The Korean Journal of Cytopathology (대한세포병리학회지)

The Korean Society for Cytopathology (대한세포병리학회)
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Diagnostic Accuracy of Cervicovaginal Cytology in the Detection of Squamous Epithelial Lesions of the Uterine Cervix; Cytologic/Histologic Correlation of 481 Cases

자궁경부 편평상피병변에서 자궁경부질도말 세포검사의 진단정확도 : 481예의 세포-조직 상관관계

  • Jin, So-Young (Department of Pathology Soonchunhyang University Hospital) ;
  • Park, Sang-Mo (Department of Pathology Soonchunhyang University Hospital) ;
  • Kim, Mee-Sun (Department of Pathology Soonchunhyang University Hospital) ;
  • Jeen, Yoon-Mi (Department of Pathology Soonchunhyang University Hospital) ;
  • Kim, Dong-Won (Department of Pathology Soonchunhyang University Hospital) ;
  • Lee, Dong-Wha (Department of Pathology Soonchunhyang University Hospital)
  • 진소영 (순천향대학교병원 병리과) ;
  • 박상모 (순천향대학교병원 병리과) ;
  • 김미선 (순천향대학교병원 병리과) ;
  • 진윤미 (순천향대학교병원 병리과) ;
  • 김동원 (순천향대학교병원 병리과) ;
  • 이동화 (순천향대학교병원 병리과)
  • Published : 2008.09.30
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Abstract

Background : Cervicovaginal cytology is a screening test of uterine cervical cancer. The sensitivity of cervicovaginal cytology is less than 50%, but studies of cytologic/histologic correlation are limited. We analyzed the diagnostic accuracy of cervicovaginal cytology in the detection of the squamous epithelial lesions of the uterine cervix and investigate the cause of diagnostic discordance. Materials and Methods : We collected a total of 481 sets of cervicovaginal cytology and biopsies over 5 years. The cytologic diagnoses were categorized based on The Bethesda System and the histologic diagnoses were classified as negative, flat condyloma, cervical intraepithelial neoplasia (CIN) I, CIN II, CIN III, or squamous cell carcinoma. Cytohistologic discrepancies were reviewed. Results: The concordance rate between the cytological and the histological diagnosis was 79.0%. The sensitivity and specificity of cervicovaginal cytology were 80.6% and 92.6%, respectively. Its positive predictive value and negative predictive value were 93.7% and 77.7%, respectively. The false negative rate was 19.4%. Among 54 false negative cytology cases, they were confirmed by histology as 50 flat condylomas, 2 CIN I, 1 CIN III, and 1 squamous cell carcinoma. The causes of false negative cytology were sampling errors in 75.6% and interpretation errors in 24.4%. The false positive rate was 7.4%. Among 15 false positive cytology cases, they were confirmed by histology as 12 atypical squamous cells of undetermined significance (ASCUS) and 3 low grade squamous intraepithelial lesions (LSIL). The cause of error was interpretation error in all cases. The overall diagnostic accuracy of cervicovaginal cytology was 85.7%. Conclusions : Cervicovaginal cytology shows high overall diagnostic accuracy and is a useful primary screen of uterine cervical cancer.

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References

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