Pleş Liana, Radosa Julia-Carolina, Sima Romina-Marina, Chicea Radu, Olaru Octavian-Gabriel, Poenaru Mircea-Octavian
Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Bucur Maternity, Saint John Hospital, 012361 Bucharest, Romania.
Diagnostics (Basel). 2022 Aug 12;12(8):1947. doi: 10.3390/diagnostics12081947.
Cervical cancer (CC) is the third most common cancer in the world, and Romania has the highest incidence of cervical cancer in Europe. The aim of this study was to evaluate the correlation between cytology, colposcopy, and pathology for the early detection of premalignant cervical lesions in a group of Romanian patients. This observational type 2 cohort study included 128 women from our unit, "Bucur" Maternity, who were referred for cervical cancer screening. Age, clinical diagnosis, cytology results, colposcopy impression, and biopsy results were considered. Colposcopy was performed by two experienced examiners. The pathological examination was performed by an experienced pathologist. The cytology found high-grade squamous intraepithelial lesions in 60.9% of patients, low-grade squamous intraepithelial lesions in 28.1%, atypical squamous cells for which a high-grade lesion could not be excluded in 9.4%, and atypical squamous cells of undetermined significance, known as LSIL, in 1.6%. The first evaluator identified low-grade lesions in 56.3%, high-grade lesions in 40.6%, and invasion in 3.1% of patients. The second evaluator identified low-grade lesions in 59.4%, high-grade lesions in 32.0%, and invasion in 8.6% of patients. The pathological exam identified low-grade lesions in 64.1%, high-grade lesions in 25%, and carcinoma in 14% of patients. The colposcopic accuracy was greater than the cytologic accuracy. Colposcopy remains an essential tool for the identification of cervical premalignant cancer cells. Standardization of the protocol provided an insignificant interobserver variability and can serve as support for further postgraduate teaching.
宫颈癌（CC）是全球第三大常见癌症，罗马尼亚的宫颈癌发病率在欧洲最高。本研究的目的是评估一组罗马尼亚患者中细胞学、阴道镜检查和病理学之间的相关性，以便早期发现宫颈前病变。这项观察性2型队列研究纳入了我院“布库尔”妇产医院的128名因宫颈癌筛查前来就诊的女性。研究考虑了年龄、临床诊断、细胞学结果、阴道镜检查印象和活检结果。阴道镜检查由两名经验丰富的检查人员进行。病理检查由一名经验丰富的病理学家进行。细胞学检查发现，60.9%的患者存在高级别鳞状上皮内病变，28.1%的患者存在低级别鳞状上皮内病变，9.4%的患者存在不能排除高级别病变的非典型鳞状细胞，1.6%的患者存在意义不明确的非典型鳞状细胞，即低级别鳞状上皮内病变（LSIL）。第一位评估者在56.3%的患者中发现了低级别病变，在40.6%的患者中发现了高级别病变，在3.1%的患者中发现了浸润。第二位评估者在59.4%的患者中发现了低级别病变，在32.0%的患者中发现了高级别病变，在8.6%的患者中发现了浸润。病理检查在64.1%的患者中发现了低级别病变，在25%的患者中发现了高级别病变，在14%的患者中发现了癌。阴道镜检查的准确性高于细胞学检查。阴道镜检查仍然是识别宫颈前癌细胞的重要工具。该方案的标准化提供了微不足道的观察者间变异性，可为进一步的研究生教学提供支持。
