Validity of the oncological cytodiagnostics and colposcopy examination versus biopsy in cervical carcinoma prevention

Czech version

Authors: J. Kobilková ¹; A. Dohnalová ²; J. E. Jirásek ⁴; M. Strunová ¹; M. Janoušek ¹; J. Horáček ³
Authors‘ workplace: Onkologické centrum gynekologické a porodnické kliniky 1. LF UK a VFN, přednosta prof. MUDr. A. Martan, DrSc. ¹; Ústav fyziologie 1. LF UK, oddělení kybernetiky, přednosta prof. MUDr. O. Kittnar, DrSc. ²; Ústav patologie, Lékařská fakulta Ostravské univerzity, přednosta doc. MUDr. J. Horáček, Ph. D. ³; Ústav pro péči o matku a dítě, Praha Podolí, ředitel doc. MUDr. J. Feyereisl, Ph. D. ⁴
Published in: Ceska Gynekol 2012; 77(4): 364-370

Overview

The aim of the study:
The basic praebioptic methods detecting the precancerous lesions of the uterine cervix are oncologic cytology (PAP smears) and colposcopy. However in the Czech Republic the incidence of the invasive carcinomas during the last 10 years did not conciderably decrease. Therefore the goal of our study is to estimate the validity of the prebioptic methods and compare the results of praebioptic methods (procedures) versus biopsy.

Type of the study:
Analysis of the results of the oncologic cervical cytology comparing with the results of cervical biopsies performed during the years 2002–2003 were compared to those of the year 2009.

The subject and methods of the study:
evaluation of the prebioptic methods (cytology, colposcopy) versus biopsy prior and during the start of the National Screening in the Czech Republic.

Setting:
1. Centre for Gynaecological Oncological prevention, 1^st Faculty of Medicine, Charles University Prague, Department of Gynaecology and Obstetrics. 2. Institute of Physiology, Department of cybernetics, 1^st Faculty of Medicine, Charles University, Prague. 3. Institute of Pathology, University of Ostrava. 4. Institue for Mother and Child Care, Prague.

Summary:
We screened the documentation related to the treatement of 423 women with cervical lesions, examined at the Oncological prevention centre of the Obstetrical and Gynaecological Department of the 1st Faculty of Medicine Charles University Prague and the General Teaching Hospital in Prague 2.

Results of the oncologic cytology, colposcopy and biopsy were compared. The comparison revealed differences related to the time of examinations. During the years 2002 and 2003 the agreement between cytologic diagnosis and biopsies in the group of HSIL was 40 %. In the year 2009 the agreement between HSIL and CIN was 68% the colposcopic diagnosis of precancerous lesions with those of bioptic specimens, during the years 2002 and 2003 was 90% while in the year 2009, during the National Screening, the agreement reached 98%.

Key words:
oncologic cytology, colposcopy, biopsy, cervical precancerous lesions.

Sources

1. Anshau, F., Guimaraes, MA. Discordance between cytology and biopsy histology of the cervix: What to concider and what to do. Acta Cytologica, 2011, 58, p. 158–162.

2. Bibbo, M. Comprehensive cytopathology. Philadelphia: W.B. Saunders, 1997, p. 11–22.

3. Errington, CA., Roberts, M., Tdle, P., et al. Colposcopic Management of High Grade Referal Smears: A retrospective audit supporting „see and treat“. Cytopathology, 2006, 17, p. 339–347.

4. Feng, J., Al Abbadi, MA., Bandyopadhyaay, S., et al. Significance of high-risk human papillomavirus dna-positive atypical squamous cells of undetermined significance pap smears in perimenopausal and postmenopausal women. Acta Cytologica, 2008, 52, 4, 434–438.

5. Jordan, J., Hirsch, MD., Arbyn, M., et al. European guidelines for clinical management of abnormal cervical cytology. Cytopathology, 2009, 20, p. 5–16.

6. Kobilková, J., Lojda, Z., Dohnalová, A. Detection of cervical and endometrial carcinoma with other genital tract involvement. Acta Cytologica, 2000, 44, 1, p. 13–17.

7. Vooijs, GP., Van der Graaf, EA., De Berg, P. The influence of sample smears takers on the cellular composition of cervical smears. Acta Cytologica, 1989, 30, p. 251–257.

8. Wied, GL., Bibbo, M., Keebler, CM., et al. Compendium on Diagnostic Cytology. TOC, USA, 1997, p. 420.