DOI QR코드

DOI QR Code

Cytohistologic Discrepancy of High-Grade Squamous Intraepithelial Lesions in Papanicolaou Smears

  • Poomtavorn, Yenrudee (Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University Hospital) ;
  • Himakhun, Wanwisa (Department of Pathology, Faculty of Medicine, Thammasat University Hospital) ;
  • Suwannarurk, Komsun (Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University Hospital) ;
  • Thaweekul, Yuthadej (Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University Hospital) ;
  • Maireang, Karicha (Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University Hospital)
  • 발행 : 2013.01.31

초록

Objectives: To evaluate the frequency of cytohistologic discrepancy of high-grade squamous intraepithelial lesions (HSILs) in Pap smears and associated factors. Methods: Medical records of 223 women with HSIL Pap smears who were treated at Thammasat University Hospital were reviewed. Data on age, parity, menopausal status, contraceptive use and colposcopic directed biopsy and loop electrosurgical excision procedure (LEEP) pathology results were recorded. Results: Mean (SD) age of patients was 38.0 (9.4) years. The majority were premenopausal (86.5%) and multiparous (83.9%). Cytohistologic discrepancy between the Pap test and colposcopic-directed biopsy histology was 45.7% and that between the Pap test and LEEP histology was 29.5%. Fifty-four (24.2%) women had no high-grade CIN on both colposcopic directed biopsy and LEEP. Nulliparity, postmenopausal status and having no oral contraceptive pills use were factors associated with cytohistologic discrepancy. Conclusion: The exact cytohistologic discrepancy rate was relatively high (24.2%). Factors associated with cytohistologic discrepancy were nulliparity and postmenopausal status and having no oral contraceptive pill use.

참고문헌

  1. Sadan O, Yarden H, Schejter E, et al (2007). Treatment of high-grade squamous intraepithelial lesions: a "see and treat" versus a three-step approach. Eur J Obstet Gynecol Reprod Biol, 131, 73-5. https://doi.org/10.1016/j.ejogrb.2005.12.025
  2. Simoens C, Goffin F, Simon P, et al,. 2012. Adverse obstetrical outcomes after treatment of precancerous cervical lesions: a Belgian multicentre study. BJOG, 119, 1247-55. https://doi.org/10.1111/j.1471-0528.2012.03429.x
  3. Sjoborg KD, Vistad I, Myhr SS, et al.,2007. Pregnancy outcome after cervical cone excision: a case-control study. Acta Obstet Gynecol Scand, 86, 423-8. https://doi.org/10.1080/11038120701208158
  4. Solomon D, Davey D, Kurman R, et al., 2002. The 2001 Bethesda System: terminology for reporting results of cervical cytology. JAMA, 287, 2114-9. https://doi.org/10.1001/jama.287.16.2114
  5. Tzeng JE, Chen JT, Chang MC, Ho WL (1999). Discordance between uterine cervical cytology and biopsy: results and etiologies of a one-year audit. Kaohsiung J Med Sci, 15, 26-31.
  6. Wright TC Jr, Massad LS, Dunton CJ,, et al.,2007. 2006 consensus guidelines for the management of women with abnormal cervical cancer screening tests. Am J Obstet Gynecol, 197, 346-55. https://doi.org/10.1016/j.ajog.2007.07.047
  7. Alvarez RD, Wright TC; Optical Detection Group (2007). Effective cervical neoplasia detection with a novel optical detection system: a randomized trial. Gynecol Oncol, 104, 281-9. https://doi.org/10.1016/j.ygyno.2006.08.056
  8. Cho H, Kim JH (2009). Treatment of the patients with abnormal cervical cytology: a "see-and-treat" versus a three-step strategy. J Gynecol Oncol, 20, 164-8. https://doi.org/10.3802/jgo.2009.20.3.164
  9. Clements AE, Raker CA, Cooper AS, et al ., 2011. Prevalence and patient characteristics associated with CIN 3 in adolescents. Am J Obstet Gynecol, 204, 1-7. https://doi.org/10.1016/j.ajog.2010.11.002
  10. Crane JM (2003). Pregnancy outcome after loop electrosurgical excision procedure: a systematic review. Obstet Gynecol, 102, 1058-62. https://doi.org/10.1016/S0029-7844(03)00741-5
  11. De Vet HC, Knipschild PG, Sturmans F (1993). The role of sexual factors in the aetiology of cervical dysplasia. Int J Epidemiol, 22, 798-803. https://doi.org/10.1093/ije/22.5.798
  12. Dunn TS, Burke M, Shwayder J (2003). A "see and treat" management for high-grade squamous intraepithelial lesion pap smears. J Low Genit Tract Dis, 7, 104-6. https://doi.org/10.1097/00128360-200304000-00006
  13. Gargano JW, Nisenbaum R, Lee DR, et al.,2012. Age-group differences in human papillomavirus types and cofactors for cervical intraepithelial neoplasia 3 among women referred to colposcopy. Cancer Epidemiol Biomarkers Prev, 21, 111-21. https://doi.org/10.1158/1055-9965.EPI-11-0664
  14. Kantathavorn N, Phongnarisorn C, Srisomboon J, et al., 2006. Northern Thai women with high grade squamous intraepithelial lesion on cervical cytology have high prevalence of underlying invasive carcinoma. Asian Pacific J Cancer Prev, 7, 477-9.
  15. Kietpeerakool C, Srisomboon J, Khobjai A, Chandacham A, Tucksinsook U (2006). Complications of loop electrosurgical excision procedure for cervical neoplasia: a prospective study. J Med Assoc Thai, 89, 583-7.
  16. Kyrgiou M, Koliopoulos G, Martin-Hirsch P, et al.,2006. Obstetric outcomes after conservative treatment for intraepithelial or early invasive cervical lesions: systematic review and meta-analysis. Lancet, 367, 489-98. https://doi.org/10.1016/S0140-6736(06)68181-6
  17. Li ZG, Qian de Y, Cen JM, Chen GD, Shu YH (2009). Three-step versus "see-and-treat" approach in women with high-grade squamous intraepithelial lesions in a low-resource country. Int J Gynaecol Obstet, 106, 202-5. https://doi.org/10.1016/j.ijgo.2009.04.011
  18. Massad LS, Collins YC, Meyer PM (2001). Biopsy correlates of abnormal cervical cytology classified using the Bethesda system. Gynecol Oncol, 82, 516-22. https://doi.org/10.1006/gyno.2001.6323
  19. Moss EL, Moran A, Douce G, et al., 2010. Cervical cytology/histology discrepancy: a 4-year review of patient outcome. Cytopathology, 21, 389-94. https://doi.org/10.1111/j.1365-2303.2010.00754.x
  20. Numnum TM, Kirby TO, Leath CA 3rd, et al (2005). A prospective evaluation of "see and treat" in women with HSIL Pap smear results: is this an appropriate strategy? J Low Genit Tract Dis, 9, 2-6. https://doi.org/10.1097/00128360-200501000-00002
  21. Parazzini F, La Vecchia C, Negri E, et al.,1992. Risk factors for cervical intraepithelial neoplasia. Cancer, 69, 2276-82. https://doi.org/10.1002/1097-0142(19920501)69:9<2276::AID-CNCR2820690912>3.0.CO;2-Q

피인용 문헌

  1. Is the Correlation between Papanicolaou Smear and Histopathology Results Affected by Time to Colposcopy? vol.15, pp.4, 2014, https://doi.org/10.7314/APJCP.2014.15.4.1527
  2. See-and-Treat Approach to Cervical Intraepithelial Lesions in HRH Princess Maha Chakri Sirindhorn Medical Center vol.15, pp.8, 2014, https://doi.org/10.7314/APJCP.2014.15.8.3483