Preceding cervical cytology in women with high-grade squamous intraepithelial lesion

Songveeratham, Sorramon; Kietpeerakool, Chumnan; Khunamornpong, Surapan; Sribanditmongkol, Narisa; Srisomboon, Jatupol

doi:10.1007/s00404-010-1581-3

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…It is important to add value to the predictive cytologic diagnosis because currently, cervical cytology remains the primary screening method. Ideally, the degree of cytologic changes should reflect the severity of the lesion histologically diagnosed 14, 15. However, subjectivity is a feature of the morphological diagnosis.…”

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confidence: 99%

Cytopathic effects of human papillomavirus infection and the severity of cervical intraepithelial neoplasia : A frequency study

Sousa

Alves

Martins

et al. 2011

Diagnostic Cytopathology

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Cytopathic effects related to the human papillomavirus (HPV) infection are more frequently found in cervical intraepithelial neoplasia (CIN) 1; however, there are indications that at least half the histological diagnoses of CIN2 and CIN3 include koilocytosis areas. The objective of this study was to evaluate the frequency of the cytological criteria suggestive of HPV infection in the cervical smears of women with a histological diagnosis of CIN. One hundred and sixty-two women with abnormal cervical smears and a diagnosis of CIN confirmed by histopathology were selected, including 46 cases of CIN 1, 42 of CIN 2 and 74 cases of CIN 3. Koilocytosis was found in 63% of the smears from women with a histopathological diagnosis of CIN 1. This sign was observed in 26.2% and 25.7% of smears of women with a diagnosis of CIN 2 and CIN 3, respectively. Cytomegaly also was frequent in cervical smears of women with histopathological diagnosis of CIN 1 (71.8%). On the other hand, spindle cells and atypical metaplasia were more frequent in women with CIN 2 and CIN 3. Atypical parakeratosis showed similar frequency in all grades of CIN diagnosis. Koilocytois and cytomegaly were inversely correlated with the diagnosis of CIN2 or CIN 3, with OR values respectively of 0.30 (95%CI 0.13-0.68) and 0.26 (95%CI 0.11-0.58). The others signs analyzed did not show any significant association. Koilocitosis and cytomegaly can provides good reassurance that a patient with atypical cervical smear have CIN 1.

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confidence: 99%

Cytopathic effects of human papillomavirus infection and the severity of cervical intraepithelial neoplasia : A frequency study

Sousa

Alves

Martins

et al. 2011

Diagnostic Cytopathology

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“…20,21 The possibility of false-negative results was greater when lesions involved only one quadrant, indicating that the lesion size might be related to better assessments and correct diagnoses. Songveeratham et al 22 found an $ 15% discrepancy rate (underdiagnosis) between Pap test and conization results for high-grade lesions; this was related to the small size of high-grade lesions and presence of lowgrade lesions.…”

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confidence: 99%

When is There no Benefit in Performing a Biopsy in the Suspicion of Intraepithelial Lesions of the Cervix?

Bonow

Collaço

Percicote

et al. 2022

Rev Bras Ginecol Obstet

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Objective To evaluate whether colposcopy-directed biopsy is necessary to increase the accuracy of diagnosing cervical intraepithelial lesions in relation to colposcopy. Methods We performed a retrospective, observational study by analyzing medical records obtained from Hospital de Clínicas do Paraná from February 2008 to February 2018. Patients with results of Pap tests, colposcopy, colposcopy-directed biopsy, and surgical procedures (high-frequency surgery or cold conization) were included. Data such as quadrants involved during colposcopy and age differences were also analyzed. Results A total of 299 women were included. Colposcopy was found to have an accuracy rate of 76.25% (95% confidence interval [CI], 71.4–81.1). Among the highest-grade lesions, the accuracy rate was 80.5% (95% CI, 75.7–85.3). The accuracy rates for biopsy were 79.6% (95% CI, 75–84.2) and 84.6% (95% CI, 80–89.1) for the highest-grade lesions. High-grade lesions were accurately confirmed in 76.9% and 85% of patients with 1 and 2 or more affected quadrants, respectively. For women younger than 40 years, the accuracy rates were 77.6% and 80.8% for colposcopy and biopsy, respectively. For women 40 years or older, the accuracy rates were 72.5% and 76.3% for colposcopy and biopsy, respectively. Conclusion There is no difference between the accuracy of colposcopy and that of biopsy in diagnosing cervical intraepithelial lesions in relation with the result of conization. The patients who received the greatest benefit when biopsy was not performed were those with high-grade lesions at colposcopy, a lesion involving 2 or more quadrants, and those younger than 40 years.

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“…Furthermore, it is known that cytology is only restricted to the observation of certain cells obtained during Pap smear examination and may not evaluate the exact kind or depth of potential dysplasia. This is the reason that, independent of the cytologist's experience, Pap smear examination generally underestimates the degree of dysplasia even in cases with HGSIL [19] . It is apparent that the observed percentages of CIN2+ diagnosis in our study may not be mainly attributed to cytology inaccuracy.…”

Section: Discussionmentioning

confidence: 99%

Cumulative High-Grade Squamous Intraepithelial Lesion Rate and Need for Surgical Intervention of Atypical Squamous Cells of Undetermined Significance Cytology-Diagnosed Patients: A Prospective Study

Petousis

Kalogiannidis²,

Margioula‐Siarkou³

et al. 2016

Gynecol Obstet Invest

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Objective: Τhe study aimed to study the rate of atypical squamous cells of undetermined significance (ASCUS) that progressed to high-grade squamous intraepithelial lesions (HGSIL), as well as the number of patients who finally necessitated a surgical intervention during follow-up. Methods: A prospective study was conducted on patients admitted for colposcopy during 2007-2012. We exclusively included those who presented with newly ASCUS diagnosis, while patients with a history of cervical intraepithelial neoplasia (CIN) were excluded. Primary end points were the cumulative rate of HGSIL during follow-up and the rate of surgical procedures performed because of such lesions. Results: There were 134 ASCUS cases included. Overall, there were 48 (35.8%) surgical excision procedures performed to treat or eliminate HGSIL during the follow-up period. According to the final histopathology of surgical specimens, the cumulative rate of CIN2 or higher cervical lesions was 28.4% (n = 38). Conclusion: The cumulative rate of CIN2+ during follow-up period was almost 30% for patients with ASCUS, with the necessity for interventional treatment being even higher.

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Preceding cervical cytology in women with high-grade squamous intraepithelial lesion

Abstract: Approximately 15% of HSIL cases are under-diagnosed by cytology. Significant factors leading to cytohistologic discrepancy are lesion size and the presence of coexisting LSIL.

Cited by 4 publications

References 13 publications

Cytopathic effects of human papillomavirus infection and the severity of cervical intraepithelial neoplasia : A frequency study

Cytopathic effects of human papillomavirus infection and the severity of cervical intraepithelial neoplasia : A frequency study

When is There no Benefit in Performing a Biopsy in the Suspicion of Intraepithelial Lesions of the Cervix?

Cumulative High-Grade Squamous Intraepithelial Lesion Rate and Need for Surgical Intervention of Atypical Squamous Cells of Undetermined Significance Cytology-Diagnosed Patients: A Prospective Study

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