Rubeša-Mihaljević Roberta, Vrdoljak-Mozetič Danijela, Dinter Morana, Verša Ostojić Damjana, Štemberger-Papić Snježana, Klarić Marko
Department of Pathology and Cytology, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia.
Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia.
Diagnostics (Basel). 2021 May 25;11(6):942. doi: 10.3390/diagnostics11060942.
The aim of the study was to evaluate the accuracy of the diagnostic Pap test (DPT) on three slides and punch biopsy and endocervical curettage (PB/ECC) compared with the final biopsy material in the detection of high-grade squamous intraepithelial lesion (HSIL).
Patients treated with conization after previous DPT and PB/ECC were analyzed. The findings of the DPT and PB/ECC as well as of the endocervical brush cytology and ECC were compared with the final conus histology.
150 patients were analyzed, and final histology verified 145 cases of HSIL and 3 cancers. The percentage of confirmed HSIL cytology was 97%, while for PB/ECC it was 79% with 30/145 false negative results. The correlation between Pap test and PB/ECC showed that the diagnostic accuracy of DPT is significantly higher ( < 0.0001). Endocervical brush cytology confirmed HSIL+ in the endocervical canal in 83% and ECC in 35% of cases ( < 0.0001).
The DPT on three slides enables better detection of HSIL compared to PB/ECC, particularly for lesions localized in the endocervical canal sampled with a cytobrush. A high quality DPT could represent a surrogate for PB/ECC and open the possibility of direct access to therapeutic procedure.
本研究旨在评估三张玻片的诊断性巴氏试验（DPT）、穿刺活检及宫颈管刮术（PB/ECC）与最终活检材料相比，在检测高级别鳞状上皮内病变（HSIL）方面的准确性。
对先前接受DPT和PB/ECC检查后行锥切术的患者进行分析。将DPT、PB/ECC以及宫颈刷细胞学检查和ECC的结果与最终的锥切组织学结果进行比较。
分析了150例患者，最终组织学检查证实145例HSIL和3例癌症。确诊HSIL细胞学检查的比例为97%，而PB/ECC为79%，有30/145例假阴性结果。巴氏试验与PB/ECC之间的相关性表明，DPT的诊断准确性显著更高（<0.0001）。宫颈刷细胞学检查在83%的病例中证实宫颈管内有HSIL+，ECC在35%的病例中证实有HSIL+（<0.0001）。
与PB/ECC相比，三张玻片的DPT能够更好地检测HSIL，特别是对于用细胞刷取样的宫颈管内病变。高质量的DPT可以替代PB/ECC，并为直接进行治疗程序开辟可能性。
