Conocimientos, actitudes y prácticas sobre la prueba de citología cervical en una población rural peruana / Knowledge, attitudes and practices on cervical cytology in a Peruvian rural population

Introducción: La citología cervical constituye la principal herramienta para la detección y tratamiento del cáncer de cérvix. Algunos estudios llevados a cabo en población urbana han relacionado la realización y adherencia con los conocimientos, las actitudes y las prácticas favorables de las mujeres con respecto a esta prueba. Objetivo: evaluar los conocimientos, actitudes y prácticas con respecto a la citología cervical en mujeres pertenecientes a un grupo poblacional del ámbito rural. Material y Métodos: estudio de corte transversal-analítico en una población de aproximadamente 3148 mujeres en edad fértil, de ellas se obtuvo una muestra representativa. Se utilizó una encuesta anónima, validada, dirigida, y aplicada por personal de salud capacitado que labora en centros de salud del primer nivel de atención de los distritos de la provincia de Bolívar, La Libertad. Resultados: El 80 por ciento de las mujeres encuestadas tuvo un nivel de conocimiento alto e intermedio, el 70 por ciento una actitud favorable, mientras que el 44 por ciento reportó prácticas correctas en relación con la prueba de citología cervical. El nivel de conocimiento alto e intermedio estuvo asociado a la edad mayor de 30 años (p:0.02), estado civil casada (p:0.05), el mayor grado de instrucción (p:0.00) y el uso de métodos anticonceptivos (p:0.01); no se encontró relación con la edad de inicio de relaciones sexuales (p:0.98). Conclusiones: Existe un alto nivel de conocimientos, actitudes y prácticas correctas hacia la citología cervical en la población rural de la provincia de Bolívar, pero una baja adherencia hacia la misma(AU)

Introduction: Cervical cytology is the main tool for the detection and treatment of cervical cancer. Some studies carried out in the urban population have associated the realization and adherence with knowledge, attitudes and favorable practices of women with respect to this test. Objective: The aim of this study was to determine the level of knowledge, attitudes and practices towards cervical cytology in women of childbearing age in a rural Peruvian province. Material and Methods: A cross-sectional analytical study was conducted in a population of approximately 3148 women of childbearing age, a representative sample was obtained. An anonymous, validated, directed survey was used; it was applied by trained health personnel working in health centers of the primary care level in the districts of the province of Bolívar, La Libertad. Results: A total of 400 surveys were carried out. The results showed that 80 percent of the women surveyed had high and intermediate levels of knowledge, 70 percent had a favorable attitude, while 44 percent reported correct practices related to the cervical cytology test. The high and intermediate levels of knowledge were associated with age over 30 years (p: 0.02), married marital status (p: 0.05), the highest level of instruction (p: 0.00) and the use of contraceptive methods (p: 0.01); no relationship was found with the age of onset of sexual intercourse (p: 0.98). Conclusions: There is a high level of knowledge, attitudes and correct practices towards cervical cytology in the rural population of the province of Bolívar, but a low adherence to it(AU)

Investigation of human papillomavirus prevalence in married women and molecular characterization and phylogenetic analysis of the virus

OBJECTIVE: Human papillomaviruses (HPVs) are among the agents responsible for infection and cancer of the skin and mucous membranes in the human body. The aim of this study was to investigate the frequency and type distribution of HPVs in married female patients with gynecological complaints, who had visited the Maternity Hospital in Erzurum, Turkey. METHODS: In this study, 263 cervical swab samples were taken from married women using the Pap smear method and were investigated for positive reactivity against HPV. The L1 gene region of HPV was investigated using molecular methods. For this purpose, polymerase chain reaction (PCR) assays and sequence analysis of positive samples were performed. Phylogenetic analyses were performed using a bioinformatics approach after sequencing. RESULTS: HPV-DNA was detected in 17 (6.5%) samples. Highest positive reactivity to HPV-DNA was found in the 35–44 age group at 9.2%. Fourteen out of seventeen positive samples were included in the phylogenetic analysis. All isolates clustered in the Alphapapillomavirus genus. Six samples were found to be HPV 70 positive, four were HPV 16 positive, and the rest were HPV 54, 72, 81, and 114 positive. When genotyping data were evaluated according to the risk group, we found that 28.6% of the 14 samples were found to be high risk-HPV, and 71.4% were low risk-HPV. CONCLUSIONS: As per our knowledge, this is the first report on the phylogenetic analysis of HPV genotypes isolated from women in Turkey. The prevalence of low- and-high risk HPV was determined in married women in Erzurum, and these results contribute to the epidemiological data on the distribution of HPV types for this region.

Use of HPV testing in cervical cancer screening services in Mexico, 2008-2018: a nationwide database study / Uso de la prueba de VPH para la detección de cáncer cervical en México, 2008-2018: estudio de una base de datos nacional

Abstract: Objective: To describe the methods of a study aimed at evaluating high risk-HPV (hrHPV)-based screening and cervical cytology as triage compared to conventional cervical cytology as primary screening in the detection of grade 2+ cervical intraepithelial neoplasia in the National Cancer Screening Program (NCSP) of Mexico. Materials and methods: We will use information originated from the Womens Cancer Information System of Mexico regarding cervical cancer from 2008 to 2018. The database includes cytology results, diagnostic confirmation by histopathology and/or treatment colposcopy. We will then carry out statistical analyses on approximately 15 million hrHPV. Results: We will evaluate the overall performance of hrHPV-based screening as part of the NCSP and compare hrHPV-based to cytology-based screening under real-life conditions. To guarantee an unbiased comparison between hrHPV with cytology triage and conventional cytology we will use propensity score matching. Conclusion: Decision makers may use our results to identify areas of opportunity for improvement in NCSP processes.

Resumen: Objetivo: Describir los métodos de un estudio que busca comparar el beneficio de la introducción de la prueba de VPH de alto riesgo como prueba primaria frente a la citología convencional para la detección de la neoplasia intraepitelial cervical grado 2 o mayor, dentro del Programa de Prevención y Control del Cáncer de la Mujer, para el periodo de 2008 a 2018. Material y métodos: Se utilizarán los registros del Sistema de Información de Cáncer de la Mujer, se realizarán los análisis estadísticos con aproximadamente 15 millones de resultados de VPH-alto riesgo, además se utilizarán los resultados de citología, colposcopia, histología y los casos referenciados al centro oncológico para tratamiento. Para comparar ambos grupos usaremos "propensity score matching". Resultados: Se evaluará el desempeño general de la prueba de VPH-alto riesgo, en condiciones reales dentro del Programa Nacional de Prevención y Control de la Mujer y su tendencia en el tiempo. Conclusiones: Los resultados de estudio ayudarán a los tomadores de decisiones a identificar áreas de oportunidad para mejorar el programa en México.

Human papillomavirus and infections of the lower genital tractin women with abnormal cervical cytological examination / Papilomavírus humano e infecções do trato genital inferior em mulheres comexame colpocitológico anormal

Aims: To study the associations of positive human papillomavirus (HPV) DNA in the female genital tract with Gardnerella vaginalis, Trichomonas vaginalis and Candida sp. vaginitis, and with possible socio-demographic risk factors for HPV infections.Methods: The study was conducted with 208 patients with abnormal cervical cytological examination assisted at the Gynecology Service of Central Clinic of Caxias do Sul University, Rio Grande do Sul, Brazil, analyzing the presence of HPV DNA by polymerase chain reaction and associating the results to diagnosis of vaginal infections obtained from the medical charts of the patients.Results: HPV DNA was detected in 60.1% of all cases analyzed; 93% of them presented simple infections and 6.9% showed multiple infections. Seventeen viral types were identified, being HPV16 the most frequent (38.8%). At least one of the vaginitis investigated was observed in 57,2% of the patients. Gardnerella vaginalis was found in 45.7%, Candida sp. in 20.2%, and Trichomonas vaginalis in 3.8% of the patients examined. No statistical association between the presence of HPV DNA and other infection of the lower genital tract or socio-demographic risk factors was observed.Conclusions: No association of HPV infection with other infections of the female genital tract or with socio-demographic features could be found. Multiple infections with up to five types of HPV were observed in a low percentage of women. It is difficult to clearly define a group at high risk for HPV infection. All women with abnormal cervical cytological examination are possible carriers of HPV and other infections of the lower genital tract.

Objetivos: Estudar as associações da positividade para o DNA de papilomavírus humano (HPV) no trato genital inferior feminino com as vaginites por Gardnerella vaginalis, Candida sp. e Trichomonas vaginalis e com a presença de possíveis fatores de risco para infecção por HPV.Métodos: O estudo foi realizado com 208 pacientes com exame colpocitológico anormal atendidas no Serviço de Ginecologia do Ambulatório Central da Universidade de Caxias do Sul analisando a presença do DNA de HPV através de reação em cadeia da polimerase e associando os resultados aos diagnósticos de infecção vaginal obtidos nos prontuários das pacientes.Resultados: Foi detectado DNA de HPV em 60,1% de todos os casos analisados , sendo que 93% apresentaram infecções simples e 6,9 % apresentaram infecções múltiplas. Dezessete tipos virais foram identificados, sendo HPV16 o mais frequente (38,8%). Pelo menos uma das vaginites investigadas foi observada em 57,2% dos pacientes. Gardnerella vaginalis foi encontrada em 45,7%, Candida sp. em 20,2%, e Trichomonas vaginalis em 3,8% das pacientes examinadas. Não foi observada nenhuma associação estatística entre a presença do DNA de HPV e outras infecções do trato genital inferior ou fatores sociodemográficos de risco.Conclusões: Não houve associação da infecção pelo HPV com outras infecções do trato genital feminino nem com características sociodemográficas. Múltiplas infecções com até cinco tipos de HPV foram observadas em uma pequena parcela das mulheres. É difícil definir claramente um grupo de risco para a infecção por HPV. Todas as mulheres com exame colpocitológico anormal são possíveis portadoras do HPV e de outras infecções do trato genital inferior.

Epstein Barr virus detection in cervical samples of women living with human immunodeficiency virus / Detecção do vírus Epstein-Barr em amostras cervicais de mulheres infectadas pelo vírus da imunodeficiência humana

Epstein Barr Virus (EBV) is transmitted commonly by saliva, but it has been found in genital secretions, which suggests sexual transmission and led researchers to connect EBV and cervical neoplasia. People living with human immunodeficiency virus (HIV) are reported to be at high risk of acquiring genital infections and cervical lesions. To verify the presence of EBV in the genital tract and/or it could affect cervical changes, we analyzed cervical smears from 85 HIV seropositive women for EBV DNA determination. EBV was only detected in two (2.3 percent) samples. The present study provides neither evidence for EBV as sexually transmitted infection nor discards this possibility.

O vírus Epstein-Barr (EBV) é transmitido comumente pela saliva, mas pode ser encontrado também em secreções genitais, sugerindo transmissão sexual e levando pesquisadores a associar este vírus à neoplasia cervical. Pessoas infectadas pelo virus da imunodeficiência humana (HIV) são de alto risco para aquisição de infecções genitais e lesões de cérvice uterina. Com o objetivo de verificar a presença do DNA do EBV no trato genital e/ou se poderia ter efeito em alterações cervicais, analisamos esfregaços cervicais de 85 mulheres HIV soropositivas. O vírus foi detectado em apenas duas (2,3 por cento) amostras. O presente estudo não fornece evidência da transmissão sexual do EBV, nem descarta esta possibilidade.

Evaluation of 100% rapid rescreening of cervical smears.

Advantage of rapid rescreening (RR) over conventional 10% random rescreening of all negative smears has been the topic of debate. RR of negative smears by cytopathologists/cytotechnologists have yielded good results. We undertook the rapid review of all the reported cervical smears to study its results as a means of strict quality control exercise on 2,500 smears.

Critérios citomorfológicos preditivos para o diagnóstico de adenocarcinoma in situ deendocérvice

Introdução: O adenocarcinoma de endocérvice é uma lesão rara e de mau prognóstico. Sua incidência vem aumentando, principalmente em mulheres jovens, enquanto se observa uma diminuição do carcinoma escamoso. Em seu estágio inicial, habitualmente, não tem expressão clínica ou colposcópica, o que dificulta sua detecção. O exame citopatológico é, na maioria das vezes, a única oportunidade de identificação destas lesões antes que evoluam para o adenocarcinoma invasor. Entretanto, os critérios utilizados para o diagnóstico são de baixa reprodutibilidade e, freqüentemente, o adenocarcinoma in situ é confundido com lesão intra-epitelial de alto grau e adenocarcinoma invasor. Objetivo: Identificar critérios morfológicos presentes no exame citopatológico, preditivos de adenocarcinoma in situ de endocérvice. Material e métodos: Foram analisados 54 critérios citomorfológicos em 26 casos com diagnóstico histopatológico de adenocarcinoma in situ, comparando-os com 63 casos de neoplasia intra-epitelial graus 2 ou 3 e 49 de adenocarcinoma invasor, identificados na Seção Integrada de Tecnologia em Citopatologia, na Divisão de Patologia, do Instituto Nacional de Câncer. Foi realizada revisão das lâminas, por dois citopatologistas, às cegas, dos exames citopatológicos que antecederam o diagnóstico. Foram construídos dois modelos de regressão logística. Resultados: Na comparação entre adenocarcinoma in situ e adenocarcinoma invasor revelaram-se preditores o fundo não necrótico (OR = 6,3; IC 95% 1,3-30,3; p = 0,024) e a ausência de nucléolo (OR = 4,3; IC 95% 1,3-13,9; p = 0,014). No modelo que comparou adenocarcinoma in situ a neoplasias intra-epiteliais cervicais graus 2 ou 3, os resultados indicaram plumagem (OR = 71,4; IC 95% 4,0-1266,2; p = 0,004), ausência de disceratose e o aumento da RNC apenas leve a moderado, (OR = 12,3 e 12,0; IC 95% 1,2-130,3 e 1,2-124,7; p = 0,037). Conclusão: O incremento da eficiência do diagnóstico precoce do adenocarcinoma in situ, cuja incidência tem aumentado nas últimas décadas, independentemente dos programas de rastreamento, reforça o papel do exame citopatológico na prevenção e controle deste câncer.

Introduction: Endocervical adenocarcinoma is a rare lesion of difficult prognosis. Its incidence is increasing, mainly among young woman, while a decrease in the squamous carcinoma is being observed. In its initial stage, it usually has no clinical or colposcopic expression, what makes its detection difficult. The cytological exam, in the majority of cases, is the only way to identify these lesions before they evolve into invasive adenocarcinoma. Meanwhile, the criteria used for diagnosis are of low reproducibility, and are often confused with high grade intraepitelial lesion and invasive endocervical adenocarcinoma. Objective: Identify morphologic criteria present in the cytological exam that can predict cervical adenocarcinoma in situ. Material and methods: 54 cytomorphological criteria of 26 cases with histopathological diagnosis of adenocarcinoma in situ were analyzed. Comparing them with 63 cases of cervical intraepithelial neoplasia grade 2 or 3 and 49 of invasive adenocarcinomas, identified in Section for Integrated Technology in Cytopathology, in the Pathology Division of National Cancer Institute. Two cytopathologists made a blind review of the slides of the cytopathological examinations that preceded the diagnosis. Two models of logistic regression were constructed. Results: In the comparison between adenocarcinoma in situ and invasive adenocarcinoma, predictors revealed were non necrotic background (OR = 6.3; IC 95% 1.3-30.3; p = 0.024) and the absence of nucleolus (OR = 4.3; IC 95% 1.3-13.9; p = 0.014). In the model that compared adenocarcinoma in situ to cervical intraepithelial neoplasia grade 2 or 3, the results indicated feathering (OR = 71.4; IC 95% 4.0-1266.2; p = 0.004), absence of dyskeratosis and the increase of NCR, only mild to moderate, (OR = 12.3 e 12.0; IC 95% 1.2-130.3 e 1.2-124.7; p = 0.037). Conclusion: The increase in the efficiency of early diagnosis of adenocarcinoma in situ, the incidence of which has increased over the last decades, regardless of tracking programs, strengthens the role of the cytopathological examination in the prevention and control of this cancer.

Avaliaçäo da celularidade citológica em preparados de base líquida / Cellularity evaluation in liquid-based cytology preparations

O método de citologia em base líquida parece apresentar uma série de vantagens em relação ao convencional: melhor disposição celular, facilitando a interpretação; redução do número de hemácias,exsudato inflamatório e muco, preparação de lâminas adicionais do mesmo caso sem ter que se convocara paciente; utilização de material residual para testes moleculares para identificação de HPV e outros microrganismos .O método de base líquida, pelas vantagens mencionadas, detecta maior número delesões, além de menor índice de amostras inadequadas ou limitadas por alguma razão. O presente trabalhoteve como objetivo avaliar os achados citológicos obtidos com duas metodologias diferentes de preparo de citologia em base líquida, o novo sistema DNA - CITOLIQ (DIGENE-Brasil) e o sistema Autocyte(TRIPATH, USA), e correlacioná-los com os achados de citologia convencional obtidos da rotina do Setor de Citologia Oncótica do Instituto Adolfo Lutz. Foram estudadas 509 amostras consecutivas pelosistema DNA - CITOLIQ e 398 amostras pelo sistema Autocyte, de mulheres atendidas no HospitalLeonor Mendes de Barros no ano de 2002, participantes voluntárias do projeto INCODEV ICA4-CT-2001-(10013). Das 509 citologias preparadas pelo método DNA - CITOLIQ (DIGENE-Brasil), 0,6% foraminsatisfatórios; 89,3% negativos; 2,0% lesões de baixo grau; 0,8% lesões de alto grau; 0,2% carcinoma e7,1% ASCUS / AGUS. Apresentou ainda 89% de amostras satisfatórias, 10,0% satisfatórias mas limitada spor ausência de JEC e 0,4% limitadas por outras causas. Pelo método Autocyte, em 398 casos, 0,5% foraminsatisfatórios; 88,2% negativos; 3,0% ASCUS / AGUS; 6,8% lesões de baixo grau e 1,5% lesões de alto grau. Apresentou 84% de amostras satisfatórias, 15,25% satisfatórias mas limitados por ausência de JECe 0,25% satisfatórias mas limitados por outras causas. Foram examinadas 33.313 citologias colhidas pelo método convencional em 2001, onde 5,0% foram insatisfatórios; 92,6% negativos; 1,3% lesões de baixo grau; 0,3% lesões de alto grau e 0,05% de carcinoma invasivo; 0,7 ASCUS / AGUS. Em relação à qualidade da amostra, apenas 22,7% dos casos apresentaram células da JEC. Conclui-se que ambos métodos decitologia em base líquida apresentaram performances semelhantes quanto à qualidade das amostras, comenos casos insatisfatórios que o convencional. Observamos ainda, para ambos métodos, aumento significativo na sensibilidade para detecção de lesões intraepiteliais, sobretudo as de baixo grau, quando comparadas ao método convencional. (AU)

Liquid-based cytology (LBC) presents several advantages when compared to theconventional smears, such as clean background, residual material for additional cytological preparationsor even for molecular tests to infectious agents identification, mainly HPV. Besides these advantages,LBC detects more lesions than the conventional smears, and also reduce the number of unsatisfactorysamples and false negative cases. The goal of this work was to evaluate the cytologic findings of twodifferent LBC methodologies, DNACITOLIQ ® (DIGENE-Brasil) and Autocyte system (Tripath, USA)concerning the adequacy of the samples and diagnosis performance, and compare these results to thosereported by conventional smears daily routine analyzed at Adolfo Lutz Institute. A total of 509 samples ofDNA- CITOLIQ ® and 398 Autocyte consecutive cases from women examined at Leonor Mendes deBarros Hospital in 2002 (INCODEV ICA-CT-2001-10013 project) were analyzed. From DNACITOLIQ®cases 0.6% were unsatisfactory, 89.3% were negative, 7,1% ASCUS/ AGUS, 2.0% LSIL, 0.8% HSIL and0.2% squamous carcinoma. Regarding adequacy parameters 89% were satisfactory, 10.0% were limited byabsence of glandular cells and 0.4 limited by other reasons. Autocyte system diagnosis were: 0.5%unsatisfactory, 88.2% negative, 3.0% ASCUS/AGUS, 6.8% LSIL and 1.5% HSIL. Conventional smearscomprised 33,313 samples where 5.0% were unsatisfactory, 92.6% were negative, 0.7% ASCUS/ AGUS,1.3% LSIL, 0.3% HSIL and 0.05% squamous carcinoma. Satisfactory samples with glandular cellsrepresentation account 22.7%. Both methods of liquid-based cytology have presented similar performancesregarning the adequacy of the samples, presenting lesser inadequate cases than the conventional. Wehave also observed that both methods have showed better sensitivity than the conventional to identifyintraepithelial lesions, mainly the low grade. (AU)

Qualification of Atypical Squamous Cells of Undetermined Significance - "ASCUS, R/O HSIL": Cytologic Features and Histologic Correlation / 대한세포병리학회지

Cytologic and histopathologic features and human papillomavirus (HPV) DNA detection associated with 101 cervicovaginal smears which are classified as 'atypical squamous cells of undetermined significance, rule out high grade squamous intraepithelial lesion(ASCUS, R/O HSIL)' were reviewed and compared to 89 smears of 'ASCUS, not otherwise specified(NOS)' . Cytologic fieatures of ASCUS, R/O HSIL included atypical single small cells(36.6%), hyperchromatic tissue fragments(35.6%), atypical metaplastic cells(18.8%), endometrial cell-like clusters(5.9%), and atypical parakeratotic cells(3.0%). A final diagnosis of HSIL on biopsy was assigned to 47(54.0%) of 87 women with ASCUS, R/O HSIL and to 13(14.6%) of 89 women with ASCUS, NOS ( p=0.000). There was no difference in HPV DNA detection rate between ASCUS, R/O HSIL and ASCUS, NOS smears. These data suggest that subclassification of ASCUS is helpful to manage patients because ASCUS, R/O HSIL is more often associated with an underlying HSIL on biopsy. Therefore, women with ASCUS, rule out HSIL should be actively managed with colposcopic examination.

The Clinical Significance and The Optimal Management of Atypical Squamous Cells of Undetermined Significance in Cervical Smears / 대한산부인과학회잡지

OBJECTIVE: To evaluate the clinical significance and the optimal management of atypical squamous cells of undetermined significance (ASCUS) in Papanicolaou cervical smears. METHOD: This study included 25380 cases of cervical Pap smears received from January 1995 to June 2000 by the Department of Obstetrics & Gynecology, Inha Hospital, Medical College, the Inha University. Retrospective review was done on 384 cases of ASCUS. RESULT: ASCUS and squamous intraepithelial lesions (SIL) were diagnosed in 384 cases (1.5%), and 311 cases (1.1%), respectively. The ratio of ASCUS to SIL was 1.2. Colposcopic directed biopsies revealed 14 cases (14.1%) of low grade SIL (LSIL), 21 cases (21.2%) of high grade SIL (HSIL), and 2 cases (2.0%) of squamous cell carcinoma. CONCLUSION: The immediate colposcopy with biopsy in women with ASCUS may decrease follow-up visits for Pap testing, reduce patient anxiety, minimize the loss of high risk cases during follow-up and lower medicolegal litigation. The early colposcopy may be the method of choice for follow-up in women with ASCUS in Korea.

Effectiveness of automated cervical cytology rescreening using the AutoPap 300 QC System / 대한산부인과학회잡지

OBJECTIVE: This study assessed the usefulness of the AutoPap 300 QC System in identifying of detection false negative(DFN) smears in a slide population previously screened as "within normal limits" and compared the rate of identification of DFN to that using 10% random selection. MATERIALS AND METHODS: From December 1996 to August 1998, we utilized the AutoPap 300 QC System at 30% selection rate to select cases for manual review. During the study period, 1,040(83.4%) among 1,247 smears and 7,848(84.0%) among 9,343 smears were screened as "within normal limits" and were included for the AutoPap 300 QC System and 10% random selection studies, respectively. RESULTS: 357(34.3%) among 1,040 were selected by the AutoPap 300 QC System at 30% QC selection rate and reviewed manually. Overall, 63 among 357 were determined to be abnormal including 47 ASCUS, 2 AGUS, and 14 LSIL. 785(10%) among 7,848 were selected by 10% random selection and reviewed manually. 96 among 785 were determined to be abnormal including 69 ASCUS, 3 AGUS, and 24 LSIL. These results represented an increase in pick up rate of DFN(detection false negative) of 5.1 and 4.4 fold for ASCUS/AGUS and LSIL, respectively and of 1.5 and 1.3 fold when accounting for the volume differences measured. CONCLUSIONS: The study demonstrated that the AutoPap 300 QC System is superior to 10% human random screening for the identification of DFN smears. Further studies are required using variable selection rates and a larger number of smears to fully assess the value of the device in quality control mode.

False Negative Rate of Cervical Cytology Using the Autopap 300 QC System in Rescreening Modality / 대한부인종양콜포스코피학회잡지

OBJECTIVES: To estimate false-negative rate of cervical smears using Autopap 300 QC system in rescreening modality. METHODS: From September 1997 to December 1997, Total 26,983 cervical smears were obtained and 18,592 cervical smears were rescreened by Autopap 300 QC system with 10% review rate. The 274 cases of total 26,983 cervieal smears were confirmed histologically by colposcopic biopsy, cone biopsy and hysterectomy. The 274 cases of cervical smears, which obtained prior to pathologic diagnosis made, were evaluated based on cyto-histologic correlation and then the false negative rate were estimated. The cervical smears were reviewed, researching for the cause of false negative. RESULTS: (1) Histologic diagnosis of 274 cases include 65 cases of Low SIL, 173 cases of High SIL, 29 cases of SCC, 2 cases of adenocarcinoma in situ, and 5 cases of invasive adenocarcinoma. (2) The false negative rate were 3% (9/274). Those were 6.2%(4/65) of LSIL, 2.3% (4/173) Of HSIL, none of SCC and AIS, and 20%(5/1) of invasive adenocarcinoma. (3) The false negative cases were reviewed. The 6 cases were sampling enor and 3 cases were screening error. CONCLUSION: Using AutoPap 300 QC system in rescreening modality, The false negative rate of cervical smears were decreased, compared with our previous study.

Histologic and Cytologic Follow-up in Atypical Squamous Cells of Undetermined Significance(ASCUS) on Cervical Smears / 대한세포병리학회지

In 1988, The Bethesda System for reporting cervical and vaginal cytologic diagnoses was introduced and this was revised in 1991. The new diagnostic category "atypical squamous cells of undetermined significance(ASCUS)" introduced by The Bethesda System is an area of controversy about the diagnostic category, clinical significance and appropriate treatment. A retrospective 2 years and 9 months study(April,1994-December,1996) was performed to evaluate the significance of reporting ASCUS on cervical smears. Sixtyseven(1.17%) of 5,730 smears were diagnosed as ASCUS and 21 cases were followed by cervical biopsies and/or endocervical curettages in 4 cases(19%), and repeat cervical smears in 17 cases (81%). Tissue diagnoses were benign in 2 cases and squamous cell carcinoma in situ in 2 cases. Cytologic diagnosis of follow up smear were negative in 14 cases (82.4%) and persistent ASCUS in 3 cases(17.6%).