • Vaginal discharge score (≥ mucus with flecks of pus) had the highest sensitivity and specificity. • Leukocyte esterase (≥ moderate amount of leukocytes) had similar accuracy than endometrial cytology (≥ 6% neutrophils). • Mean within-herd prevalence of reproductive tract disease was estimated at 47.9%. Abstract The objectives of this retrospective study were: 1) to determine the sensitivity (Se) and specificity (Sp) of leukocyte esterase test (LE), endometrial cytology (CYTO) and vaginal discharge score (VDS) for diagnosis of reproductive tract diseases in dairy cows at the moment of sampling; 2) to assess the impact of different thresholds on test accuracy and misclassification costs; and 3) to quantify herd prevalence of reproductive tract diseases in dairy farms from Québec, Canada. Data from 2092 cows (39 herds) enrolled in two randomized control trials were included. Cows were examined at 35 (± 7) days in milk using LE, CYTO, and VDS to determine their reproductive tract health status. A latent class model assuming conditional dependence of CYTO and LE was fit within a Bayesian framework. Non-informative priors were used for the Se and Sp of LE, CYTO, and VDS, while prior information for disease prevalence was obtained from expert opinions (mode = 20%, 5th percentile = 10%). Posterior inferences (median and 95% Bayesian credible intervals; BCI) were obtained using the WinBUGS statistical freeware. An initial model was built using thresholds of ≥ 1 (small amount of leukocytes), of ≥ 6%, and of ≥ 3 (mucopurulent discharge) for the LE, CYTO, and VDS, respectively. Then, the impact on tests accuracy and misclassification costs of using different thresholds was explored. Optimal thresholds balancing the need for good antimicrobial stewardship and animal health considerations were proposed. The optimal thresholds obtained in the final model were: LE ≥ 2 (moderate amount of leukocytes), CYTO ≥ 6%, and VDS ≥ 2 (mucus with flecks of pus). In the final model, median (95% BCI) Se for LE, CYTO and VDS were 42.6% (38.8–47.0), 45.9% (41.9–50.7), and 64.2% (59.1–70.3), respectively. Median Sp was 90.9% (88.0–93.6) for LE, 92.2% (89.2–94.9) for CYTO and 96.6% (91.3–99.8) for VDS. Median within-herd prevalence of reproductive tract disease was estimated at 47.9% (39.0–56.7). At a threshold ≥ 2 (mucus with flecks of pus), VDS had the highest Se and Sp among the tests evaluated. The LE is an interesting diagnostic alternative for detecting reproductive tract disease in dairy cows. At a threshold ≥ 2 (moderate amount of leukocytes), LE Se and Sp were comparable to those of CYTO. This is the first study reporting the accuracy of LE, CYTO, and VDS for diagnosing reproductive tract diseases in dairy cows at the moment of sampling. [ABSTRACT FROM AUTHOR]

Although liquid‐based cytology (LBC) has increased the sensitivity of cytological diagnosis of endometrial cancer (EC) compared with conventional smear cytology, the sensitivity of LBC for the detection of EC is between 70% and 96% and remains unsatisfactory. In the present study, we compared the efficacy of LBC with liquid‐based genetic diagnosis (LBGDx) by amplicon sequencing of five genes including PTEN,PIK3CA,CTNNB1,KRAS, and TP53 in 48 LBC subjects who underwent endometrial screening. Consequently, LBC classified 15 samples as "positive or suspicious for malignancy" and the 15 were later confirmed as EC. However, LBC failed to identify five cases who were diagnosed as EC by additional transvaginal ultrasound and endometrial curettage, indicating that the sensitivity of cytology alone was 75% (15/20). LBGDx identified 11 pathogenic PTEN variants in 10 subjects, six PIK3CA variants in nine, three CTNNB1 variants in five, two KRAS variants in four, and three TP53 variants in three. Collectively, at least one pathogenic variant was identified in 19 subjects, which included 17 EC (15 endometrioid carcinoma and 2 endometrial carcinosarcomas), and one cervical adenocarcinoma. However, LBGDx did not identify any pathogenic mutations in three of the 20 EC, indicating that the sensitivity of LBGDx alone was 85% (17/20). Although five EC were negative for malignancy by LBC and three were negative for pathogenic mutations by LBGDx, the combination of LBC and LBGDx would successfully diagnose all 20 EC. These data suggested that LBGDx is a useful strategy to improve the sensitivity of screening of EC by LBC. We have shown that liquid‐based genetic diagnosis should be a useful strategy to improve the diagnostic sensitivity and specificity of endometrial screening. [ABSTRACT FROM AUTHOR]

A limited number of cow-side diagnostic techniques exist for the diagnosis of subclinical endometritis (SCE) in dairy cattle. The objectives of this study were to compare results of endometrial cytology from samples collected by cytobrush (CB) and low-volume lavage (LVL) and to assess leukocyte esterase (LE) test strips and Brix refractometry as surrogate cow-side tests for SCE. Two samples were consecutively collected from 248 Holstein cows between 29 and 35 days postpartum, using CB and LVL techniques. Each sample was analyzed using cytology with a cut-point of ≥5% polymorphonuclear (PMN) cells, LE strips using cut-points of ≥1 and ≥ 2, and a Brix refractometer. Each diagnostic technique was compared intra-sample using the respective cytology as a gold standard and inter-sample using CB samples as the referent. The concordance correlation coefficient (CCC, ρ c ) for PMN% between CB and LVL was ρ c  = 0.59 [95% confidence interval (CI): 0.50 to 0.67] and the Kappa (κ) for agreement was κ = 0.35 [sensitivity (Se) = 0.88, specificity (Sp) = 0.45]. The optimal cut-point of LE ≥ 2 resulted in moderate agreement between CB and LVL samples, κ = 0.56 (Se = 0.89, Sp = 0.65). Agreement between LE and cytology using CB (κ = 0.49; Se = 0.89, Sp = 0.57) and LVL (κ = 0.44; Se = 0.77, Sp = 0.67) were similar. The correlation between Brix values from CB and LVL was ρ c  = 0.12 (CI -0.01 to 0.26). The correlation between CB cytology and Brix was ρ c  = 0.33 (CI 0.20 to 0.45) but ρ c  = −0.07 (CI -0.21 to 0.06) between LVL cytology and Brix. While LE strips with a cut-point of LE ≥ 2 had moderate agreement with cytology, Brix refractometry had poor performance for the diagnosis of SCE. Samples taken by CB and LVL produced comparable cow-side diagnostic results and either is a viable method for the diagnosis of SCE. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the diagnostic efficacy and utility of liquid-based cytology in ThinPrep (Cytyc Corporation, Boxborough, MA) for endometrial lesions in patients presenting with abnormal uterine bleeding.Materials and Methods: Two hundred and thirteen women scheduled for dilatation and curettage because of abnormal uterine bleeding were enrolled in the study. After providing informed consent, all the women proceeded sequentially to endometrial cytology and then dilatation and curettage.Results: In the premenopausal group, cytological failure was 4.8%, histopathological failure was 2.4%; cytologic insufficiency in the postmenopausal group was 2.1%, and histopathologic insufficiency was 19.6%. When cytologic and histopathological sufficiency rates were compared in all cases, cytologic insufficiency was 4.2% and histopathologic insufficiency was 6.1%. This difference was statistically significant (p < 0.039). The diagnostic accuracy, sensitivity, specificity, PPV, and NPV of the liquid-based endometrial cytology for premenopausal patients were 96.79, 58.33, 97.92, 70, and 96.58%, respectively. In the postmenopausal cases, the accuracy of diagnosis of endometrial cytology was 97.30%, sensitivity 100%, specificity 96.67%, PPV 87.50%, and NPV 100%. When cytologic and histopathologically inadequate cases were excluded, no cytologic and histopathological abnormal findings were found in endometrial thickness cutoff ≤ 5 mm for all patients.Conclusion: The use of liquid-based cytology with TVS may contribute to increasing the diagnostic accuracy of the test and reduce unnecessary D&C for women. When TVS is used as a triage indicator, regardless of menopausal status in ≤ 5 mm endometrial thickness cases, endometrial cytology is an absolutely reliable method for detecting cancer. [ABSTRACT FROM AUTHOR]

The present study was conducted on repeat breeder (RB, n=40) crossbred cows under field conditions to evaluate their endometrial cytology and cervico-vaginal mucus (CVM) characteristics in relation to post-treatment fertility. The endometrial cytology was obtained using cytobrush technique and CVM by aspiration technique from vaginal fornix using sterile pipette and syringe. The cows yielding bacterial growth in CVM were treated with sensitive antibiotics (i/m) for 3-5 days (Gr I, RBT: 28) and cows not yielding bacterial growth (control, Gr II, RBC: 12) were given 10 ml of normal saline (i/m). The cows were inseminated at subsequent estrus and followed for repeating to estrus and/or pregnancy. The subclinical endometritis was diagnosed using endometrial cytology (PMN%: ≥ 4%) in cows yielding bacterial isolates (n=28) with mean PMN% of 21.80±8.39, 32.18±3.26 and 29.25±6.63 for those having clear stringy consistency, turbid viscous, and watery white flaky CVM, respectively. The mean PMN% in RB cows with no bacterial isolates (n=12) and having clear stringy CVM was 1.50±0.23. The mean values of spinnbarkeit (cm), pH and Whiteside test scores of CVM were 14.60±0.51, 5.82±0.85 and 3.00±0.17; 7.41±0.15, 7.44±0.21 and 7.08±0.19; and 1.40±0.60, 1.91±0.28, and 1.75±0.25, respectively, for culturally positive cows having CVM of clear stringy, turbid viscous and watery with white flakes, respectively (Group I). The mean spinnbarkeit (cm), pH and Whiteside test scores in control cows not yielding any bacterial isolates and having clear stringy CVM (Group II) were 13.08±0.99, 7.37±0.10 and 0.33±0.19. The RB cows with clear stringy, turbid viscous and white flaky CVM and yielding bacterial isolates had mean inter-estrus intervals of 18.80 ±0.51, 15.91±0.48 and 13.83±0.41 days, respectively, the differences being significant (P<0.05), with respective post-treatment pregnancy rates of 80.00, 63.63 and 41.66 %, with an overall pregnancy rate of 57.15%. This interval was 19.42±0.45 days in RB control cows, wherein the pregnancy rate was 66.66% without any treatment. The cytobrush technique (PMN%) for endometrial cytology and Whiteside test of CVM were good tools for ruling out the subclinical genital infections in repeat breeding cows. [ABSTRACT FROM AUTHOR]

Present work was planned to predict the fertility in relation to frequency of neutrophils in cytological smears from genital secretions in crossbred cows. A total of 100 crossbred cows including 73 apparently healthy normal parous cows in group I and 27 repeaters in group II were utilized. The discharges from cervix and fornix vagina at standing estrus were aspirated from every cow and processed for cytological studies. In the present work, in both groups no animal conceived with neutrophils threshold ≥5% in cytological smears from cervix. It was concluded that cut off point of ≥5% could be considered to predict its implications on fertility and to define subclinical endometritis in cows. [ABSTRACT FROM AUTHOR]

Background: Cytology of the endometrium is an underused technique in diagnostic pathology. It has been used in the past for endometrial hyperplasia and carcinoma. Only few studies have used cytology in the diagnosis of dysfunctional uterine bleeding (DUB). Endometrial imprint cytology has been rarely used except for application of immunocytochemistry in diagnosis of endometrial carcinoma. Aim: The present study was conducted to evaluate whether it is possible to assign histopathology-like diagnosis by imprint cytology and also to evaluate its usefulness in the assessment of patients of dysfunctional uterine bleeding of low clinical suspicion. Materials and Methods: Imprint smears were made from 93 curettage materials during a study of DUB. Blinded analysis of imprint smears was performed by using McKenzie′s criteria and some criteria devised for the requirements of this study. Results of cytology were correlated with histopathology. Statistical analysis was carried out by GraphpadInStat Demo. Results: Majority of the patterns classifiable in histopathology could also be classified in this study on imprint cytology. The overall sensitivity and specificity of cytology in the detection of endometrial patterns in DUB patients were 91.23% and 83.87%, respectively, although the sensitivities and specificities differ according to the phase of endometrium. Conclusion: Histopathology-like categories can be assigned on imprint smears in the diagnosis of DUB. Endometrial imprint cytology can be helpful in centers where histopathology laboratories are not available and even in well-established institutes. It is possible to improve the sensitivity and specificity with better imprinting techniques.