engleski

Cone Excision - The Diagnostic Accuracy of Cytology

CONE EXCISION - THE DIAGNOSTIC ACCURACY OF CYTOLOGY Šentija K*, Krivak-Bolanča I*, Gašparov S** *Laboratory for medical genetics and cytology, Dpt of Gyn&Obs, ** Dpt of Pathology and cytology, KB “ Merkur” , Zajčeva 19, Zagreb, Croatia BACKGROUND: We evaluated the diagnostic accuracy of Pap smears in patients that subsequently underwent conization due to abnormal cytological findings. METHODS: On the basis of an abnormal Pap smear, 107 patients underwent conization. The preoperative cytological and postoperative histological findings on the excised cone were compared. Cytological diagnoses were reported according to the modified Bethesda System. The abnormal Pap smears were ranging from LGSIL (2) to frequent HGSIL (99), microinvasive (1) and invasive carcinoma (5). Histological findings exhibited a wide spectrum ranging from no pathologic abnormality (1), CIN II (6), CIN III (39), CIS (51), MICA (6), and invasive carcinoma (4). RESULTS: The Pap test was fully diagnostic in 94/107 (87.9%) cases: 6/6 (100%) CIN II cases, 38/39 (97.4%) CIN III cases, 47/51 (92.2%) CIS cases and 3/4 (75%) invasive carcinomas. In 8/107 (7.5%) cases cytological and histological findings differed within one degree, and more than one degree in 5/107 (4.7%) patients: in one patient with cytological HGSIL histopathology showed no abnormalities ; two patients with cytological LGSIL had CINIII and a CIS lesion ; seven patients with HGSIL had MICA (6) and invasive carcinoma (1) ; three patients cytologicaly overdiagnosed as MICA (1) and invasive carcinoma (2) had CIS. CONCLUSION: In our material, we observed high correspondence between the cytological and histological diagnosis of high grade intraepithelial lesions of the cervix, and, unexpectedly, lower accuracy of cytological smear in the diagnosis of (micro)invasive lesions

Cone excision; accuracy of cytology

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