Impact of liquid-based gynecologic cytology on an HIV-positive population.
OBJECTIVE
To examine the imprint of liquid-based technologies for cervicovaginal cytology on HIV-positive women, who are at high risk for cervical intraepithelial neoplasia.


METHODS
We performed a retrospective search of the cytopathology files of Johns Hopkins Hospital for the cervicovaginal cytology of HIV-positive women to examine the effect of liquid-based technology on this population.


RESULTS
Significant intraepithelial lesions (SILs) (low grade SIL or greater) were identified in 24% of the conventional smears and 23% of the liquid-based cytology. Atypical squamous cells of undetermined significance (ASCUS)/atypical glandular cells of undetermined significance was diagnosed in 15% of the conventional smears and 9% of the liquid-based preparations (P = .02). In patients with ASCUS diagnoses and tissue follow-up within 7 months, significant SILs were identified in 29% with conventional smears and in 65% with liquid-based cytology.


CONCLUSIONS
There was no statistically significant difference in the rate of SILs between conventional smears and liquid-based cervicovaginal preparations in HIV-positive women. The diagnosis of ASCUS on liquid-based cytology may have an increased likelihood of representing a significant SIL in comparison to conventional smears. For the high-risk, HIV-positive population, immediate colposcopy and biopsy may be warranted following ASCUS diagnoses on liquid-based cytology.
Swierczynski
Sharon L
SL
Departments of Pathology, Obstetrics and Gynecology, Neuroscience and Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Lewis-Chambers
Susan
S
Anderson
Jean R
JR
Keller
Jean M
JM
Hinkle
David A
DA
Ali
Syed Z
SZ
D000328:Adult; D002584:Cervix Uteri / Q000473:pathology; D003951:Diagnostic Errors / Q000517:prevention & control; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D018579:Patient Selection; D011230:Precancerous Conditions / Q000209:etiology / Q000473:pathology*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000209:etiology / Q000473:pathology*; D014626:Vaginal Smears / Q000592:standards*; D002578:Uterine Cervical Dysplasia / Q000209:etiology / Q000473:pathology*