Assessment of the efficiency of cervical cytology in detection of cervical premalignant conditions and cervical carcinoma
Journal Title: Postępy Nauk Medycznych - Year 2013, Vol 26, Issue 7
Abstract
Introduction. Uterine cervical cancer is one of the most common malignancies diagnosed in women. The most common form of the cervical cancer is the squamous cell carcinoma. Its development is often preceded by premalignant changes which include cervical intraepithelial neoplasia grade I, II or III also called, respectively, mild, moderate or severe dysplasia. Detection of these precancerous lesions is possible with the use of diagnostic tests, of which the first exam performed is a cervical cytological smear assessed and classified according to the Bethesda System, last modifed in 2001.Aim. The aim of the study was to assess the efficiency of cervical cytology in detection of cervical premalignant conditions and cervical carcinoma.Material and methods. We assessed 91 patients with an abnormal cervical cytology exam, who were hospitalised in the Gynaecology Department of the Chair and Department of Obstetrics, Gynecology and Oncology II Faculty of Medicine, Medical University of Warsaw. All women underwent a procedure of diagnostic fractional dilation and curettage and ectocervical biopsy under colposcopic control.Results. Among all the examined patients, abnormalities in the histologic exam were revealed in 42 (46.16%) cases. CIN 1 was discovered in 57.14% of women, CIN 2 in 28.57%, CIN 3 in 4.76% and cervical cancer in 9.5% of women. Correlation between cytologic and histologic exam in patients who presented withan initial diagnosis of LSIL was 34.61%, in patients with a cytologic result of HSIL – 35.12%.Conclusions. 1. Correlation between cytologic and histologic exams is lower than that described by other authors. 2. The diagnosis of HSIL not confirmed in the histologic specimen requires further diagnostic investigation. 3. To improve the efficiency of cervical cytology exam in detection of cervical premalignant lesions and cervical carcinoma in an early stage, a unification of the centers assesing the cervical cytology smears is recommended.
Authors and Affiliations
Adrianna Skrajna, Aleksandra Zielińska, Małgorzata Kania, Krzysztof Cendrowski, Włodzimierz Sawicki
Keywords
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