通过宫颈细胞学对子宫内膜癌进行特异性诊断很困难，几乎没有报道有用的细胞形态学线索。本研究回顾了一组宫颈细胞学检查，以调查非典型腺细胞 (AGC) 中角化的存在，这是一种未描述的细胞形态学线索，可用于在宫颈细胞学检查中识别子宫内膜样子宫内膜样癌。回顾了组织学诊断为子宫内膜样子宫内膜样癌的患者的宫颈细胞学切片与 AGC 相关的角化的存在。对相应的组织学切片进行肿瘤分级和鳞状细胞分化程度的检查。共回收41例患者的42例宫颈细胞学标本，其中7例（16.7%）可见AGC相关角化，35例（83.3%）未见角化。组织学分级的比较并未证明与细胞学上角化的存在相关（p = 0.565）。 37 例有相应的组织学切片。细胞学和组织学角化具有统计学相关性（p = 0.002）。在 5 个病例的组织学切片上观察到 Frank 角化，其中 4 个还显示细胞学角化。鳞状分化面积，包括鳞状桑葚形成，与细胞学制备中的角化不相关（p = 0.185）。在子宫内膜样子宫内膜癌中观察到组织学和细胞学角化。这在宫颈细胞学中反映为 AGC 簇内或与 AGC 簇相关的亲橙、刚性和无细胞碎片的存在。当与 AGC 一起鉴定时，角化应被视为提示子宫内膜起源的子宫内膜样癌的细胞学线索。© 2023 作者。细胞病理学由约翰·威利出版

Specific diagnosis of endometrial carcinomas on cervical cytology is difficult with few useful cytomorphological clues reported. This study reviews a cohort of cervical cytology to investigate the presence of keratinization in atypical glandular cells (AGC), an undescribed cytomorphological clue for identifying endometrial endometrioid carcinomas on cervical cytology.Cervical cytology slides from patients with a histologic diagnosis of endometrial endometrioid carcinoma were reviewed for the presence of keratinization associated with AGCs. Corresponding histology slides were reviewed for tumour grading and degree of squamous differentiation.In total, 42 cases of cervical cytology specimens from 41 patients were retrieved, including 7 (16.7%) with keratinization associated with AGCs seen and 35 (83.3%) without. Comparison of histologic grading did not demonstrate an association with the presence of keratinization on cytology (p = 0.565). Corresponding histology slides were available for 37 cases. Cytologic and histologic keratinization were associated statistically (p = 0.002). Frank keratinization was seen on histologic slides of five cases, with four also showing cytologic keratinization. Area of squamous differentiation, including squamous morule formation, did not correlate with keratinization on cytologic preparation (p = 0.185).Histologic and cytologic keratinization are observed in endometrioid endometrial carcinomas. Such is reflected in cervical cytology by the presence of orangeophilic, rigid and acellular fragments within or associated with AGC clusters. Keratinization, when identified with AGCs, should be regarded as a cytologic clue suggestive of an endometroid carcinoma of endometrial origin.© 2023 The Authors. Cytopathology published by John Wiley & Sons Ltd.