title: How accurate is cytological diagnosis of cervical glandular lesions?
abstract: 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.
authors.affiliation: Department of Pathology, School of Medicine, Federal University of Goiás, Goiás, Brazil.
authors.forename: Marise A R
authors.initials: MA
authors.lastname: Moreira
authors.forename: Adhemar
authors.initials: A
authors.lastname: Longatto Filho
authors.forename: Adauto
authors.initials: A
authors.lastname: Castelo
authors.forename: Maria Rita Evangelista
authors.initials: MR
authors.lastname: de Barros
authors.forename: Ana Paula da
authors.initials: AP
authors.lastname: Silva
authors.forename: Patrícia
authors.initials: P
authors.lastname: Thomann
authors.forename: Maria da Gloria
authors.initials: Mda G
authors.lastname: Mattosinho de Castro Ferraz
authors.forename: Gerson Botacini das
authors.initials: GB
authors.lastname: Dores
mesh_terms: 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