How accurate is cytological diagnosis of cervical glandular lesions?
Gynecological cytology has some inaccurate morphological categorization and poor interobserver reproducibility especially for glandular lesions. Liquid-based cytology (LBC) preparations are presumed to reduce artifacts that interfere in diagnosis performance, but its value to correctly identify glandular alterations has not been sufficiently reported. The objective of this study was to compare the diagnostic performance and interobserver agreement of LBC and conventional Pap smear to identify histologically confirmed glandular lesions according to five cytologists. Sensitivity ranged from 55.8 to 73.1% and 32.7 to 48.1% for Pap smear and LBC, respectively. Specificity ranged from 66.1 to 87.1% and 69.4 to 94.4%, respectively. In general, agreement between pairs of cytologists was poor with kappa-values around 0.45. In conclusion, relying entirely on cervical cytology to rule out glandular lesions may be risky. The use of HPV DNA test alone or combined to screening glandular lesions may contribute to minimize the limitations of both conventional and LBC preparations to diagnose glandular abnormalities.
Moreira
Marise A R
MA
Department of Pathology, School of Medicine, Federal University of Goiás, Goiás, Brazil.
Longatto Filho
Adhemar
A
Castelo
Adauto
A
de Barros
Maria Rita Evangelista
MR
Silva
Ana Paula da
AP
Thomann
Patrícia
P
Mattosinho de Castro Ferraz
Maria da Gloria
Mda G
Dores
Gerson Botacini das
GB
D003584:Cytological Techniques; D005260:Female; D006801:Humans; D065006:Papanicolaou Test; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology