CYTOLOGICAL DIAGNOSTICS OF ENDOMETRIUM DISORDERS WITH THE HELP OF DECISION RULE

Yerokhina O.A., Klyukina L.B.

Cytograms of 216 patients were reviewed, including 137 patients with endometrium cancer (EC) diagnosed on the basis of clinical and histological data and 79 patients with hyperplasia of the endometrium (EH). On the basis of in-detail description of the cellular composition of the uterine cavity aspirate smears, a list of all cellular elements present in the cytograms was established; structural and cellular signs of the atypia of endometrium cells were identified; the degree of their evidence was assessed; and the algorithm for the cytological investigation of the endometrium was established. Data of microscopic studies of the cytograms were processed with the help of computers and an expert system for identification of pathology processes in the endometrium was created. A decision rule (DR) was developed, which includes 12 most important differential diagnostics cytological signs of EH and EC, such as: deteriorated polarity of nuclei (cells) in the structures, multiple layers, presence of irregular-shaped nuclei and nucleoli, macronucleoli, nucleocytoplasmic ratio exceeding 0.7, irregular nuclear membrane, tumor diathesis, giant-size layers, odd-shaped layers with vascular-stromal component, loopy pattern of the chromatin and structures in the form of three-dimension spheres. Application of the DR in complicated diagnostic cases is of a considerable consultative importance.