The prognostic role of Pap smear, hemoglobin level, blood group on endometrial carcinoma, a clinicopathological study in 175 Iranian women with endometrial carcinoma

Background and Aim : Endometrial carcinoma (EC) is a common gynecologic malignancy in femalegenital tract especially in postmenopausal women. The current study aimed to readout Pap smear in patientswith EC to assess the relationship between abnormal cells on Pap smear, ABO blood group, anemia withclinically parameters such as grade, stage and myometrial invasionMethods : : A retrospective study was performed on 175 patients with Endometrial Cancer in ImamHossein Hospital, Tehran, Iran during 2013-2019. The histology information of cases was extracted fromhospital database and Pap smears slides were taken from pathological archives. Then, reviewed by an expertpathologist in this center. The data was analyzed in SPSS (version 18) by Chi-Square, Fisher exact andindependent t-test. P value <0.05 is considered significant.Results : The mean age of patients was 54.47±11.34 years and varied between 32 to 85 years old and 31.4%were pre-menopausal women. Grade III, invasion 50% of myometrial and advanced stage (III and IV)were diagnosed in 30%, 7.4%, and 22.86% of cases, respectively. The most common histological type ofEC was endometrioid 66.9%, papillary 10.3%, MMMT Carcinosarcoma 5.7%. The abnormal Pap smearwas achieved only in 37 (21.1%) EC cases. Endometrial cell in patients > 40 years old, ASCUS and AGCwas the Pap smear results in 56.8%, 29.7% and 13.5% of patients with abnormal Pap smear, respectively.In patients with normal Pap smear the most common results were inflammation in 75.1% and atrophy in14.6%. Abnormal uterine bleeding (AUB) was the most important problem of EC patients.Conclusion : The efficacy of Pap smears in detection of EC is limited It is better that women with abnormalPap smear and women with endometrial cell in Pap smears whose aged > 40 years, with heavy bleeding,anemia , obesity ,O blood group and woman with sever inflammation in pap smear follow and check forEC. Furthermore, endometrial sampling is a necessary screening for all women with abnormal endometrialcells on Pap tests.

Keywords:

Endometrial cancer , Myometrial invasion , Pap smear , postmenopausal women