Proffered papers 9.30-10.00 Monday 15 September 2003.

摘要

INTRODUCTION: Recent changes in terminology have recognized that cervical smears may contain cells with a high nuclear-cytoplasmic ratio, suspicious for high grade dyskaryosis, which are not definitively diagnostic. AIMS: The correlation of cyopathological features present in a prospective series of cervical smears diagnosed as 'borderline nuclear change - high grade dyskaryosis not excluded' (BNCH) with clinical and histological follow-up. METHODS: We have been using the BNCH diagnosis in our practice since June 1999. Cases of BNCH between June 1999 and June 2002 were retrieved from computerized laboratory records. Questionnaires were sent to referring clinicians regarding clinical follow-up, including results of colposcopy, histology and follow-up smears. Smears were reviewed for the presence of microbiopsies or single atypical cells. Numbers of atypical cells were quantified as less than/equal to or greater than 3. RESULTS: A total of 106 reports on conventional cervical smears diagnosed as BNCH from 1999 to 2002 were retrieved; they comprised of 0.098% of a total of 107 634 smears screened over that period. Clinical follow-up, with histology (n = 54), colposcopy (n = 26) or repeat cytology (n = 10), was available in 88 of 106 cases. Thirty-one (35%) showed a high grade abnormality (CIN2, CIN3 or invasive squamous or adenocarcinomas), 15 (17%) showed a borderline/low grade abnormality (repeat BNCH or CIN1) and 42 (48%) were negative. Eighty-seven of these were reviewed cytologically ( Table 1). CONCLUSIONS: The BNCH category has a substantial yield of high grade abnormalities on follow-up, which may be greater in cases where atypical cells are pre-dominantly within microbiopsies. These findings support the introduction of the BNCH terminology.