Cervical cytology quality control cytological and histological correlation at a private laboratory in Barbados - abstract

ABSTRACT

In this study, the cytological and histological diagnoses made during a six and a half-year period were compared with the aim of assessing the diagnostic accuracy of cervical cytology in a small private laboratory. There were 3486 cases biopsied, 40 (1.2 percent) cases with previous inadequate cervical smears, 195 (5.6 percent) cases with normal cytology and the remaining 3251 (93.2 percent) with abnormal cytological diagnoses. The overall concordance between the cytological and histological diagnoses was 63.9 percent. The greatest concordance was in cases with cytodiagnosis of CIN grade 3 (CIS) and invasive carcinoma combined 100/112 (89.3 percent), and the lowest with normal cytodiagnosis 75/195 (38.5 percent) cases. The significant histological diagnoses of the discordant cases were CIN 22.6 percent, condyloma 15.3 percent and carcinoma 1.1 percent. Fifty percent of the carcinomas diagnosed by cytology were of endometrial origin. Significant discordance occurred in cases with cytodiagnosis of HPV infection and CIN, in that 113 cases with cytodiagnosis of HPV infection/codyloma had histological diagnosis of CIN, and 156 cases with the cytodiagnosis of CIN had histological diagnosis of condyloma. The sensitivity rate for the diagnosis of HPV infection or condyloma by cytology was 632/1214 (52 percent). Most of the cases with inadequate smears had histodiagnosis of cervicitis with inflammatory atypia. This study has shown that the cytological evaluation of the severity of significant cervical abnormalities was a reliable guide for the clinician to the proper management of the patient (AU)