Adenocarcinomas in the cervicovaginal papanicolaou smear: Analysis of a 12-year experience

✍ Scribed by Han-Seob Kim; Diane Underwood

• Publisher: John Wiley and Sons
• Year: 1991
• Tongue: English
• Weight: 628 KB
• Volume: 7
• Category: Article
• ISSN: 8755-1039
• DOI: 10.1002/dc.2840070203

✦ Synopsis

We attempted to reassess the signi'jcance of cervicovaginal Papanicolaou smear(s) in identifying adenocarcinoma (AC) by comparing Papanicolaou smears with histopathology in a pool of 188 patients. The jirst part of study dealt with 95 patients, seen over a 12-yr period (1975-1986), who had tissue diagnosis of cervical or endometrial AC, all with prior Papanicolaou smears available. Of the 95 patients, Papanicolaou smears were positive and/or inconclusive for uterine A C in 37 (38.9%) and falsely negative in 58 (61. I %) patients. Of the latter, six were either positive and/or inconclusive for squamous carcinoma and moderate to severe dysplasia; thus, the effective detection rate (sensitivity) for malignancy and related condition of Papanicolaou smears was 45.3 % (43 of 95). The second part of the study concerned the analysis of 130 patients with 148 Papanicolaou smear in whom cytologic diagnosis positive and/or inconclusive for A C was made during the same study period, Tissue diagnoses were available in I07 of these as follows: A C and glandular hyperplasia in 66 patients (61.7% predictive value), with I I (10.3%) from extrauterine sources; squamous carcinoma in 12 and moderate to severe dysplasia in 5, totalling I7patients (15.9%); miscellaneous conditions Q~olyps, radiation change, and glandular atrophy) in I 1 patients (10.3%); and no pathologic change in 13 patients (12. I %). The effective predictive value of positive and/or inconclusive Papanicolaou smears for all malignancy and related states