[Accuracy of liquid-based cytology in diagnosis of high-grade squamous cervical intraepithelial neoplasia].
OBJECTIVE
To investigate factors affecting the diagnostic accuracy of cervical liquid-based cytology for high-grade squamous intraepithelial lesion (HSIL).


METHODS
A retrospective evaluation of cytological and histological slides was performed in 415 patients who had cytological HSIL between 2007 and 2010.


RESULTS
Among 42 209 cases screened by ThinPrep liquid-based cytology, 415 cases (1.0%) of HSIL were eventually identified. The mean age of HSIL patients was 41.6 years, and 30-49 years were the most common age group. Among 415 cases, 325 patients had available histological diagnosis as follows: 23 (7.1%) negative, 22 (6.8%) CIN1/HPV, 223 (68.6%) CIN2/CIN3, and 57 (17.5%) squamous cell carcinoma (SCC). The positive predictive values of HSIL to predict CIN2 (or higher grade of dysplasia) and CIN1 were 86.2% (280/325) and 92.9% (302/325), respectively. Inadequate biopsy, reactive glandular cells, islet atrophy, chemo/radiotherapy and others were responsible for the cytologically false-positive diagnosis. Fifty-seven (17.5%) cases of HSIL had a histological diagnosis of SCC. The possible causes of misdiagnosis were social factors, under-recognized cytological features of poorly-differentiated SCC and absence of typical diagnostic features in cytology slides.


CONCLUSIONS
Cytology of HSIL has a high positive predictive value for the presence of CIN2/CIN3 and SCC. Cytologists and gynecologists should be aware of the diagnostic pitfalls that may lead to the discrepancy between cytology and histology.
Department of Pathology, Guangdong General Hospital, Academy of Medical Science, Guangzhou 510080, China.
Min
M
Li
Ping
P
Mei
Dong-lan
DL
Luo
Xiao-bing
XB
Wang
Yan-hui
YH
Liu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology; D003584:Cytological Techniques; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D030361:Papillomavirus Infections; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology / Q000821:virology