Correlation Between Cervical Cytology and Histopathological Cervical Biopsy Findings According to the Bethesda System / Stepen Korelacije Cervikalne Citologije Po Bethesda Klasifikaciji Sa Patohistološkim Nalazima Cervikalne Biopsije

Open access

ABSTRACT

The Pap test (Pap smear) is a morphological cytodiagnostic test that reveals premorbid and early stages of cervical cancer through the use of cervicovaginal cytology.

The present study was conducted at the Department of Gynecology and Obstetrics, Clinical Center Kragujevac, from January 01, 2013, to December 1, 2013, with patients who were part of the national screening program and who used a secondary cytological examination (Pap test) performed using a conventional method.

The patients were grouped according to the results of a Pap smear and histopathological findings. The classification of cytological smears was performed in accordance with the Bethesda system. The hypotheses established in this study were statistically tested.

The greatest number of cytological findings was NILM. However, the most frequent abnormal cytological findings in terms of percentage were ASC-US. After secondary cervical findings of 8.1% of the total number of women, biopsies were performed. In 68.57% of the biopsies performed, CIN was present in all of them, with the most frequent ones being LSIL (50.6%), HSIL (10.4%) and CA Invasiva (0.5%). This study, using the X2 test, confirmed that cervical cytology and biopsy results are dependent features (sig. = 0.036), between which there is a medium association (Cramer’s V = 0.176). In the ASC-US cytological findings, small percentages of CIN1 and CIN2 were detected. Cervical cytology in this study presented high sensitivity, specificity, positive and negative predictive value. As a relatively inexpensive, painless and easily approachable method, cervical cytology fully substantiates its implementation in diagnostic procedures as well as in organized screening programs.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • 1. Broćić M Dodić V Perišić Ž. Ginekološka citodijagnostika i kolposkopija. Beograd: Eksportpress. 1991.

  • 2. -Department for Prevention and Control of Noncommunicable Diseases. Cancer incidence and mortality in central Serbia 2011 Cancer registry of central Serbia. Beograd: Institute of Public Health of Serbia “Dr Milan Jovanović Batut”. 2013. report No. 13.

  • 3. Mitrovic-Jovanovic A Stanimirovic B Nikolic B Zamurovic M Perisic Z Pantic-Aksentijevic S. Cervical vaginal and vulvar intraepithelial neoplasms. Vojnosanitetski pregled 2011;68(12):1051-1056. doi: 10.2298/ VSP1112051M

  • 4. Matovina M Sabol I Grubisic G Gasperov NM Grce M. Identification of human papillomavirus type 16 integration sites in high-grade precancerous cervical lesions. Gynecol Oncol 2009;113(1):120-7. PubMed PMID: 19157528. doi: 10.1016/j.ygyno.2008.12.004

  • 5. Djordjevic M. Citoloski atlas malignih tumora. Beograd: Elit- Medica.

  • 6. Vrdoljak-Mozetic D. Papa test danas - nova “Bethesda” klasifikacija. Medix 2005;11(58):85-89.

  • 7. Pavlovic S. Citopatologija zenskih genitalija. Nis: Prosveta. 1980.

  • 8. Apgar BS Zoschnick L Wright TC. The 2001 Bethesda System terminology. Am Fam Physician 2003;68(10):1992-8. PubMed PMID: 14655809

  • 9. Mathilde EB Albert JHS. The Pap Smear 3rd ed. Amsterdam: Harwood academic publishers. 1996.

  • 10. Solomon D Nayar R. The Bethesda System for Reporting Cervical Cytology. Definitions Criteria and Explanatory Notes 2nd ed. New York: Springer Science; New York: Business Media LLC.. 2004.

  • 11. -Мinistаrstvо zdrаvljа Rеpubliке Srbiје -Rеpubličка stručnа коmisiја zа izrаdu i implеmеntаciјu vоdičа dоbre кliničке prакsе . Nаciоnаlni vоdič dоbrе кliničке prакsе zа diјаgnоstifiкоvаnjе i lеčеnjе rака grlićа mаtеricе. Кliničкi vоdič 12/14. Bеоgrаd: Аgеnciја zа акrеditаciјu zdrаvstvеnih ustаnоvа Srbiје. 2013.

  • 12. Pogacnik A et al. . Uputstva za tumačenje briseva cervikalne citologije-klasifikacija prema Bethesdi. Beograd: Institut za javno zdravlje Srbije “Dr Milan Jovanović- Batut”. 2012. (prevod slovenačke skraćene verzije).

  • 13. Melnikow J Nuovo J Willan AR Chan BK Howell LP. Natural history of cervical squamous intraepithelial lesions: a meta-analysis. Obstet Gynecol 1998;92(4 Pt 2):727-735.

  • 14. Koss LG Melamed MR. Koss’ Diagnostic Cytology and Its Histopathologic Bases 5th ed. USA: Lippincott Williams & Wilkins. 2006.

  • 15. Milenkovic V Sparic R Dotlic J Tulic L Mirkovic L Milenkovic S Atanackovic J. Reliability and relationship of colposcopical cytological and histopathological findings in the diagnostic process. Vojnosanitetski Pregled 2012;69(10):869-873.

  • 16. Cibas ES Ducatman BS. Cytology: Diagnostic principles and clinical correlates 3rd ed. Philadelphia: Saunders. 2009.

  • 17. Kesic V Jovicevic-Bekic A Vujnović M. Cervical cancer screening in Serbia. Coll Antropol 2007;31(2):31-6. PubMed PMID: 17598502

  • 18. Schiffman M Solomon D. Findings to date from the ASCUS-LSIL Triage Study (ALTS). Arch Pathol Lab Med 2003;127(8):946-9. PubMed PMID: 12873166

  • 19. Massad LS Collins YC Meyer PM. Biopsy correlates of abnormal cervical cytology classified using the Bethesda system. Gynecol Oncol 2001;82(3):516-22. PubMed PMID: 11520149. doi: 10.1006/gyno.2001.6323

  • 20. Chivukula M Shidham VB. ASC-H in Pap test - definitive categorization of cytomorphological spectrum. Cytojournal 2006;3(1):14. doi: 10.1186/1742-6413-3-14

  • 21. Barcelos ACM Antoniazi Michelin M Adad SJ Candido Murta EF. Atypical Squamous Cells of Undetermined Significance: Bethesda Classification and Association with Human Papillomavirus. Infectious Diseases in Obstetrics and Gynecology 2011;904674:9. doi: 10.1155/2011/904674

  • 22. Stoler MH Schiffman M. Interobserver reproducibility of cervical cytologic and histologic interpretations: realistic estimates from the ASCUS-LSIL Triage Study. JAMA 2001;285(11):1500-5. PubMed PMID: 11255427

  • 23. Sherman ME Wang SS Tarone R Rich L Schiffman M. Histopathologic extent of cervical intraepithelial neoplasia 3 lesions in the atypical squamous cells of undetermined significance low-grade squamous intraepithelial lesion triage study: implications for subject safety and lead-time bias. Cancer Epidemiol Biomarkers Prev 2003;12(4):372-9. PubMed PMID: 12692113

  • 24. Castle PE Cox JT Schiffman M Wheeler CM Solomon D. Factors Influencing Histologic Confirmation of High-Grade Squamous Intraepithelial Lesion Cytology. Obstet Gynecol 2008;112(3):637-645.

  • 25. Perisi Z Plesinac-Karapandzic V Dzinic M Zamurovic M Perisic N. Cervical cancer screening in Serbia. Vojnosanitetski pregled 2013;70(1):86-89. doi: 10.2298/ VSP1301086P

  • 26. -Vlаdа Rеpubliке Srbiје. Uredba o nacionalnom programu ranog otkrivanja karcinoma grlića materice. Službeni glasnik RS 2013 73/2013 :83/2013.

  • 27. Plummer M Schiffman M Castle PE Maucort-Boulch D Wheeler CM. A 2-year prospective study of human papillomavirus persistence among women with a cytological diagnosis of atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion. J Infect Dis 2007;195(11):1582-9. PubMed PMID: 17471427

  • 28. Stoler MH Wright TC Sharma A Apple R Gutekunst K Wright TL. High-risk human papillomavirus testing in women with ASC-US cytology: results from the ATHENA HPV study. Am J Clin Pathol 2011;135(3):468-75. PubMed PMID: 21350104. doi: 10.1309/AJCPZ5JY6- FCVNMOT

  • 29. Wright TC Massad L Dunton CJ Spitzer M Wilkinson EJ Solomon D. 2006 consensus guidelines for the management of women with abnormal cervical cancer screening tests. Am J Obstet Gynecol 2007;197(4):346-55. PubMed PMID: 17904957

  • 30. Jordan J Arbyn M Martin-Hirsch P Schenck U Baldauf J Da SD Prendiville W. European guidelines for quality assurance in cervical cancer screening: recommendations for clinical management of abnormal cervical cytology part 1. Cytopathology 2008;19(6):342-54. PubMed PMID: 19040546. doi: 10.1111/j.1365-2303. 2008.00623.

Search
Journal information
Impact Factor


CiteScore 2018: 0.13

SCImago Journal Rank (SJR) 2018: 0.118
Source Normalized Impact per Paper (SNIP) 2018: 0.079

Metrics
All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 365 208 6
PDF Downloads 145 97 2