Original scientific paper
Pap Smear Adequacy – Is the Assessing Criterion Including Endocervical Cells Really Valid?
M. Pajtler
S. Audy-Jurković
Abstract
The significance of endocervical cylindrical cells (EC) as a criterion of sample adequacy
has been established on 1,000 patients by comparing VCE smears (vaginal, cervical,
endocervical) with or without EC in relation to prevalence of abnormal cells, prevalence
of histological diagnosed lesions and sensitivity and negative predictive value of
Pap smear, as well as by comparison of negative findings without EC with control
smears with the aim of discovering overlooked lesions. A considerably greater yield of
cytological (107/536 in relation to 49/464) and histological (105/536 in relation to
55/464) (p<0.05) abnormalities in smears with EC support the hypothesis that the presence
of EC is strongly and positively associated with prevalence of disease. In contrast,
the presence of EC predicts only a moderate improvement in Pap smear quality with a
weaker effect on sensitivity (95% in relation to 80%). During two-years monitoring of patients
with negative Pap smear and negative colposcopy (403 with EC and 390 without
EC in smears), no positive cytology/histology diagnosis was made. Also, because the
prevalence of missed lesions among negative Pap smears is extremely low in absolute
terms, no appreciable impact on negative predictive value was observed (98.8% in relation
to 97.3%).
Keywords
Hrčak ID:
28299
URI
Publication date:
16.12.2002.
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