Interpreting microbiopsies in cervical smears. A cytohistologic approach

Area of Science:

• Gynecologic Pathology
• Cytopathology

Background:

• Cervical cytology screening generates numerous smears, some with diagnostic challenges.
• Microbiopsies offer tissue for histologic evaluation but require standardized diagnostic approaches.

Purpose of the Study:

• To assess interobserver variation in diagnosing cervical microbiopsies and their histologic sections.
• To evaluate the utility of MIB-1 staining in microbiopsy interpretation.
• To determine the diagnostic value of processing microbiopsies in cases with inconclusive or atypical squamous cells of undetermined significance (ASCUS) cytology.

Main Methods:

• Selected cervical smears with microbiopsies and diagnostic disagreements.
• Assessed interobserver variation among pathologists and cytologists for microbiopsies and histologic sections.
• Utilized MIB-1 staining for consensus diagnosis and correlated with follow-up.
• Analyzed the impact of processing microbiopsies in inadequate or ASCUS smears.

Main Results:

• Moderate interobserver variability was observed for microbiopsy and histologic section diagnoses (kappa = .44).
• MIB-1 staining showed a correlation (r = .62) with the consensus diagnosis.
• The consensus diagnosis had 71% sensitivity and 60% specificity for follow-up.
• Processing microbiopsies in inadequate or ASCUS smears enabled a correct diagnosis in approximately 50% of cases.

Conclusions:

• Histotechnical processing of cervical microbiopsies is feasible, but diagnostic interpretation presents challenges due to a lack of established criteria.
• MIB-1 staining can aid in the diagnosis of histologic sections from microbiopsies, improving correlation with follow-up.
• The microbiopsy technique is valuable for resolving inconclusive or ASCUS cytology findings, achieving correct diagnoses in half of such cases.