Korean J Gynecol Oncol.  2008 Mar;19(1):40-47. 10.3802/kjgo.2008.19.1.40.

False-negative results of conventional Papanicolaou cervical cytology in women with cervical conization

• Park CH

• KMID: 1979500
• DOI: http://doi.org/10.3802/kjgo.2008.19.1.40

Abstract

OBJECTIVE
The conventional Papanicolaou smear seems to be more accurate for detecting a high-grade squamous intraepithelial lesion (HSIL) than a low-grade squamous intraepithelial lesion (LSIL). The purpose of this study was to investigate false-negative results of conventional Pap smear cytology in women with cervical conization.
METHODS
This study was performed in Gynecologic Oncology Clinic of the Department of Obstetrics and Gynecology at Dankook University Medical Center from July 1, 1994 to December 31, 2004. 260 women from age 22 to 75 years had undergone conventional Papanicolaou cervical cytologic test and cervical conization. Conization was performed using ncold-knife cone' method or nlarge electrosurgical excision procedure (LEEP) cone' method. The cervical cytology were studied in comparison with histology of conization specimens.
RESULTS
Of the 260 histologic diagnoses, there were 41 (15.8%) diagnoses of chronic cervicitis, 8 (3.1%) of CIN 1, 18 (6.9%) of CIN 2, 150 (57.7%) of CIN 3, 38 (14.6%) of SCC, 2 (0.8%) of AIS, 1 (0.4%) of ACC, and 2 (0.8%) of ASC. Pap cytology showed sensitivity of 97.9-98.2%, specificity of 4.9-6.7%, and false-negative rate of 1.8-2.2% according to the variables.
CONCLUSION
Significantly false-negative rate of Pap cytology in women with conization was very low. And so, conventional Pap cytology is still clinically efficient for screening high-grade cervical lesions with adequate sampling technique.

Keyword

Conventional Papanicolaou smear cytology; High-grade cervical lesions; Conization; False-negative rate; Diagnostic efficacy

MeSH Terms

Academic Medical Centers
Conization
Female
Gynecology
Humans
Mass Screening
Obstetrics
Sensitivity and Specificity
Uterine Cervicitis
Vaginal Smears

Figure

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  Fig. 1 Preferred procedure for obtaining a Papanicolaou smear. ➀ Expose the entire cervix including transformation zone through the speculum, as much as possible. ➁ Rotate Ayre type spatula 360℃ twice. ➂ Rotate Endocervical cytobrush 180-360℃ softly. ➃ Spread cells in spatula on the upper half area of the slide, and roll brush over the lower half area of the same slide.

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