Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Clinicopathologic Importance of Women with Squamous Cell Carcinoma Cytology on Siriraj Liquid-Based Cervical Cytology

  • Ruengkhachorn, Irene (Gynecologic Oncology Division, Faculty of Medicine, Siriraj Hospital, Mahidol University) ;
  • Laiwejpithaya, Somsak (Gynecologic Cytology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University) ;
  • Leelaphatanadit, Chairat (Gynecologic Oncology Division, Faculty of Medicine, Siriraj Hospital, Mahidol University) ;
  • Chaopotong, Pattama (Gynecologic Oncology Division, Faculty of Medicine, Siriraj Hospital, Mahidol University)
  • Published : 2012.09.30
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Abstract

Objectives: The purposes of this study were to determine the prevalence and predictive value to detect significant neoplasia and invasive lesions, and to evaluate the correlation between clinical and histopathology of women with squamous cell carcinoma (SCCA) on Siriraj liquid-based cervical cytology (Siriraj-LBC). Methods: The computerized database of women who underwent Siriraj-LBC at Siriraj Hospital, Mahidol University from January 2007 to December 2010 were retrieved. The hospital records of women with SCCA cytology were reviewed. Results: The prevalence of SCCA cytology was 0.07%. A total of 86 women, mean age was 58.1 years. Sixty-one women (70.9%) were post-menopausal. Overall significant pathology and invasive gynecologic cancer were detected in 84 women (97.7%) and 71 women (82.5%), respectively. The positive predictive values for detection of significant neoplasia and invasive lesion were 97.7% and 82.6%, respectively. The cervical cancer was diagnosed in 69 women and among these 58 women were SCCA. Thirteen women (15.1%) had cervical intraepithelial neoplasia (CIN) 3 and two women (2.3%) had cervicitis. The sensitivity and specificity of colposcopy for cervical cancer detection in SCCA cytology were 83.3% and 75%, respectively. Median follow up period was 17.6 months and 64 patients were alive without cytologic abnormality. Conclusions: The final histopathology of SCCA cytology in our populations demonstrated a wide variety, from cervicitis to invasive cancer and the most common diagnosis was invasive cervical cancer. Colposcopy with biopsy and/or endocervical curettage and loop electrosurgical excision procedure should be undertaken to achieve histologic diagnosis.

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References

  1. American College of Obstetricians, Gynecologists (2008). ACOG Practice Bulletin No. 99: management of abnormal cervical cytology and histology. Obstet Gynecol, 112, 1419-44. https://doi.org/10.1097/AOG.0b013e318192497c
  2. Charoenkwan K, Srisomboon J, Suprasert P, et al (2006). Histopathological outcomes of women with squamous cell carcinoma on cervical cytology. Asian Pac J Cancer Prev, 7, 403-6.
  3. Clark SB, Dawson AE (2002). Invasive squamous-cell carcinoma in ThinPrep specimens: diagnostic clues in the cellular pattern. Diagn Cytopathol, 26, 1-4. https://doi.org/10.1002/dc.10033
  4. Edebiri AA (1990). The relative significance of colposcopic descriptive appearances in the diagnosis of cervical intraepithelial neoplasia. Int J Gynaecol Obstet, 33, 23-9. https://doi.org/10.1016/0020-7292(90)90650-A
  5. Grubb C, Janota I (1967). Squamous differentiation in carcinoma in situ of the cervix uteri. A cyto-histological correlation of malignant intraepithelial lesions with invasive carcinoma. J Clin Pathol, 20, 7-14. https://doi.org/10.1136/jcp.20.1.7
  6. Jones BA, Davey DD (2000). Quality management in gynecologic cytology using interlaboratory comparison. Arch Pathol Lab Med, 124, 672-81.
  7. Karnon J, Peters J, Platt J, et al (2004). Liquid-based cytology in cervical screening: an updated rapid and systematic review and economic analysis. Hlth Technol Assess, 8, 1-78.
  8. Kietpeerakool C, Srisomboon J, Khunamornpong S, et al (2007). How can the overtreatment rate of "see and treat" approach be reduced in women with high-grade squamous intraepithelial lesion on cervical cytology? Asian Pac J Cancer Prev, 8, 206-8.
  9. Laiwejpithaya S, Benjapibal M, Laiwejpithaya S, et al (2009). Performance and cost analysis of Siriraj liquid-based cytology: a direct-to-vial study. Eur J Obstet Gynecol Reprod Biol, 147, 201-5. https://doi.org/10.1016/j.ejogrb.2009.08.002
  10. Laiwejpithaya S, Rattanachaiyanont M, Benjapibal M, et al (2008). Comparison between Siriraj liquid-based and conventional cytology for detection of abnormal cervicovaginal smears: a split-sample study. Asian Pac J Cancer Prev, 9, 575-80.
  11. Levine PH, Elgert PA, Mittal K (2003). False-positive squamous cell carcinoma in cervical smears: cytologic-histologic correlation in 19 cases. Diagn Cytopathol, 28, 23-7. https://doi.org/10.1002/dc.10220
  12. 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
  13. Massad LS, Jeronimo J, Katki HA, et al (2009). The accuracy of colposcopic grading for detection of high grade cervical intraepithelial neoplasia. J Low Genit Tratc Dis, 13, 137-44. https://doi.org/10.1097/LGT.0b013e31819308d4
  14. Nguyen GK, Jeannot AB (1984). Exfoliative cytology of in situ and microinvasive adenocarcinoma of the uterine cervix. Acta Cytol, 28, 461-7.
  15. Numnum TM, Korby TO, Leath CA, et al (2005). A prospective evaluation of "see and treat" in women with HSIL Pap smear results: is this as appropriate strategy? J Low Genit Tract Dis, 9, 2-6. https://doi.org/10.1097/00128360-200501000-00002
  16. 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
  17. Stoler MH, Vichnin MD, Ferenczy A, et al (2011). The accuracy of colposcopic biopsy: analyses from the placebo arm of the Gardasil clinicl trials. Int J Cancer, 128, 1354-62. https://doi.org/10.1002/ijc.25470
  18. Strander B, Andersson-Ellstrom A, Milsom I, et al (2007). Liquid-based cytology versus conventional Papanicolaou smear in an organized screening program: a prospective randomized study. Cancer, 111, 285-91. https://doi.org/10.1002/cncr.22953
  19. Underwood M, Arbyn M, Parry-Smith W, et al (2012). Accuracy of colposcopy-directed punch biopsies: a systematic review and meta-analysis. BJOG, in press.
  20. Uyar DS, Eltabbakh GH, Mount SL (2003). Positive predictive value of liquid-based and conventional cervical Papanicolaou smears reported as malignant. Gynecol Oncol, 89, 227-32. https://doi.org/10.1016/S0090-8258(02)00102-6
  21. Wright TC Jr, Massad LS, Dunton CJ, et al (2007). 2006 consensus guidelines for the management of women with abnormal cervical screening tests. J Low Genit Tract Dis, 11, 201-22. https://doi.org/10.1097/LGT.0b013e3181585870

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