Histology corresponding to mildly dyskaryotic smears--a study of 190 laser cone biopsied patients.
OBJECTIVE
The aim of the study was to evaluate the histological outcome of laser ring biopsies in patients with one or more smears showing cytological mild dyskaryosis where punch biopsies were not performed. The possibilities of predicting histological findings of CIN 2 and CIN 3 were analyzed.


METHODS
The study comprised 190 laser ring biopsied patients with mildly dyskaryotic smears. Eighty-five patients were excluded from the initial 275 because of up- and downgrading of smears. Conization specimens and smears were reviewed by an experienced histopathologist and two experienced cytotechnicians. The histological findings were correlated to smear findings.


RESULTS
Histologically, CIN 2 was found in 60 and CIN 3 in 45 patients (31 and 24%, respectively). The incidence of histological CIN 3 was higher in those with two or more mildly dyskaryotic smears and in those dyskaryotic smears lacking koilocytic change. Mildly dyskaryotic smears without endocervical cells indicated higher incidence of histological CIN 3. The fact that 36 of 96 CIN 2 and 3 lesions (38%) involved only 3 mm or less of the mucosa might be one important explanation for the absence of representative cells in the corresponding smears.


CONCLUSIONS
Our study has shown that a mildly dyskaryotic smear is a strong indicator of CIN 2-3 histologically, especially in those cases without koilocytic cells and in those with repeatedly abnormal smears. The importance of inadequate sampling is indicated by higher incidence of histological CIN 3 in those with less than optimal smears. These findings are some of the factors to be taken into account when planning treatment strategies for this group of patients.
Risberg
B
B
Department of Pathology/Cytology, Medical Centre Hospital, Orebro, Sweden.
Andersson
A
A
Lie
K A
KA
Nordin
B
B
Zetterberg
C
C
D000328:Adult; D001706:Biopsy / Q000379:methods*; D005260:Female; D006801:Humans; D007621:Karyotyping; D007834:Lasers; D008875:Middle Aged; D002583:Uterine Cervical Neoplasms / Q000235:genetics* / Q000473:pathology*; D002578:Uterine Cervical Dysplasia / Q000235:genetics* / Q000473:pathology*