Abali Remzi, Bacanakgıl Besim Haluk, Celık Serdar, Aras Ozlem, Koca Pelin, Boran Birtan, Dursun Nevra
Department of Obstetrics and Gynaecology Namık Kemal University, Faculty of Medicine, Tekirdağ, Turkey.
Turk Patoloji Derg. 2011 May;27(2):144-8. doi: 10.5146/tjpath.2011.01063.
To investigate the correlation between cytology and cervical biopsy in patients with squamous cell abnormality on cervical cytology.
The cervical smears diagnosed in our clinic between 2005-2008 were reviewed retrospectively. Cases which exhibited squamous cell abnormality (n: 374) were evaluated.
The mean age was 45.15±10.78. In the cytopathological results, 256 (68.4%) ASC-US, 21 (5.6%) ASC-H, 31 (8.2%) LSIL, 48 (12.8%) HSIL, and 8 (4.8%) invasive carcinomas were diagnosed. Histopathological results were 213 (57%) nonneoplastic, 85 (22.7%) CIN I, 14 (3.7%) CIN II, 34(9.0%) CIN III and 28 (7.5%) invasive squamous cell carcinomas. Including all squamous cell abnormalities, the sensitivity of the smear test in CIN I and higher grade lesions was 56.95% and the false positivity was 43.04%. Excluding ASC-US and ASC-H lesions, the sensitivity of the smear test was 77.31% and the false positivity was 22.68%. After evaluating cervical cytohistopathological correlation, the positive predictive value was found to be 100% in invasive carcinoma, 62% in HSIL and 38% in LSIL.
As the grade of cytopathological result increases, the correlation between biopsy and the smear test also increases. The high sensitivity of the cervical smear test for high-grade lesions shows that it is an effective screening test.
探讨宫颈细胞学检查发现鳞状细胞异常的患者中细胞学与宫颈活检结果之间的相关性。
回顾性分析2005年至2008年在我院门诊诊断的宫颈涂片。对表现出鳞状细胞异常的病例（n = 374）进行评估。
平均年龄为45.15±10.78岁。在细胞病理学结果中，诊断出256例（68.4%）意义不明确的非典型鳞状细胞（ASC-US）、21例（5.6%）不典型鳞状细胞不能排除高度病变（ASC-H）、31例（8.2%）低级别鳞状上皮内病变（LSIL）、48例（12.8%）高级别鳞状上皮内病变（HSIL）和8例（4.8%）浸润癌。组织病理学结果为213例（57%）非肿瘤性病变、85例（22.7%）宫颈上皮内瘤变1级（CIN I）、14例（3.7%）CIN II、34例（9.0%）CIN III和28例（7.5%）浸润性鳞状细胞癌。包括所有鳞状细胞异常情况，涂片检查对CIN I及更高级别病变的敏感性为56.95%，假阳性率为43.04%。排除ASC-US和ASC-H病变后，涂片检查的敏感性为77.31%，假阳性率为22.68%。评估宫颈细胞组织病理学相关性后，发现浸润癌的阳性预测值为100%，HSIL为62%，LSIL为38%。
随着细胞病理学结果分级的增加，活检与涂片检查之间的相关性也增加。宫颈涂片检查对高级别病变具有较高敏感性，表明它是一种有效的筛查方法。
