Correlation between cytopathology and histopathology in women with squamous cell abnormalities of the uterine cervix

Abstract

Objective: The aim of the study was to correlate the results of cervical cytology and cervical biopsy in women with squamous cell abnormalities of the uterine cervix. Materials and Methods: This comparative retrospective study was conducted in a series of 184 sexually active women, aged 20 to 60, who came to their annual gynecological exam at the University Clinic for Gynecology and Obstetrics in Skopje between September 2015 and March 2016. In all 184 patients with cytologically diagnosed squamous cell abnormalities of the uterine cervix, a colposcopic cervical biopsy with endocervical curettage for histopathological analysis was taken, with was analyzed at the University Clinic for Radiotherapy and Oncology in Skopje. The results of the liquid-based cytology smears and cervical biopsies were compared to evaluate the diagnostic agreement between the cytology findings and the biopsies. Results: Cytopathologically, there were 118 (64.13%) ASC-US, 22 (11.96%) LSIL, 38 (20.65%) HSIL and 6 (3.26%) invasive carcinoma cases. Histopathologically, there were 108 (58.70%) non-neoplastic lesions, 24 (13.04%) LGSIL cases, 42 (22.83%) HGSIL cases and 10 (5.43%) invasive squamous cell carcinomas. Including all squamous cell abnormalities, the sensitivity of the smear test in low-grade and higher grade lesions was 58.70% (108/184) and the false positivity was 41.30% (76/184). Excluding ASC-US lesions, the sensitivity of the smear test was 78.80% (52/66) and the false positivity was 21.21% (14/66). After evaluating cervical cytopathological correlation the positive predictive value was found to be 100% (6/6) in invasive carcinoma, 68.42% (26/38) in HGSIL and 31.82% (7/22) in LGSIL. Conclusions: The high sensitivity of the cervical smear test for high-grade squamous lesions shows that it is an effective screening test for cervical cancer and precursor lesions.