Cytology in the follow-up of cervical cancer.
OBJECTIVE
To determine the value of cytology in the follow-up of cervical cancer.


METHODS
The study group consisted of 230 patients with invasive cervical carcinoma who were followed for one to seven years. Forty-four patients developed recurrences or metastases. During this period, cytologic investigations involved 795 exfoliative smears from the cervix or vaginal vault, 10 fine needle aspirates and 5 fluids.


RESULTS
Thirty-three patients had positive or inconclusive cervical or vault smears that were histologically proven to be recurrences, and the other 11 patients had clinically obvious recurrences that were not smeared. Cytology first alerted the clinicians to recurrence in eight patients. Of 25 cervical or vault smears reported as malignant, 24 (96%) were histologically confirmed, and 1 showed radiation change on biopsy. In all 22 cases of smears reported as inconclusive, a biopsy followed, and in 9 (41%) of these, recurrence was demonstrated histologically. Inability to distinguish radiation change from recurrent malignancy was the chief cause of inconclusive smears. Five fluids and seven fine needle aspirates were diagnosed as malignant, saving patients an invasive diagnostic procedure.


CONCLUSIONS
Cytology is a useful, cost-effective, noninvasive and accurate investigation in the follow-up of cervical cancer.
McKenzie
D C
DC
Department of Pathology, Mercy Hospital for Women, East Melbourne, Victoria, Australia.
Scurry
J P
JP
Planner
R S
RS
Grant
P T
PT
D001707:Biopsy, Needle; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D014626:Vaginal Smears