Praxis Medica (Jan 2015)

Histological-cytological reports correlation and reliability of papanicolau test for the detection of malignant changes in the cervix

  • Vitković L.,
  • Mijović M.,
  • Vukićević D.,
  • Đerković B.,
  • Mitić N.,
  • Ilić A.,
  • Trajković G.,
  • Jakovljević S.

DOI
https://doi.org/10.5937/pramed1501023V
Journal volume & issue
Vol. 44, no. 1
pp. 23 – 31

Abstract

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The incidence rate of cervical cancer in Serbia is among the highest in Europe and is 23.8 in 100.000. Papanicolaou test, colposcopy and pathohistology report are the basic method of secondary prevention of cervical cancer. The aim of the study was to examine the correlation between histological-cytological findings and reliability of the Papanicolaou test in detection of cervical lesions. We analyzed cervical smears (Papanicolaou test) in 3868 women. Among them 190 women had suspect finding and because of that they were underwent to cervical biopsy. We detected premalignant or malignant changes of the cervix in 77 women. LSIL was found at 43 (22.6%), HSIL at 25 (13.2%) and carcinoma planocellulare at 9 (4.7%) women. There is a statistically significant positive correlation (Spearman=0.829; p<0,001) between histological and cytological findings of the respondents. Most estimates of diagnostic performance of Papanicolaou test in discrimination of LSIL, HSIL and carcinoma planocellulare in accordance with cervicitis are for cytological findings of ASCH (PA IIIa) (Sp=90.6% and Sn=100% for carcinoma planocellulare; Sn = 96% for HSIL and Sn=86% for LSIL). In discrimination HSIL from LSIL the best discrimination is achieved by finding LSIL (PAIIIb) Papanicolaou test (Sn=72.0%, Sp=67.4%), and in discrimination carcinoma planocellulare from LSIL best discrimination is achieved by finding HSIL (PA IIIb/IV) Papanicolaou test (Sn=77.8%, Sp=97.7%). Based on our results we can conclude that there is a positive correlation between histological-cytological findings and that the Papanicolaou test more reliable in detecting severe premalignant lesions. Cytological diagnosis of ASCH (PAIIIa) and LSIL (PAIIIb) can reliably indicate the presence of premalignant cervical lesions in women, and patients with these findings must be more controlled and treated.

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