Clinical Significance of Conventional Papanicolaou Cervical Cytology Test: A Cytohistologic Comparison.
- Author:
Young Hoon SUH
1
;
Mi Na HA
;
Choong Hak PARK
Author Information
1. Department of Obstetrics and Gynecology, College of Medicine, Dankook University, Cheonan, Korea.
- Publication Type:Clinical Trial ; Original Article
- Keywords:
Cervical cancer;
Conventional Papanicolaou cervical cytologic test;
Cytohistologic comparison
- MeSH:
Academic Medical Centers;
Adenocarcinoma;
Age Distribution;
Ambulatory Care Facilities;
Carcinoma, Squamous Cell;
Diagnosis;
Gynecology;
Humans;
Mass Screening;
Obstetrics;
Papanicolaou Test;
Uterine Cervical Neoplasms
- From:Korean Journal of Obstetrics and Gynecology
2002;45(9):1537-1553
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: The purpose of this study was to obtain an important basic data which would be useful not only in clinical practice but also in clinical trial of ThinPrep Pap Test and Computerized Screening Test as the new trends of cervical cancer detection, by analyzing the conventional Papanicolaou cervical cytologic test according to The Bethesda System (TBS) and investigating the correlation between abnormal cytologic diagnoses and histologic diagnoses. METHODS: This study was performed in Obstetrics and Gynecology outpatient clinic (OG group: high risk and screening population) and in Health Check-up Center/Industrial Medicine clinic (HC group: screening population) at Dankook University Medical Center from January 1, 1999 to December 31, 2000. Ten thousand and seven hundred eighty seven cases (5,019 cases in OG group and 5,768 cases in HC group) who underwent conventional Papanicolaou cervical cytologic test were analyzed. Abnormal cytologic diagnoses ([Atypical Squamous Cells of Undetermined Significance (ASCUS) or worse]) were compared with histologic diagnoses as a reference standard. RESULTS: Followings are the results summarized. 1. Of the 10,807 patients, 20 (0.19%) were diagnosed as unsatisfactory for evaluation. Of 10,787 cases, there were 5,501 (51.00%) cytologic diagnoses of Within Normal Limit (WNL), 4,911 (45.53%) of Benign Cellular Change (BCC), 168 (1.56%) of ASCUS, 67 (0.62%) of Low-grade Squamous Intraepithelial Lesion (LSIL), 89 (0.83%) of High-grade Squamous Intraepithelial Lesion (HSIL), 34 (0.32%) of Squamous Cell Carcinoma (SCC), 16 (0.15%) of Atypical Glandular Cells of Undetermined Significance (AGUS) and 1 (0.01%) of Adenocarcinoma (ACC), respectively in conventional Papanicolaou smear series. The ASCUS/SIL ratio was 1.08. Statistically, there were more cytologic diagnoses of WNL, ASCUS, LSIL, HSIL, and SCC in OG group but BCC in HC group. 2. The age distribution of patients were as follows: 9 cases under 19 years, 1,011 in the 20's, 3,244 in the 30's, 3,110 in the 40's, 2,218 in the 50's, 1,035 in the 60's, 148 in the 70's, and 12 over 80 years. The mean age was 44.03 years. The mean age of HC group was significantly higher than that of OG group. The mean ages of BCC and ASCUS in HC group were significantly higher than those in OG group. 3. Of 10,787 cases, there were 375 abnoraml cytologic diagnoses (ASCUS/AGUS or worse): 245 in OG group and 130 in HC group. Statistically, there were more high-grade cytologic diagnoses (HSIL, SCC, and ACC) both in older age and in OG group. 4. Of 375 cases with abnormal cytologic diagnoses, 176 patients had histologic diagnoses. Of the 56 ASCUS, 21 (37.5%) showed positive histologic LSIL or worse diagnoses. Of the 112 cytologic LSIL or worse cases, 91 (81.25%) showed positive histologic LSIL or worse diagnoses. Of 176 cases, 105 (59.66%) showed high-grade histologic diagnoses (HSIL or worse). Of the 7 AGUS, 5 (71.43%) showed HSIL or worse diagnoses. There was a statistically significant relation between cytologic diagnoses and high-grade histologic diagnoses in squamous abnormalities. CONCLUSION: This study showed that our data according to TBS criteria were similar to other reports in the literatures. There were statistically significant difference between OG group and HC group in age and some diagnoses. And there was a statistically significant relation between cytologic diagnoses and high-grade histologic diagnoses in squamous cell abnormalities. This study will play a relevant role in clinical trial of ThinPrep Pap Test and Computerized Screening Test as well as in clinical practice.
