Adenocarcinomas in the cervicovaginal papanicolaou smear: Analysis of a 12‐year experience

摘要

AbstractWe attempted to reassess the significance of cervicovaginal Papanicolaou smear(s) in identifying adenocarcinoma (AC) by comparing Papanicolaou smears with histopathology in a pool of 188 patients. The first part of study dealt with 95 patients, seen over a 12‐yr period (1975–1986), who had tissue diagnosis of cervical or endometrial AC, all with prior Papanicolaou smears available. Of the 95 patients, Papanicolaou smears were positive and/or inconclusive for uterine AC in 37 (38.9) and falsely negative in 58 (61.1) patients. Of the latter, six were either positive and/or inconclusive for squamous carcinoma and moderate to severe dysplasia; thus, the effective detection rate (sensitivity) for malignancy and related condition of Papanicolaou smears was 45.3 (43 of 95). The second part of the study concerned the analysis of 130 patients with 148 Papanicolaou smear in whom cytologic diagnosis positive and/or inconclusive for AC was made during the same study period, Tissue diagnoses were available in 107 of these as follows: AC and glandular hyperplasia in 66 patients (61.7 predictive value), with 11 (10.3) from extrauterine sources; squamous carcinoma in 12 and moderate to severe dysplasia in 5, totalling 17 patients (15.9); miscellaneous conditions (polyps, radiation change, and glandular atrophy) in 11 patients (10.3); and no pathologic change in 13 patients (12.1). The effective predictive value of positive and/or inconclusive Papanicolaou smears for all malignancy and related states is 77