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Cytology - general
Reviewer: Marlin Rosa, M.D., University of Florida (see Reviewers page)
Revised: 29 September 2010, last major update August 2010
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● The most successful application of clinical cytology is diagnosing cervical abnormalities before they develop into invasive cervical carcinoma
● Used for screening and follow-up of cervical carcinoma, particularly squamous carcinoma
● Cytology smears are sensitive to abnormalities, although there is variable interpretation on any particular smear
● The most important factor is to detect an abnormality and to start an appropriate management plan
● Specimen should be obtained and prepared by trained individuals
● False negative tests are often due to poor quality specimens and inadequate sampling (Mod Pathol 1992;5:337), or interpretation/ screening errors
● Endocervical sampling should be performed to confirm that the entire transition zone was sampled, although many studies show no association between the absence of endocervical cells / transition zone and a higher risk of squamous lesions on subsequent smears (Am J Clin Path 2001;115:851, Acta Cytol 1986;30:258, Cancer 2001;93:237, Lancet 1991;337:265)
● For endometrial carcinoma, pap smear is only 50% sensitive; 60% with cervical scrapings, 75% with vaginal pool material; thus, pap smears are not appropriate for screening endometrial abnormalities (Cytopathology 2009;20:380)
● Liquid based cytology performed by cytocentrifugation is reported to be efficient and inexpensive (CytoJournal 2005;2:15); is associated with higher rates of LSIL and lower ratios of atypical squamous cells/LSIL (Arch Pathol Lab Med 2004;128:1224, Arch Pathol Lab Med 2003;127:200)
Cervix-cytology > Cytology - general
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