Diagnostic Three Slides Pap Test Compared to Punch Biopsy and Endocervical Curettage in Confirmed HSIL+ Diagnosis
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Methods
2.3. Statistical Analysis
3. Results
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Conflicts of Interest
References
- Rebolj, M.; Rimmer, J.; Denton, K.; Tidy, J.; Mathews, C.; Ellis, K.; Smith, J.; Evans, C.; Giles, T.; Frew, V.; et al. Primary cervical screening with high risk human papillomavirus testing: Observational study. BMJ 2019, 364, l240. [Google Scholar] [CrossRef]
- Veijalainen, O.; Kares, S.; Kotaniemi-Talonen, L.; Kujala, P.; Vuento, R.; Luukkaala, T.; Kholová, I.; Mäenpää, J. Primary HPV screening for cervical cancer: Results after two screening rounds in a regional screening program in Finland. Acta Obstet. Gynecol. Scand. 2021, 100, 403–409. [Google Scholar] [CrossRef]
- Ronco, G.; Dillner, J.; Elfström, K.M.; Tunesi, S.; Snijders, P.J.F.; Arbyn, M.; Kitchener, H.; Segnan, N.; Gilham, C.; Giorgi-Rossi, P.; et al. Efficacy of HPV-based screening for prevention of invasive cervical cancer: Follow-up of four European randomised controlled trials. Lancet 2014, 383, 524–532. [Google Scholar] [CrossRef]
- Gov.UK. Cervical Screening: Implementation Guide for Primary HPV Screening. Available online: https://www.gov.uk/government/publications/cervical-screening-primary-hpv-screening-implementation/cervical-screening-implementation-guide-for-primary-hpv-screening (accessed on 10 April 2021).
- Vrdoljak-Mozetič, D.; Ostojić, D.V.; Štemberger-Papić, S.; Janković, S.; Glibotić-Kresina, H.; Brnčić-Fischer, A.; Benić-Salamon, K. Cervical cancer screening programme in Primorsko-Goranska County, Croatia-the results of the pilot study. Coll. Antropol. 2010, 34, 225–232. [Google Scholar]
- Znaor, A.; Babić, D.; Ćorušić, A.; Grce, M.; Mahovlić, V.; Pajtler, M.; Šerman, A. Prijedlog programa ranog otkrivanja raka vrata maternice u Hrvatskoj. Liječ. Vjesn. 2007, 129, 158–163129. [Google Scholar]
- Grce, M.; Grahovac, B.; Rukavina, T.; Vrdoljak-Mozetič, D.; Glavaš-Obrovac, L.; Kaliterna, V.; Zele-Starčević, L. HPV testing for cervical cancer screening in Croatia. Coll. Antropol. 2007, 31, 67–71. [Google Scholar]
- Grce, M.; Sabol, I.; Milutin Gašperov, N. Burden and prevention of HPV related diseases: Situation in Croatia. Period. Biol. 2012, 114, 175–186. [Google Scholar]
- Xie, F.; Zhang, L.; Zhao, D.; Wu, X.; Wei, M.; Zhang, X.; Wu, X.; Fang, H.; Xu, X.; Yang, M.; et al. Prior cervical cytology and high-risk HPV testing results for 311 patients with invasive cervical adenocarcinoma: A multicenter retrospective study from China’s largest independent operator of pathology laboratories. BMC Infect. Dis. 2019, 19, 962. [Google Scholar] [CrossRef]
- von Karsa, L.; Arbyn, M.; De Vuyst, H.; Dillner, J.; Dillner, L.; Franceschi, S.; Patnick, J.; Ronco, G.; Segnan, N.; Suonio, E.; et al. European guidelines for quality assurance in cervical cancer screening. Summary of the supplements on HPV screening and vaccination. Papillomavirus Res. 2015, 1, 22–31. [Google Scholar] [CrossRef]
- Stelow, E.B.; Gulbahce, H.E.; Kjeldahl, K.; Oprea, G.M.; Savik, K.; Pambuccian, S.E. Interpretive yields of screening Pap tests and diagnostic Pap tests. Diagn. Cytopathol. 2004, 31, 427–429. [Google Scholar] [CrossRef]
- Perkins, R.B.; Guido, R.S.; Castle, P.E.; Chelmow, D.; Einstein, M.H.; Garcia, F.; Huh, W.K.; Kim, J.J.; Moscicki, A.B.; Nayar, R.; et al. 2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors. J. Low. Genit. Tract Dis. 2020, 24, 102–131. [Google Scholar] [CrossRef]
- Croatian Society of Gynecology and Obstetrics. Cervikalne Intraepitelne Lezije: Smjernice za Dijagnostiku i Liječenje. Available online: https://www.hdgo.hr/Default.aspx?sifraStranica=642 (accessed on 5 April 2021).
- National Cancer Control Plan 2020–2030. Available online: https://www.nppr.hr/wp-content/uploads/2020/01/NPPR_ENG_final.pdf (accessed on 5 April 2021).
- Chen, C.J.; Hong, M.K.; Ding, D.C. Effective reduction in inadequate Pap smears by using a saline-lubricated speculum and two glass slides. Taiwan. J. Obstet. Gynecol. 2020, 59, 906–909. [Google Scholar] [CrossRef]
- Gultekin, M.; Dundar, S.; Keskinkilic, B.; Turkyilmaz, M.; Ozgul, N.; Yuce, K.; Kara, F. How to triage HPV positive cases: Results of four million females. Gynecol. Oncol. 2020, 158, 105–111. [Google Scholar] [CrossRef]
- Isidean, S.D.; Mayrand, M.H.; Ramanakumar, A.V.; Rodrigues, I.; Ferenczy, A.; Ratnam, S.; Coutlée, F.; Franco, E.L.; CCCaST Study Group. Comparison of Triage Strategies for HPV-Positive Women: Canadian Cervical Cancer Screening Trial Results. Cancer Epidemiol. Biomark. Prev. 2017, 26, 923–929. [Google Scholar] [CrossRef]
- Chrysostomou, A.C.; Kostrikis, L.G. Methodologies of Primary HPV Testing Currently Applied for Cervical Cancer Screening. Life 2020, 10, 290. [Google Scholar] [CrossRef]
- Bergeron, C.; von Knebel Doeberitz, M. The Role of Cytology in the 21st Century: The Integration of Cells and Molecules. Acta Cytol. 2016, 60, 540–542. [Google Scholar] [CrossRef]
- Rijkaart, D.C.; Berkhof, J.; van Kemenade, F.J.; Coupe, V.M.; Hesselink, A.T.; Rozendaal, L.; Heideman, D.A.; Verheijen, R.H.; Bulk, S.; Verweij, W.M. Evaluation of 14 triage strategies for HPV DNA-positive women in population-based cervical screening. Int. J. Cancer 2012, 130, 602–610. [Google Scholar] [CrossRef]
- Lukic, A.; Iannaccio, S.; Heyn, R.; Villani, S.; Nobili, F.; Giarnieri, E.; Mancini, R.; Moscarini, M.; Giovagnoli, M.R. Satisfactory sampling in cytological cervical diagnosis: Comparison between a conventional and a new sampling device. Anticancer Res. 2013, 33, 917–922. [Google Scholar]
- Ihonor, A.O.; Cheung, W.Y.; Freites, O.N. A comparative study of the assessment of cervical intraepithelial neoplasia in women having large loop excision of the transformation zone. J. Obstet. Gynaecol. 1999, 19, 169–171. [Google Scholar] [CrossRef]
- Al-Mosawi, F.H. Comparative Study of Pap Smear and Cervical Biopsy Findings. Kerbala J. Med. 2015, 8, 2272–2281. [Google Scholar]
- Aydogmus, H.; Sen, S.; Aydogmus, S. Pathological discrepancy between colposcopic directed cervical biopsy and conisation results: A five years experience of a single center in Turkey. Pak. J. Med. Sci. 2019, 35, 1627–1630. [Google Scholar] [CrossRef] [PubMed]
- Driggers, R.W.; Zahn, C.M. To ECC or not to ECC: The question remains. Obstet. Gynecol. Clin. N. Am. 2008, 35, 583–597. [Google Scholar] [CrossRef] [PubMed]
- Andersen, W.; Frierson, H.; Barber, S.; Tabbarah, S.; Taylor, P.; Underwood, P. Sensitivity and specificity of endocervical curettage and the endocervical brush for the evaluation of the endocervical canal. Am. J. Obstet. Gynecol. 1988, 159, 702–707. [Google Scholar] [CrossRef]
- Zou, T.; Dave, S.; Adler, R.N.; Manning, M.J.; Scott, M.P.; Strock, C.; Kandil, D.; Cosar, E.; Fischer, A.H. Colposcopic endocervical brushing cytology appears to be more sensitive than histologic endocervical curettage for detecting endocervical adenocarcinoma. J. Am. Soc. Cytopathol. 2021, 10, 135–140. [Google Scholar] [CrossRef] [PubMed]
- Smith, H.J.; Leath, C.A., 3rd; Huh, W.K.; Erickson, B.K. See-and-Treat for High-Grade Cytology: Do Young Women Have Different Rates of High-Grade Histology? J. Low. Genit. Tract Dis. 2016, 20, 243–246. [Google Scholar] [CrossRef] [PubMed]
Age (y) | Total Number of Patients | |
---|---|---|
N | (%) | |
20–24 | 10 | (6.6%) |
25–29 | 22 | (14.7%) |
30–34 | 29 | (19.3%) |
35–39 | 40 | (26.7%) |
40–44 | 16 | (10.7%) |
45–49 | 10 | (6.6%) |
50–54 | 7 | (4.7%) |
55–59 | 7 | (4.7%) |
>60 | 9 | (6%) |
Title | Title | Title |
---|---|---|
Diagnostic Pap Test Findings | ||
ASCUS | 0 | (0%) |
LSIL | 4 | (2.4%) |
ASC-H | 29 | (20%) |
HSIL | 116 | (77%) |
Carcinoma | 1 | (0.6%) |
Cervical Biopsy/Endocervical Curettage Findings | ||
Negative | 15 | (10%) |
LSIL | 17 | (11%) |
HSIL | 118 | (79%) |
Carcinoma | 0 | (0%) |
Colposcopic Findings | ||
Negative | 10 | (14%) |
Grade 1 (G1) | 40 | (57%) |
Grade 2 (G2) | 15 | (22%) |
Unsatisfactory | 5 | (7%) |
Final histologic Findings | ||
Negative | 1 | (1%) |
LSIL | 1 | (1%) |
HSIL | 145 | (96%) |
Carcinoma | 3 | (2%) |
Final Histologic Diagnosis | DPT Findings N (%) | Total Number N | PB/ECC Findings N (%) | Total Number N | ||
---|---|---|---|---|---|---|
Negative | Positive | Negative | Positive | |||
Negative | 0 | 0 | 0 | 1 | 0 | 1 |
LSIL | 0 | 1 | 1 | 1 | 0 | 1 |
HSIL | 4 (3%) | 142 (97%) | 146 | 30 (20%) | 115 (79%) | 145 |
Carcinoma | 0 | 3 | 3 | 0 | 3 | 3 |
Total | 4 | 146 | 150 | 32 | 118 | 150 |
Final Histologic Diagnosis | Endocervical Brush N (%) | Total Number N | ECC N (%) | Total Number N | ||
---|---|---|---|---|---|---|
Negative | Positive | Negative | Positive | |||
Negative | 0 | 1 | 1 | 2 | 1 | 3 |
LSIL | 0 | 1 | 1 | 1 | 2 | 3 |
HSIL | 15 (17%) | 73 (83%) | 88 | 55 (65%) | 29 (35%) | 84 |
Carcinoma | 0 | 2 | 2 | 0 | 2 | 2 |
Total | 15 | 77 | 92 | 58 | 34 | 92 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Rubeša-Mihaljević, R.; Vrdoljak-Mozetič, D.; Dinter, M.; Verša Ostojić, D.; Štemberger-Papić, S.; Klarić, M. Diagnostic Three Slides Pap Test Compared to Punch Biopsy and Endocervical Curettage in Confirmed HSIL+ Diagnosis. Diagnostics 2021, 11, 942. https://doi.org/10.3390/diagnostics11060942
Rubeša-Mihaljević R, Vrdoljak-Mozetič D, Dinter M, Verša Ostojić D, Štemberger-Papić S, Klarić M. Diagnostic Three Slides Pap Test Compared to Punch Biopsy and Endocervical Curettage in Confirmed HSIL+ Diagnosis. Diagnostics. 2021; 11(6):942. https://doi.org/10.3390/diagnostics11060942
Chicago/Turabian StyleRubeša-Mihaljević, Roberta, Danijela Vrdoljak-Mozetič, Morana Dinter, Damjana Verša Ostojić, Snježana Štemberger-Papić, and Marko Klarić. 2021. "Diagnostic Three Slides Pap Test Compared to Punch Biopsy and Endocervical Curettage in Confirmed HSIL+ Diagnosis" Diagnostics 11, no. 6: 942. https://doi.org/10.3390/diagnostics11060942
APA StyleRubeša-Mihaljević, R., Vrdoljak-Mozetič, D., Dinter, M., Verša Ostojić, D., Štemberger-Papić, S., & Klarić, M. (2021). Diagnostic Three Slides Pap Test Compared to Punch Biopsy and Endocervical Curettage in Confirmed HSIL+ Diagnosis. Diagnostics, 11(6), 942. https://doi.org/10.3390/diagnostics11060942