Diagnostic value of liquid-based cytology and smear cytology in pancreatic endoscopic ultrasound-guided fine needle aspiration: A meta-analysis

BACKGROUND Smear cytology(SC)using endoscopic ultrasound-guided fine needle aspiration(EUS-FNA)is the established and traditional choice for diagnosing pancreatic lesions.Liquid-based cytology(LBC)is a novel alternative cytological method,however,the comparative diagnostic efficacy of LBC remains inconclusive.AIM To examine the diagnostic efficacy of LBC and SC for pancreatic specimens obtained through EUS-FNA via a systematic review and meta-analysis.METHODS A systematic literature search was performed using PubMed,EMBASE,the Cochrane Library,and Web of Science.The numbers of true positives,false positives,true negatives,and false negatives for each cytological test(LBC and CS)were extracted from the included studies.The pooled sensitivity and specificity and the area under the summary receiver operating characteristic curve(AUC)were calculated,and the AUC was compared by Tukey's multiple comparisons test.The quality of the included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies II tool.RESULTS A total of 1656 patients in eight studies were included.The pooled sensitivity and specificity and the AUC for LBC were 0.76(95%CI:0.72-0.79),1.00(95%CI:0.98-1.00),and 0.9174,respectively,for diagnosing pancreatic lesions.The pooled estimates for SC were as follows:Sensitivity,0.68(95%CI:0.64-0.71);specificity,0.99(95%CI:0.96-100.00);and AUC,0.9714.Similarly,the corresponding values for LBC combined with SC were 0.87(95%CI:0.84-0.90),0.99(95%CI:0.96-1.00),and 0.9894.Tukey’s multiple comparisons test was used to compare the sensitivities and AUCs of the three diagnostic methods;statistically significant differences were found between the three methods,and LBC combined with SC was superior to both LBC(P<0.05)and SC(P<0.05).The pooled sensitivity and AUC did not change significantly in the sensitivity analysis.CONCLUSION LBC may be sensitive than SC in the cytological diagnosis of pancreatic lesions,however,the superior diagnostic performance of their combination emphasizes their integrated usage in the clinical evaluation of pancreatic lesions.

Comparison of smear cytology with liquid-based cytology in pancreatic lesions: A systematic review and meta-analysis

BACKGROUND Endoscopic ultrasonography-guided fine-needle aspiration(EUS-FNA)is a safe and accurate technique to confirm the diagnosis of pancreatic cancers.Recently,numerous studies comparing the diagnostic efficacy of smear cytology(SC)and liquid-based cytology(LBC)for pancreatic lesions yielded mixed results.AIM To compare and identify the better cytology method for EUS-FNA in pancreatic lesions.METHODS A comprehensive search of PubMed,Embase,and Cochrane was undertaken through July 18,2020.The primary endpoint was diagnostic accuracy(sensitivity and specificity).Secondary outcomes included sample adequacy and post procedure complications.In addition,factors affecting diagnostic efficacy were discussed.RESULTS Data on a total of 1121 comparisons from 10 studies met the inclusion criteria.Pooled rates of sensitivity for SC and LBC were 78%(67%-87%)vs 75%(67%-81%),respectively.In any case,both SC and LBC exhibited a high specificity close to 100%.Inadequate samples more often appeared in LBC compared with SC.However,the LBC samples exhibited a better visual field than SC.Very few post procedure complications were observed.CONCLUSION Our data suggested that for EUS-FNA in pancreatic lesions(particularly solid lesions),SC with Rapid On-Site Evaluation represents a superior diagnostic technique.If Rapid On-Site Evaluation is unavailable,LBC may replace smears.The diagnostic accuracy of LBC depends on different LBC techniques.

Comparative Study of Cell Findings by Conventional Smear and Liquid-Based Cytology for Oral Exfoliative Cytology

Background: Liquid-based cytology (LBC) is a method of manufacturing cyto-diagnostic specimens. Improved accuracy is expected from standardizing specimen production and use of this method is rapidly spreading in oral cytology. On the other hand, LBC reportedly requires training to show peculiar cell findings compared to those of conventional smear cytology (CVC). Few studies have compared detailed cell findings for oral CVC and LBC. Objectives: The aim of this study was to compare cytological findings between CVC and LBC using cytomorphological image analysis. Materials and Methods: Cytological specimens were collected from 20 patients (negative for squamous neoplasia in 10, dysplasia in 5, squamous cell carcinoma in 5) and 5 controls of the tongue between January 2017 and December 2018. Two different preparation techniques were investigated cytomorphologically for CVC and LBC (BD CytorichTM). Results: LBC showed significantly higher cell numbers than CVC for all lesions. LBC-to-CVC ratio ranged from 9.52 (hyperkeratosis) to 1.87 (deep cells in oral squamous cell carcinoma (OSCC)). Nuclear area of normal, hyperkeratosis, and inflammation were significantly higher in LBC than those of CVC. Hyperchromasia was significantly more frequent with CVC than with LBC for hyperkeratosis, inflammation, dysplasia and OSCC. There was no significant difference in circularity between CVC and LBC among all lesions. Conclusion: Only one cytomorphological disadvantage was seen with LBC, in the form of decreased hyperchromasia. Further clarification of the advantages and disadvantages of LBC is needed, including management of precision and screening practices.

Vaginal Intraepithelial Neoplasia Detected with Cervical Liquid-Based Cytology: Old Concerns or New Facilities?

Background: The detection of vaginal intraepithelial neoplasia (VAIN) in cervical samples is not a common finding. Therefore, we aimed to report VAINs detected in liquid-based cytology (LBC) from women examined at Hospital das Clínicas of Faculty of Medicine, Sao Paulo State University. Materials and Methods: We evaluated LBC samples from women referred to gynecology examination for different reasons (previous abnormal PapTest, follow up of treated cervical lesion, ecc) and women examined for regular screening proposals, and compared with biopsy diagnoses, including the controversial diagnoses of vaginal intraepithelial neoplasia (VAIN). Results: From 1866 patients, 1423 (76.3%) cases were negative and 443 (23.7%) were positive for any cellular alteration. Age of patients ranged from 12 to 86 years. We detected 25 histologically confirmed VAIN (1.3% p = 0.0002 by Fisher’s exact test IC 95% 0.0090 - 0.0198) and 1.1% VAIN (p = 0.0031 by Fisher’s exact test IC 95% 0.0077 - 0.0179). Conclusion: The identification of VAIN in routine is feasible;the professionals involved with cytological examination should be aware of these lesions in Pap test samples.

Research of cervical cytology screening in diagnosis of 370,000 cases with cervical lesion in Guangdong

Objective： Analysis of the results of 37 million cases by using cervical liquid-based cytology screening, discussion the situation of cervical cancer and precancerous lesions in Guangdong province. Methods： From 2002 to 2006, using liquid-based thin-layer cytology （TCT） method screening cervical lesions within 371,929 women in Guangdong. Cytological diagnosis adopt TBS （the Bethesda system） Standard （TBS improved 2001 version of the diagnostic criteria）, statistic positive rate by age and region respectively. Results： 371,929 cases of gynecology cervical samples in Guangdong, 331,251 cases were negative, accounted for 91.23%; cytology positive cases： 32,548 cases were squamous intraepithelial lesions （8.96%）, 486 cases were glandular epithelial lesions （0.13%）; grouped according to age： 30 to 40-year-old positive rate was 9.13%, 40 to 50-year-old positive rate was 9.60%, the latter had higher cytology positive rate; grouped according to region： the total samples in PRD areas were 304.951 cases, accounted for 81.99%, in which 24301 cases were positive （8.14%）, in 66978 cases （18.01%） of NON-PRD regions, 7645 cases were positive （11.87%）, there were 1858 cases had biopsy/follow-up results from 2004 to 2005, and the rate was 2.88%. Conclusion： The cytological positive rate of cervical cancer and its precancerous lesions was 9.09% in Guangdong （of which the rate of cytological diagnosis as precancerous lesions was 3.40%）, 30 to 50 age group had the high incidence of cervical cancer and its precursor lesions, and also the main stage of prevention for cervical cancer. Cytology positive rate was 11.87% in economic underdevelopment Non-Pearl River Delta regions, much higher than the Pearl River Delta region.

Effectiveness of Co-Testing in Cervical Cancer Screening Program in Macao SAR

Background: Cervical cancer remains a significant public health concern in Macao SAR despite the implementation of a cervical cancer screening program and HPV vaccination. To improve early detection, Macao SAR introduced HPV DNA testing alongside cytology (co-testing) as the primary screening method in 2019. This study evaluates the effectiveness of co-testing in identifying cervical precancerous lesions (CIN2+) compared to cytology alone. Methods: We conducted a retrospective analysis of women aged 30 - 65 years who participated in the routine cervical cancer screening program in Macao SAR Primary Healthcare Centers from 2019 to 2022. Data from over 70,000 women were analyzed, comparing the detection rates of CIN2+ through co-testing and cytology alone. Women with abnormal cytology or positive HPV results were referred for colposcopy. Results: The introduction of co-testing led to a significant increase in the detection of CIN2+, particularly in women with atypical squamous cells of undetermined significance (ASCUS) or negative for intraepithelial lesion or malignancy (NILM) cytology results. Between 2019 and 2022, the percentage of women with ASCUS/NILM and any high-risk HPV (hrHPV) positive who were diagnosed with CIN2+ after colposcopy were 24%, 13%, 10% and 7.5% respectively. This highlights the ability of co-testing to identify high-risk individuals who would have been missed by cytology alone. Discussion: Our findings demonstrate the effectiveness of co-testing in improving the sensitivity of cervical cancer screening in Macao SAR. The inclusion of HPV DNA testing allows for better risk stratification of women with ASCUS/NILM cytology, leading to more targeted referrals for colposcopy and timely detection of precancerous lesions. The initial high positive rate in 2019 (24%) might be attributed to the small sample size and potentially reflects a backlog of undiagnosed cases prior to co-testing implementation. Conclusion: The implementation of co-testing in Macao SAR’s cervical cancer screening program significantly improves the early detection of precancerous lesions, particularly in women with ambiguous cytology results. This proactive approach contributes to reducing cervical cancer morbidity and mortality and improving women’s health outcomes in Macao SAR.

Study on the Correlation between Human Papillomavirus and Mycoplasma genitalium Combined with TCT Detection

Objective: This study aims to explore the correlation between human papillomavirus (HPV) and Mycoplasma genitalium (CT) combined with TCT detection in cervical cancer screening. Method: A cross-sectional study design was adopted, and a total of 609 women who came to seek medical treatment were recruited as the study subjects. Combination testing was evaluated on cervical cancer screening by testing the women for HPV, CT with TCT detection and analyzing the relationship of cervical lesions with HPV and CT infection. Results: The study results showed that 21.57% of the subjects were infected with both HPV and CT, and 48.42% of the cases had abnormal TCT results at the same time. Further data analysis showed that HPV infection was significantly associated with abnormal TCT outcomes (p < 0.05), suggesting a possible synergistic effect of the two infections in cervical lesions. The combined sensitivity and specificity of HPV, CT and TCT detection were 21.57% and 48.42%, respectively, which were significantly higher than that of single detection. Conclusion: In summary, the results of this study support the importance of combined HPV, CT, and TCT testing in cervical cancer screening, and propose the hypothesis that combined testing may improve screening effectiveness. However, further large sample studies are needed to confirm this conclusion and explore the prospects of combined testing in clinical practice.

Case Report:Liquid-based cytology aids in primary fallopian tube cancer diagnosis

Primary fallopian tube carcinoma(PFTC) is a rare malignant carcinoma among all genital tract malignancies.It occurs most commonly in postmenopausal women and is similar to ovarian malignancy historically and clinically.Because of its insidious onset and silent course,the diagnosis is made usually postoperatively.Liquid-based cytology(LBC) is a type of method for cervical cancer screening,but sometimes it may aid in making PFTC diagnosis.We report a 47-year-old woman with PFTC,whose diagnosis was made with the aid of LBC.

肺泡灌洗液液基薄层细胞学制片技术对肺癌的诊断价值

目的探讨肺泡灌洗液传统细胞学与液基薄层细胞学(liquid-based thin-preparation cytologic test,LCT)制片技术对肺癌的诊断价值。方法收集2020年1月至2022年8月厦门大学附属第一医院收治的肺癌患者106例,采用两种方法对其肺泡灌洗液进行细胞学制片,比较传统细胞学与LCT制片技术在阳性检出率、制片质量及阅片时间方面的差异。结果肺泡灌洗液LCT制片技术的阳性检出率为98.1%,高于传统方法的91.5%;LCT制作的涂片厚薄适当,分布均匀,细胞结构清晰,核质对比分明,无人工假象,封固适当,优于传统涂片;肺泡灌洗液LCT涂片的制片质量得分为9.06±0.06分,显著高于传统涂片的7.11±0.09分;肺泡灌洗液LCT涂片的阅片时间为27.15±0.42 s,显著短于传统涂片的92.27±1.06 s。结论肺泡灌洗液LCT制片技术相较于传统涂片技术在诊断肺癌方面具有更高的应用价值。

北京市宫颈癌筛查宫颈细胞学机构事前质控评估方法及结果分析

目的探索建立宫颈癌筛查宫颈细胞学机构事前质控评估方法 ,并用该方法对参与北京市宫颈癌免费筛查的宫颈细胞学检查机构进行事前质控评估,掌握机构服务现况及存在问题,筛选出宫颈细胞学产品、制片、阅片质量良好的机构,参与北京市宫颈癌免费筛查,提高筛查质量。方法采用资料审核、现场评价两种方法对影响细胞学检查质量的机构资质、硬件条件、制度、保存液质量、制片操作流程、人员能力等进行综合评价,筛选出宫颈细胞学产品、制片、阅片质量良好的机构。结果 16家机构参与了事前质控。通过专家组统一对资料进行审核剔除资料不全、字迹模糊、无相关资质、不符合技术要求的机构,最终6家机构5种产品进人现场评价阶段。保存液质量评估发现1家机构的产品不合格;2家机构的保存液取材后应在1周内尽快制片;2家机构的保存液可以4周内完成制片。现场评价基本具备承担筛查的硬件条件,但细胞学检查机构制度不健全,5家机构制订了质控方案,5家机构未对可疑病例进行追访;检查机构间人员的阅片能力有差异,人员阅片考核的平均分为64.6分;细胞学检查机构阅片质量复核符合率为95%,制片的操作流程欠规范。结论通过事前质控评估方法 ,筛选出了合格的细胞学检査机构及产品,要求各区从评估合格的机构中择优选择承担本区宫颈癌免费筛查中宫颈细胞学检测工作。同时通过评估发现宫颈细胞学检查机构管理及操作欠规范,阅片人员的技能需加强。下一步将针对存在问题,组织统一培训,规范服务流程,加强对筛选合格机构的日常监管和内部质控,不断提高筛查质量和技术水平。

银杏叶注射液对牛视网膜毛细血管周细胞的保护作用

目的:研究糖基化终产物(AGEs)和银杏叶注射液对体外培养的牛视网膜毛细血管周细胞增殖、细胞周期和转化生长因子β(TGF- β)表达的影响,观察银杏叶注射液对周细胞的保护作用。方法:应用MTT比色分析法、流式细胞术及免疫荧光检测等方法进行分析。结果:银杏叶注射液能促进AGEs作用下周细胞的增殖,浓度12 5～4 0 0 mg·L- 1 的银杏叶能明显促进AGEs作用下周细胞的增殖(P<0 .0 1) ,呈剂量依赖性。银杏叶注射液能明显抑制AGEs对周细胞细胞周期的影响及其促进凋亡的作用,使周细胞S期细胞减少,G2 - M期细胞增多,凋亡细胞数下降(P<0 .0 1) ,并能降低AGEs诱导周细胞TGF- β的表达。结论:AGEs可通过氧化应激对视网膜微血管周细胞产生损伤,应用抗氧化剂银杏叶注射液可以减少AGEs对周细胞的毒性作用。

晚期糖基化终产物对心肌细胞细胞周期和凋亡的影响

目的探讨晚期糖基化终产物(advanced glycation end products,AGEs)对体外培养乳鼠心肌细胞细胞周期及凋亡的影响.方法体外培养3～5 d的乳鼠心肌细胞,用含1%或10%胎牛血清的DMEM培养基中继续培养24 h,应用流式细胞仪和原位末端标记技术观察不同浓度AGEs(50、100μg/ml)对心肌细胞刺激12、24、48 h后细胞周期分布、凋亡率及凋亡小体/凋亡细胞核分布的影响.结果AGEs对心肌细胞细胞周期分布无明显影响;在正常培养液培养时,心肌细胞的凋亡随着培养时间延长而增加,24、48 h与12h相比,凋亡小体/凋亡细胞核分别增加了0.55、1.23倍;AGEs可以明显增加心肌细胞的凋亡程度,并随着刺激时间、刺激浓度的增加而增加,50、100μg/ml AGEs组与对照组相比,凋亡小体/凋亡细胞核12、24、48 h分别增加了0.74和1.21、1.15和1.78、0.83和1.19倍.结论AGEs对心肌细胞细胞周期分布无影响,但可以通过增加心肌细胞凋亡率对心肌细胞造成损伤.

根尖分生组织细胞核大小：一个可能用于植物入侵性评估的新指标(英文)

植物的入侵性与DNA C-值之间存在统计学上的负相关关系。在这种关系中,细胞和细胞核大小可能起关键作用,因此我们推测分生组织细胞核大小在评估植物或至少某些分类群的入侵性方面有潜在的应用价值。本研究以豌豆属(Vicia)5种入侵能力不同的植物为材料,观察了它们的分生组织染色体、细胞核和细胞大小以及有丝分裂速率,同时测定了种子产量、单位种子干重产生的幼苗生物量(近似于幼苗相对生长速率)和生活史的长短。结果显示根尖分生区细胞核较小的植物细胞较小,细胞分裂速率快,单位种子干重产生的幼苗生物量高,种子小而数量多,生活史短。这些结果表明5种豌豆属植物中分生组织细胞核较小的倾向于具有较高的入侵性,其原因主要是:(1)能够产生小而多的种子;(2)具有较高的有丝分裂速率、相对较快的幼苗生长速率和短的生活史。分生组织细胞核大小影响植物入侵性与DNA C-值的作用是一致的,在植物入侵性评估模型中,分生组织细胞核大小在评估植物入侵性方面可能具有潜在的应用价值,而且其测定方便、费用低廉。但是,这一指标的应用范围和条件需要进一步筛选。

植物中药材微量样品库的建库方法学研究

目的 从中药材中筛选具有开发潜力的有效成分并阐明中药作用机制。方法 参照国际植物样品库的建库方法 ,根据中药材的种属和药用部位不同 ,比较乙醇提取效率的影响因素 ,建立适合于植物中药材微量样品库的制备方法。结果 醇提和两步拆分法建立的样品库具有疾病特异性和微量特点 ,并初步成功地筛选到多个utrophin刺激剂。结论 本研究根据中医临床用药理论 ,建立的以单一疾病为基础的小样品微量样品库 ,适用于一般实验室对单一疾病的药物研究。

双苯氟嗪抗大鼠全脑缺血再灌注所致海马CA1区神经元凋亡

目的 研究L 型钙通道拮抗剂双苯氟嗪在大鼠全脑缺血再灌注后海马CA1区神经元中的抗凋亡作用及与CD95 (Fas)分子启动的死亡信号转导通路之间的关系。方法 四血管阻断法制备全脑缺血再灌注损伤模型 (缺血 15min ,再灌注 3d) ,双苯氟嗪 (2 0 ,4 0和 80mg·kg-1)每日灌胃给药 1次。激光扫描共聚焦显微镜 (Confocal)和HE染色观察海马CA1区神经元细胞形态学改变 ,流式细胞仪 (FCM)分析海马DNA含量变化 ;Western blotting和RT PCR方法检测CD95 (Fas)分子启动的死亡信号转导通路相关蛋白Fas,FasL和Caspase3蛋白及mRNA表达变化。结果 全脑缺血再灌注后海马CA1区神经元呈现典型凋亡细胞形态学改变 ,凋亡细胞百分率明显上升 (P <0 0 1)。双苯氟嗪明显改善海马CA1区神经元形态 ,显著降低凋亡细胞百分率 (P<0 0 1)。Westernblotting及RT PCR结果显示 ,双苯氟嗪显著降低CD95 (Fas)分子相关蛋白Fas、FasL和Caspase3在蛋白及核酸水平的表达。结论 双苯氟嗪对缺血性脑损伤的保护作用可能通过抑制CD95 (Fas)分子启动的死亡信号转导通路 ,从而发挥其抗脑缺血再灌注损伤作用。

氨基胍抑制丙酮醛介导的脑微血管内皮细胞缺糖缺氧损伤

目的:研究氨基胍对丙酮醛加重脑微血管内皮细胞(HBMEC)缺糖缺氧损伤的保护作用。方法:在培养的HBMEC上,利用丙酮醛加重缺糖缺氧诱导的损伤,通过MTT检测细胞活力,LDH释放检测细胞死亡,流式细胞仪检测细胞凋亡,Western-blot检测晚期糖基化终产物的形成,观察氨基胍的作用和机制。结果:丙酮醛呈浓度依赖地诱导细胞损伤,在2 mmol/L时细胞的存活率为56.1%,而丙酮醛合并缺糖缺氧后,细胞的损伤率增加到90.0%。氨基胍(1 mmol/L)能抑制丙酮醛和缺糖缺氧诱导的LDH释放和AnnexinV/PI的形成。进一步研究发现氨基胍能抑制丙酮醛和缺糖缺氧诱导晚期糖基化终产物的形成。结论:氨基胍对丙酮醛加重HBMEC的缺糖缺氧损伤具有保护作用,这可能与其抗糖基化作用有关。

宫颈细胞学传统制片与液基制片在宫颈病变筛查中的应用价值分析

目的探讨在宫颈病变筛查的过程中宫颈细胞学传统制片及液基制片的应用价值分析。方法随机选择在我院治疗的5000例宫颈病变筛查为研究对象。根据制片方法的不同分为两组,观察组(宫颈细胞学液基制片,共2500例),对照组(宫颈细胞学传统制片,共计2500例)。对两组细胞学阳性率及微生物阳性率结果进行分析。结果观察组非典型鳞状细胞无明确诊断意义(ASC-US)阳性率4.16%,非典型鳞状细胞不排除高度病变(ASC-H)阳性率0.76%,非典型宫颈管腺细胞无特殊指定(AGC-NOS)阳性率0.12%,低度鳞状上皮内病变(LSIL)阳性率1.28%,高度鳞状上皮内病变(HSIL)阳性率1.32%,鳞状细胞癌(SCC)阳性率0.12%;对照组非典型鳞状细胞无明确诊断意义(ASC-US)阳性率3.80%,非典型鳞状细胞不排除高度病变(ASC-H)阳性率1.48%,非典型宫颈管腺细胞无特殊指定(AGC-NOS)阳性率0.24%,低度鳞状上皮内病变(LSIL)阳性率1.36%,高度鳞状上皮内病变(HSIL)阳性率1.28%,鳞状细胞癌(SCC)阳性率0.20%。对照组阴道毛滴虫阳性率5.00%、细菌性阴道病阳性率5.12%、细胞形态符合单纯疱疹病毒所致改变阳性率0.04%;观察组阴道毛滴虫阳性率4.80%、细菌性阴道病阳性率5.44%、细胞形态符合单纯疱疹病毒所致改变阳性率0.12%,两组差异均无统计学意义(P>0.05)。结论在宫颈病变筛查的过程中,传统制片和液基制片虽然制片方法不同,但两种方法均可适用于临床上宫颈病变的筛查。

浊度仪在液基细胞学数字化定量制片中的应用探讨

目的研究使用麦氏浊度仪对液基细胞学制片进行数字标准定量转化,检验是否可以标准化制片细胞数。方法选取细胞液基样本360份,分别设立批内实验组、批内对照组、批间实验组、批间对照组、室间实验组、室间对照组,每组60份,实验组使用麦氏浊度仪进行定量液基制片,对照组按传统方式进行液基制片。结果目的细胞量精密度分析批内实验组-批间对照组差异有统计学意义(P<0.05),四分位数间距批内实验组<批内对照组;批内实验组-批间实验组差异无统计学意义(P>0.05),四分位数间距批间实验组<批间对照组;批内实验组-室间实验组差异无统计学意义(P>0.05),批内对照组-室间对照组差异有统计学意义(P<0.05);覆盖率实验组3组均为0.0%,对照组总覆盖率分别为10.0%、13.3%和3.3%。结论基于麦氏浊度仪对细胞悬液进行数字化调整可以实现液基标准化定量制片,提高实验的精密度和减少细胞重叠情况。

Combining Endometrium Sampling Device and SurePath Preparation to Screen for Endometrial Carcinoma： A Validation Study

Background：The aim of this study was to compare specimen adequacy of SAP-I provided for cytology with that of dilation and curettage （D ＆ C） or hysteroscopy for histology,and evaluate the accuracy of combining endometrium sampling by SAP-1 and liquid-based cytology using SurePath preparation for screening endometrial carcinoma and its precursor.Methods：Endometrial specimens from women （n =1514） with risk factors were obtained using an SAP-l device for cytological analysis; histological samples were obtained from 375 of these women who underwent D ＆ C or hysteroscopy.Cytological specimens were prepared to liquid-based smear using SurePath technology and stained by Papanicolaou.Histological samples were processed in routine pathology and stained by hematoxylin and eosin.Results：Adequate specimens for cytology were obtained from 1458/1541 patients （96.3%）,while adequate samples for pathology were obtained from 285/375 patients （76%）.However,for postmenopausaI women,1006 of 1045 cytology （86.3%） were adequate,153 of 238 histology （64.3%） were adequate,it was easier to collect cytological specimens than histological specimens （P 〈 0.05）.The accuracy of endometrial cytology for detecting endometrial carcinoma and its precursor was 92.4% （sensitivity,73%; specificity,95.8%; positive predictive value,75%; and negative predictive value,95.3%）.Conclusions：Endometrial cytology using SAP-1 sampling and SurePath preparation may be a reliable approach for screening patients with endometrial carcinoma and its precursor.

Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas diagnosed by endoscopic ultrasonography-guided fine-needle aspiration

Undifferentiated carcinoma with osteoclast-like giant cells, also formerly known as osteoclast-like giant cell tumor, is a rare neoplasm of the pancreas and usually diagnosed after pancreatectomy. The presence of non-neoplastic osteoclast-like giant cells is the histological hallmark of this tumor and the diagnosis is usually not difficult on tissue sections. However there have been relatively few reports regarding the cytological features of this type of tumor in literatures. Here we present a case of undifferentiated pancreatic carcinoma with osteoclast-like giant cells coexisting with ductal adenocarcinoma diagnosed by endoscopic ultrasonography （EUS）-guided fine-needle aspiration （FNA） and liquid-based cytology test. To our knowledge,