Nenning H, Horn L C, Kühndel K, Bilek K
Institute of Pathology, University of Leipzig, Germany.
Anal Cell Pathol. 1995 Jul;9(1):61-8.
The evidence of exfoliative cytology of the cervix uteri depends on various factors. The rate of false positive cervical smears is on average 8.8%. We have reviewed 170 false positive routinely Papanicolaou-stained cervical smears and the corresponding histological specimens. The aim was to look for non-neoplasic changes explaining the cytological over-interpretation. In addition, nuclear Feulgen-DNA measurements of the smears were made to look for changes in DNA pattern. In 50% of all cases, a cause was found for the false positive cytological diagnosis by means of histological reexamination: non-neoplastic nuclear and cellular polymorphia, severe purulent-erosive inflammation, a higher reclassification or a positive presurgical biopsy. In 51.9% of these cases, there were signs of an infection with human papilloma virus (HPV). In cases without histological explanation of the cytological findings, DNA measurements were made on the suspicious cells. By means of single cell algorithm (5c/9c exceeding events), a general rate of 62.7% of aneuploid specimens was detected. The number of aneuploid single cells ranged between 5 and 63 per slide. Of these cases, 23.1% showed signs of HPV infection. As a result of the study, the number of real 'false positive' cytological diagnoses decreased from 170 to 97 as a result of histological reexamination and DNA measurement. In doubtful cases, DNA measurement of suspicious smears should be made.
子宫颈脱落细胞学的证据取决于多种因素。宫颈涂片假阳性率平均为8.8%。我们回顾了170例常规巴氏染色的宫颈涂片假阳性病例及相应的组织学标本。目的是寻找能解释细胞学过度解读的非肿瘤性改变。此外，对涂片进行核福尔根DNA测量以寻找DNA模式的变化。在所有病例中，50%通过组织学复查找到了细胞学假阳性诊断的原因：非肿瘤性核及细胞多形性、严重脓性糜烂性炎症、更高的重新分类或术前活检阳性。在这些病例中，51.9%有人类乳头瘤病毒（HPV）感染迹象。在细胞学结果无组织学解释的病例中，对可疑细胞进行了DNA测量。通过单细胞算法（5c/9c超事件），检测到非整倍体标本的总体比例为62.7%。每张涂片非整倍体单细胞数量在5至63个之间。在这些病例中，23.1%有HPV感染迹象。研究结果显示，经组织学复查和DNA测量，真正“假阳性”的细胞学诊断数量从170例降至97例。在可疑病例中，应对可疑涂片进行DNA测量。
