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Overall accuracy of cervical cytology and clinicopathological significance of LSIL cells in ASC ‐H cytology
Author(s) -
Kim S. H.,
Lee J. M.,
Yun H. G.,
Park U. S.,
Hwang S. U.,
Pyo J.S.,
Sohn J. H.
Publication year - 2017
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/cyt.12351
Subject(s) - cytology , medicine , gynecology , pathology
Objective The aims of this study were (i) to investigate the diagnostic accuracy of Papanicolaou (Pap) smears and (ii) to evaluate the clinicopathological significance of the presence of low‐grade squamous intraepithelial lesion ( LSIL ) cells in atypical squamous cells cannot exclude high‐grade squamous intraepithelial lesion ( HSIL ) ( ASC ‐H) cytology. Methods We retrospectively reviewed paired cytological and histological findings from 3141 patients. ASC ‐H cytology was classified as either ASC ‐H or LSIL with some features suggestive of the presence of a concurrent HSIL ( LSIL ‐H). Clinicopathological characteristics were evaluated through a retrospective study and meta‐analysis. Results The accuracy of the cytological diagnosis was 93.7% (2942 of 3141 cases). The positive predictive value (PPV) of ASC ‐H for cervical intraepithelial neoplasia grade 2 or worse ( CIN 2+ ) was 51.4%. In cases of LSIL ‐H, CIN 2+ histology was more prevalent in the pre‐menopausal period (19–44 years) than in peri‐ and postmenopausal periods (older than 45 years) ( P = 0.024). There was no difference in the ability of LSIL ‐H and ASC ‐H to predict CIN 2+. Conclusion The Pap smear is a good cervical cancer screening method. Although there was no difference in the predictive value for CIN 2+ between LSIL ‐H and ASC ‐H, the presence of definite LSIL cells was more predictive of CIN 2+ in younger patients than in older patients.