Nayak Sonali Susmita, Dutta Anupurva, Khedkar Rutvij, Roy Sabyasachi
Department of Pathology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India.
Department of Oncopathology, Tata Memorial Hospital, Mumbai, Maharashtra, India.
J Cytol. 2024 Jan-Mar;41(1):1-7. doi: 10.4103/joc.joc_112_23. Epub 2023 Dec 28.
Many developments in cervical cancer screening have happened in the past century, helping women in earlier detection of cervical cancer and its precursors. Cytology still holds the fort as being a specific test, though it suffers in sensitivity. As a part of the quality control program, the aim of the study is to determine the total number of abnormal liquid-based cervical cytology (LBC) at our center and correlate the abnormal LBC with histology and human papillomavirus (HPV) DNA test results.
Retrospective analysis of 4286 LBC screening cases was carried out over a period of 5 years. For cytology-histology correlation, cervical biopsy and cytology test results were analyzed. The two-tier grading system for biopsy interpretation was used. HPV DNA test results wherever available were correlated.
Of the 4286 LBC cases, 157 samples (3.7%) were unsatisfactory for evaluation, 3915 samples (91.3%) were negative for intra-epithelial lesion or malignancy, and 214 samples (5%) showed epithelial cell abnormality. ASC-US was reported in 60 cases (1.4%), ASC-H in 35 cases (0.8%), LSIL in 47 cases (1.1%), HSIL in 41 cases (1.0%), squamous cell carcinoma in a single case (0.02%), and atypical glandular cells in 30 cases (0.7%). The ASC/SIL ratio was 1.07:1. The CHC major discrepancy was calculated as 16.2%. The concordance of HSIL on cytology and biopsy as a measure of PPV is 94.4%. Of the epithelial cell abnormalities, 24 cases were positive for high-risk HPV (hrHPV). Molecular test results of 2737 samples showed HPV detected in 50 cases, of which 24 cases were positive for hrHPV.
The study helped us to analyze the quality parameters of our cytopathology laboratory which are within the acceptable limits.
在过去的一个世纪里，宫颈癌筛查取得了许多进展，有助于女性更早地发现宫颈癌及其癌前病变。细胞学检查仍是一项具有特异性的检查，尽管其敏感性较差。作为质量控制计划的一部分，本研究旨在确定我们中心异常液基宫颈细胞学检查（LBC）的总数，并将异常LBC结果与组织学和人乳头瘤病毒（HPV）DNA检测结果进行关联分析。
对4286例LBC筛查病例进行了为期5年的回顾性分析。为进行细胞学-组织学相关性分析，对宫颈活检和细胞学检查结果进行了分析。活检结果采用两级分级系统进行解读。对所有可用的HPV DNA检测结果进行了关联分析。
在4286例LBC病例中，157份样本（3.7%）因评估不满意被排除，3915份样本（91.3%）上皮内病变或恶性病变呈阴性，214份样本（5%）显示上皮细胞异常。报告意义不明确的非典型鳞状细胞（ASC-US）60例（1.4%），不除外高级别鳞状上皮内病变的非典型鳞状细胞（ASC-H）35例（0.8%），低级别鳞状上皮内病变（LSIL）47例（1.1%），高级别鳞状上皮内病变（HSIL）41例（1.0%），鳞状细胞癌1例（0.02%），非典型腺细胞30例（0.7%）。ASC/SIL比例为1.07:1。宫颈活检与细胞学检查结果的主要差异率为16.2%。以HSIL在细胞学和活检结果中的一致性作为衡量阳性预测值（PPV）的指标，其PPV为94.4%。在上皮细胞异常的样本中，24例高危型HPV（hrHPV）检测呈阳性。2737份样本的分子检测结果显示，50例检测到HPV，其中24例hrHPV检测呈阳性。
本研究有助于我们分析细胞病理学实验室的质量参数，这些参数均在可接受范围内。
