title: Clinical parameters associated with absence of endocervical/transformation zone component in conventional cervical Papanicolaou smears.
abstract: OBJECTIVE
  To study clinical factors predicting the absence of endocervical/transformation zone (EC/TZ) components of conventional cervical Papanicolaou (Pap) smears.
  
  
  METHODS
  The medical charts of patients who received Pap smears between March 2006 and August 2006 in the hospital were reviewed. The results of their Pap smears were retrieved while their demographic and clinical information were obtained from the medical charts. After excluding 378 cases with incomplete demographic data and 1397 cases with a history of pelvic irradiation, pelvic malignancy, and hysterectomy, 5662 cases were enrolled for data analysis. The relationship between clinical parameters and the absence of EC/TZ component was analyzed by Pearson Chi-square tests with Yates continuity correction and binary logistic regression tests.
  
  
  RESULTS
  The incidence of satisfactory but absence of EC/TZ component was 8.7% (491/5662). Pregnancy increased the absence of EC/TZ component [odds ratio (OR}: 2.84, 95% confidence interval (CI): 2.14-3.77, p<0.0001]. Postpartum status and endocervical polyps decreased incidence (OR: 0.61, 95% CI: 0.38-0.98, p = 0.043 and OR: 0.33, 95% CI: 0.25-0.44, p<0.0001, respectively).
  
  
  CONCLUSIONS
  Pregnancy is the only clinical factor associated with increased incidence of absence of EC/TZ cells. For these pregnant women undergoing a Pap smear, a more effective strategy may be needed to get a satisfactory smear with adequate EC/TZ components.
authors.affiliation: Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Lou
authors.initials: L
authors.lastname: Sun
authors.affiliation: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Peng-Hui
authors.initials: PH
authors.lastname: Wang
authors.affiliation: Department of Pathology and Laboratory Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Chen-Hui
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Graduate Institute of Biomedicine and Biomedical Technology, National Chi Nan University, Nantou County, Taiwan.
authors.forename: Tsai-Feng
authors.initials: TF
authors.lastname: Fu
authors.affiliation: Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Min-Min
authors.initials: MM
authors.lastname: Chou
authors.affiliation: Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Sheau-Feng
authors.initials: SF
authors.lastname: Hwang
authors.affiliation: Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Yu-Min
authors.initials: YM
authors.lastname: Ke
authors.affiliation: Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Shih-Tien
authors.initials: ST
authors.lastname: Hsu
authors.affiliation: Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan; Department of Pathology and Laboratory Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Institute of Biomedical Sciences, National Chung-Hsing University, Taichung, Taiwan; Rong-Hsing Research Center for Translational Medicine, National Chung-Hsing University, Taichung, Taiwan. Electronic address: chlu@mail.vghtc.gov.tw.
authors.forename: Chien-Hsing
authors.initials: CH
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002584:Cervix Uteri / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test / Q000592:standards*; D011127:Polyps / Q000150:complications*; D049590:Postpartum Period; D011247:Pregnancy; D019984:Quality Indicators, Health Care; D002577:Uterine Cervical Diseases / Q000150:complications*; D055815:Young Adult
keywords: Papanicolaou smear; endocervical cell; endocervical polyp; transformation zone