Turkish Journal of Pathology

Türk Patoloji Dergisi

Turkish Journal of Pathology

Turkish Journal of Pathology

2013, Vol 29, Num, 3     (Pages: 179-184)

Patients with Epithelial Cell Abnormality in PAP Smears: Correlation of Results with Follow-Up Smears andCervical Biopsies

İlknur Çetinaslan TÜRKMEN 1, Nuray BAŞSÜLLÜ 1, Pınar KORKMAZ 2, Banu GÜNENÇ 3, Cem Murat BAYKAL 3, Nilgün GÜDÜCÜ 3, Herman İŞÇİ 3, İlkkan DÜNDER 3, Gülen BÜLBÜL DOĞUSOY 2

1 Department of Pathology, İstanbul Bilim University Faculty of Medicine, İSTANBUL, TURKEY
2 Group Florence Nightingale Hospitals, Pathology Laboratory, İSTANBUL, TURKEY
3 Department of Obstetrics and Gynecology, İstanbul Bilim University, Group Florence Nightingale Hospitals, İSTANBUL, TURKEY

DOI: 10.5146/tjpath.2013.01182
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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 efficient screening test. We aimed to compare the cervical cytology diagnosis with biopsy 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 with their biopsy and smear follow ups. The diagnoses were compared with the 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 different populations, the ASC/SIL is a more definite variable to be used for quality assurance. The efficiency 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.

Keywords : Cervical smear, Cytology, Biopsy, Quality control