Cytopathology and the management of early invasive cancer of the uterine cervix.

This study was designed to review the effectiveness of cytopathology as it entered into the evaluation of patients with possible microinvasive or early occult carcinoma of the uterine cervix. During the 7-year period of 1971 to 1977, 39 consecutive patients were found for whom either a cytopathologic diagnosis of early invasive carcinoma had been made or suggested, or a histopathologic diagnosis of early invasive carcinoma had been made. After review, 35 patients had an ample number of cytopathologic and histopathologic materials and clinical records to be included in the study. The results of these studies have shown that when cytopathology on review predicted a lesion more severe than carcinoma in situ, it was confirmed by histopathology in more than 78% of patients (22 of 28 cases). In those patients shown by histopathology to have microinvasive or occult invasive carcinoma, the cytopathology reflected it in 87% of patients (27 of 31 cases). In the cases of histologically proved microinvasive carcinoma, the corresponding genital smears either diagnosed or suggested invasive carcinoma in 81% of cases and carcinoma in situ in 19%. From these studies it has been concluded that diagnostic cytopathology is potentially a highly reliable tool when used in conjunction with other modern diagnostic modalities to aid the decision-making in cases of probable early cancer of the uterine cervix.