Journal of Pathology and Translational Medicine (대한병리학회지)

The Korean Society of Pathologists (대한병리학회)
권호 표지
DOI QR코드

DOI QR Code

Correlation Analysis Between Cervicovaginal Cytologic and Histopathologic Diagnoses in Cervical Squamous Cell Neoplasm

Lee, Kyoung-Bun;Park, Woon-Sun;Sohn, Jin-Hee;Kim, Min-Kyung;Kim, Dong-Hoon;Kim, Hee-Sung;Chae, Seoung-Wan;Kang, Sung-Hee;Cho, Young-Hye;Pak, Hee-Dae;Kim, Sun-Hee

  • Published : 2009.04.25
⟨ Previous Next ⟩

Abstract

Background : The aim of this study was to confirm the usefulness of cervicovaginal smears in the screening of squamous cell neoplasms of the uterine cervix by comparative analysis between the cytologic diagnosis of cervicovaginal smears and the histologic diagnosis of tissue specimens. Methods : We selected 743 patients who had both cervicovaginal smears and histologic evaluations of the uterine cervix by colposcopic biopsy, conization, or hysterectomy at the Kangbuk Samsung Medical Center between January 2005 and December 2007. Results : The accuracy rate of cervicovaginal smears and histologic diagnoses was 93.0% (691/743) and showed a high correspondence (kappa value, 0.770, p-value, 0.000). The false-negative and false-positive rates were 0.5% (6/484) and 17.8% (46/259), respectively. The sampling and interpretation errors were identified in four and two cases of six false-negative cases and 29 and 17 cases of 46 false-positive cases, respectively. In screening high grade squamous cell neoplasms, there were no false-negative cases and only one false-positive case which resulted from sampling error. The false-negative rate of cervicovaginal smears and the false-positive rate in high-grade squamous cell neoplsams were very low. Conclusions : The cervicovaginal smear is a powerful tool for screening of cervical squamous cell neoplasms.

Keywords

References

  1. Miller AB, Lindsay J, Hill GB. Mortality from cancer of the uterus in Canada and its relationship to screening for cancer of the cervix. Int J Cancer 1976; 17: 602-12 https://doi.org/10.1002/ijc.2910170508
  2. AHCPR (Agency for Health Care Policy and Research). Evaluation of cervical cytology. Evidence report/Technology assessment. No5, 1999
  3. Yoo BG, Lee JH, Lee JY, Lee EK, Kim KT, Kim HC. Clinical and pathological observation on the diagnosis and treatment of cervical intraepithelial neoplasia III (CIN III) of the uterine cervix. Korean J Obstet Gynecol 1993; 36: 366-76
  4. Kim HS, Back HS, Son CW, et al. False-negative cytology in cervical smears: an evaluation on 1000 cases of squamous intraepithelial esion and squamous cell carcinoma histologically confirmed. Korean J Gynecol Oncol Colposc 1995; 6: 31-7
  5. Song MK, Kwon YI, Park TC, et al. False negative cytology in cervical smears: an evaluation of 186 cases of squamous intraepithelial lesion and squamous cell carcinoma, hitologically confirmed. Korean J Obstet Gynecol 2001; 44: 763-8
  6. Jang JH, Kim SH, Jang SH, et al. PAP Smear: analysis of 10 Years Results (1992-2001). Korean J Obstet Gynecol 2003; 46: 1714-9
  7. Jin SY, Park SM, Kim MS, Jeen YM, Kim DW, Lee DW. Diagnostic accuracy of cervicovaginal cytology in the detection of squamous epithelial lesions of the uterine cervix; cytologic/histologic correlation of 481 cases. Korean J Cytopathol 2008; 19: 111-8 https://doi.org/10.3338/kjc.2008.19.2.111
  8. Gay JD, Donaldson LD, Goellner JR. False-negative results in cervical cytologic studies. Acta Cytol 1985; 29: 1043-6
  9. Zahniser DJ, Sullivan PJ. CYTYC Corporation. Acta Cytol 1996; 40: 37-44 https://doi.org/10.1159/000333583
  10. Sherman ME, Mango LJ, Kelly D, et al. PAPNET analysis of reportedly negative smears preceding the diagnosis of a high-grade squamous intraepithelial lesion or carcinoma. Mod Pathol 1994; 7: 578-81
  11. Sherman ME, Mango LJ, Kelly D, et al. PAPNET analysis of reportedly negative smears preceding the diagnosis of a high-grade squamous intraepithelial lesion or carcinoma. Mod Pathol 1994; 7: 578-81
  12. National cancer screening project: National cancer information center 2008
  13. Husain OA, Butler EB, Evans DM, Macgregor JE, Yule R. Quality control in cervical cytology. J Clin Pathol 1974; 27: 935-44 https://doi.org/10.1136/jcp.27.12.935
  14. Joseph MG, Cragg F, Wright VC, Kontozoglou TE, Downing P, Marks FR. Cyto-histological correlates in a colposcopic clinic: a 1-year prospective study. Diagn Cytopathol 1991; 7: 477-81 https://doi.org/10.1002/dc.2840070508
  15. DiBonito L, Falconieri G, Tomasic G, Colautti I, Bonifacio D, Dudine S. Cervical cytopathology. An evaluation of its accuracy based on cytohistologic comparison. Cancer 1993; 72: 3002-6 https://doi.org/10.1002/1097-0142(19931115)72:10<3002::AID-CNCR2820721023>3.0.CO;2-4
  16. Cho SH, Kim SR, Moon H, et al. Accuracy of cervical pap smear. Korean J Gynecol Oncol Colposc 1999; 10: 156-63
  17. Noh HT, Lee SS. The efficacy of cervicography combined with pap smear in cervical cancer screening. Korean J Gynecol Oncol Colposc 1999; 10: 13-23
  18. Townsend DE, Ostergard DR, Mishell DR Jr, Hirose FM. Abnormal Papanicolaou smears. Evaluation by colposcopy, biopsies, and endocervical curettage. Am J Obstet Gynecol 1970; 108: 429-34 https://doi.org/10.1016/0002-9378(70)90426-6
  19. Morell ND, Taylor JR, Snyder RN, Ziel HK, Saltz A, Willie S. Falsenegative cytology rates in patients in whom invasive cervical cancer subsequently developed. Obstet Gynecol 1982; 60: 41-5
  20. Dvorak KA, Finnemore M, Maksem JA. Histology correlation with atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LSIL) cytology diagnoses: an argument to ensure ASCUS follow-up that is as aggressive as that for LSIL. Diagn Cytopathol 1999; 21: 292-5 https://doi.org/10.1002/(SICI)1097-0339(199910)21:4<292::AID-DC13>3.0.CO;2-N
  21. Grenko RT, Abendroth CS, Frauenhoffer EE, Ruggiero FM, Zaino RJ. Variance in the interpretation of cervical biopsy specimens obtained for atypical squamous cells of undetermined significance. Am J Clin Pathol 2000; 114: 735-40 https://doi.org/10.1309/K7C9-X5P0-001B-2HK5
  22. Jones BA, Davey DD. Quality management in gynecologic cytology using interlaboratory comparison. Arch Pathol Lab Med 2000; 124: 672-81
  23. Kirschner B, Simonsen K, Junge J. Comparison of conventional papanicolaou smear and surepath liquid-based cytology in the copenhagen population screening programme for cervical cancer. Cytopathology 2006; 17: 187-94 https://doi.org/10.1111/j.1365-2303.2006.00384.x
  24. Williams AR. Liquid-based cytology and conventional smears compared over two 12-month periods. Cytopathology 2006; 17: 82-5 https://doi.org/10.1111/j.1365-2303.2006.00339.x
  25. Syrjanen K, Kataja V, Yliskoski M, Chang F, Syrjanen S, Saarikoski S. Natural history of cervical human papillomavirus lesions does not substantiate the biologic relevance of the Bethesda System. Obstet Gynecol 1992; 79: 675-82