Recent evidence suggests that a cytology–histology correlation (CHC) with discrepancy detection can both evaluate errors and improve the sensitivity and specificity of the cytologic method. We aimed to analyze the errors in cytologic–histologic discrepancies according to the CHC protocol guideline of the American Society of Cytopathology (2017). This retrospective study included 273 patients seen at the National Medical Research Center of Obstetrics, Gynecology and Perinatology (Moscow, Russia) between January 2019 and September 2021. The patients’ mean age was 34 ± 8.1 years. The cytology–histology agreement was noted in 158 cases (57.9%). Major discrepancies were found in 21 cases (7.6%), while minor discrepancies were noted in 93 cases (34.1%). The reason for 13 (4.8%) discrepancies was a colposcopy sampling error and, in 46 (16.8%) cases, the reason was a Papanicolaou (PAP) test sampling error. The discrepancy between primary and reviewed cytology was due interpretive errors in 13 (4.8%) cases and screening errors in 42 (15.4%) cases. We demonstrated that the ASC guidelines facilitate cervical CHC. A uniform application of these guidelines would standardize cervical CHCs internationally, provide a scope for the inter-laboratory comparison of data, and enhance self-learning and peer learning.
The article presents a systematic review of the results of modern clinical studies devoted to the problem of the microbiome and transcriptome in women with cervical intraepithelial neoplasia (CIN). Moderate to severe CIN (CIN II – III) can precede the development of cervical cancer (CC) by several years or even decades. Cervical cancer (CC) is an important global health problem. There is a year-on-year increase in the prevalence of CC. Currently, there are many known risk factors that contribute to the development of CIN and cervical cancer. However, the vaginal and cervical microbiome play an important role in the development and progression of CIN and CC, according to some authors. Thus, the timely detection and treatment of cervical intraepithelial lesion-associated genital infections is now especially important. From these point of view, bacterial vaginosis (BV) is considered an acute problem in gynecological practice, which affects the incidence of precancerous conditions of the cervix. The results of the studies have shown the importance of detailed analysis of the vaginal microbial community, which was performed by the method of next generation sequencing (NGS). These studies were conducted using the NGS method based on the analysis of bacterial 16S rRNA genes, which has a high diagnostic accuracy and allows to determine the verity of the microbial landscape. The study of the transcriptome in women with CIN showed a change in many microRNA molecules, which can become markers of the CIN and cervical cancer upon further study. The introduction of the NGS method into the laboratory diagnostics complex will improve the diagnosis and timely prevent the progression of CIN to cervical cancer.The study of the microbiome of the vaginal biotope and cervical canal will allow to identify the groups of patients at high risk for the progression of precancerous lesions of the cervix and cervical cancer. Transcriptome studies have shown changes in many microRNA molecules (SALL4, FOXO1, HBD-1, HBD-2, HBD-3, LL37, psoriasin and IL-8, etc.) in women with CIN and cervical cancer.
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