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Significance of atypia in conventional Papanicolaou smears and liquid‐based cytology: a follow‐up study
Author(s) -
Schledermann D.,
Ejersbo D.,
Hoelund B.
Publication year - 2004
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/j.1365-2303.2004.00139.x
Subject(s) - medicine , atypia , papanicolaou test , papanicolaou stain , dysplasia , cytology , liquid based cytology , pap test , bethesda system , gynecology , pathology , cervical cancer , cancer , cervical cancer screening
The diagnosis of atypical squamous epithelial cells, borderline nuclear changes, is associated with some controversy, as it encompasses benign, reactive, as well as possible neoplastic conditions. The aim of this study was to evaluate the follow‐up diagnoses of cytological atypia in conventional Papanicolaou smears (CP) and liquid‐based samples by the ThinPrep ® Pap Test TM (TP). A total of 1607 CP smears from 1 January 2000 to 31 December 2000 and 798 TP samples from 1 January 2002 to 31 December 2002 diagnosed as atypia were included. The results show that the detection rate of atypia in cervical cytological samples was reduced by 41.3% ( P < 0.001) in TP compared with CP. Cytological and histological follow‐up data showed the presence of neoplastic lesions in 34.7% of patients screened by TP versus 22.3% of patients screened by CP, corresponding to a 55.6% increase in TP ( P < 0.001). Follow‐up diagnosis of mild dysplasia was seen more than twice as often in TP than in CP (12.8% versus 5.0%, P < 0.001). The prevalence of moderate and severe dysplasia was significantly increased with 26.7% in TP compared with CP (21.9% versus 17.2%, P < 0.01). In conclusion, the ThinPrep ® Pap Test TM yielded a significant decrease in atypia rates compared with the conventional Papanicolaou test. In subsequent follow‐up the percentage of neoplastic lesions was significantly increased in the ThinPrep ® Pap Test TM samples.