[Association between the cervico-vaginal inflammatory cytology and the intraepithelial cervical lesion in patients from a sexual and reproductive health clinic in Bogotá, Colombia, 1999-2003].
OBJECTIVE
Cervical cancer is the most common malignancy affecting Colombian women. Pap smear screening is used for its early detection. Early stages of cervical cancer can be expressed by the presence of inflammatory atypia in the Pap smear. The main objective of this study is to evaluate the role of inflammatory atypia in Pap smear as a marker of squamous intraepithelial lesions (SIL), given that it is not clear how to deal with the presence of inflammatory cells in Pap smear.


METHODS
A cross sectional study was carried out to establish the operative characteristics of the cervical Pap smear in the colposcopy clinic of the Clínica Piloto Profamilia, Bogotá, between January 1999 and December 2003. We compared patients with biopsies reporting SIL and those with a benign report in the pathologic study. We evaluated sensitivity the and the specificity of the Pap smear in different cutting points compared to the pathology report as gold standard.


RESULTS
The prevalence found was 48,7 % for low grade - Squamous Intrepithelial Lesions (SIL) and 9,7 % for high grade - SIL. The best performance for the Pap smear test to detect SIL was when the atypical squamous cells of undetermined significance (ASCUS) were considered as abnormal. Severe inflammatory atypia were associated to SIL in a similar way as to ASCUS.


CONCLUSIONS
Sensitivity of the Pap smear as a screening test decreases when excluding Pap smears reporting ASCUS as a cutting point. In our environment, we recommend to report inflammatory atypia on the Pap smear test stratified by severity until the role of severe inflammatory atypia for the diagnosis of SIL is defined.
Duarte
Hernando Gaitán
HG
Instituto de Investigaciones Clinicas, Universidad Nacional de Colombia. hggaitand@unal.edu.co
Romero
Jorge A Rubio
JA
Schmalbach
Javier Eslava
JE
D000328:Adult; D000368:Aged; D003105:Colombia; D003430:Cross-Sectional Studies; D005260:Female; D006268:Health Facilities; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D014504:Urban Health; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000473:pathology*; D002575:Uterine Cervicitis / Q000453:epidemiology / Q000473:pathology*; D014626:Vaginal Smears; D014627:Vaginitis / Q000453:epidemiology / Q000473:pathology*; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000473:pathology*