Patients withepithelial cell abnormality in PAP smears: Correlation of results with follow-up smears and cervical biopsies [PAP smearde epitel hücre atipisi saptanan hastalar: Sonuçlarin takip smear ve servikal biyopsi ile uyumlari]

Abstract

Objective: Cervical carcinoma has been included in the preventable diseases category ever since the use of cervical cytology in routine practice. The Pap test is an eff icient screening test. We aimed to compare the cervical cytology diagnosis wiThbiopsy and smear follow up results in our institution. Material and Method: We aimed to compare the diagnosis of cytology material examined in our institution during the 2009-2012 period wiThtheir biopsy and smear follow ups. The diagnoses were compared wiThthe follow up smears and/or cervical biopsies. Results: 13610 Pap tests were examined during September 2009-July 2012. Among these cases, there were 370 atypical squamous cells of undetermined significance (ASCUS), 29 atypical squamous cells-high grade intraepithelial lesions cannot be excluded (ASC-H), 155 low grade squamous intraepithelial lesion (LSIL), 33 high grade squamous intraepithelial lesion (HSIL), and 5 atypical glandular cell (AGC) diagnoses. The ratio of atypical squamous cell (ASCUS and ASC-H) to squamous intraepithelial lesions was 2.12. Squamous intraepithelial lesion was verified in 47 of 91 ASCUS cases. Among patients who had a cervical biopsy, 52 of 64 LSIL cases and all of the 21 HSIL cases had biopsy-proven SIL. Conclusion: Atypical squamous cell (ASC) is the most common diagnosis in abnormal cervical cytology. As it is indefinite, ASC is used as a quality assurance parameter and the aim is to decrease its use. As the ratio of epithelial cell abnormality is variable in diff erent populations, the ASC/SIL is a more definite variable to be used for quality assurance. The eff iciency in clinical use of the cervical cytology screening test is determined by biopsy verification. Our epithelial cell abnormality, ASC/SIL ratio and cytology-histology correlation values were parallel to the literature, proving that the methods are used reliably at our institution.