Related Experiment Videos
High grade abnormalities following an 'inconclusive' smear.
S Valmadre1, K Atkinson, R Houghton
1Colposcopy Service, Sydney Gynaecological Oncology Group, King George V and Royal Prince Alfred Hospitals, New South Wales, Australia.
The Australian & New Zealand Journal of Obstetrics & Gynaecology
|October 31, 2002
Summary
Many laboratories report "inconclusive" results for cervical abnormalities, potentially masking high-grade disease. This study found significant disease, including high-grade lesions and carcinoma, in a substantial portion of these patients, highlighting the need for clearer reporting.
Area of Science:
- Gynecologic Pathology
- Cervical Cytology
- Colposcopy
Background:
- The National Health and Medical Research Council (NHMRC) recommends reporting "inconclusive possible high grade epithelial abnormality."
- Many laboratories simplify this to "inconclusive," potentially obscuring significant findings.
- This ambiguity can lead to diagnostic and management challenges.
Purpose of the Study:
- To investigate the reasons behind cytological difficulties leading to "inconclusive" reports.
- To determine the actual prevalence of significant cervical disease in patients with "inconclusive" cytology results.
Main Methods:
- Retrospective review of 200 patient records with "inconclusive" cytological abnormalities.
- Analysis of clinical details, colposcopic findings, and histopathological results.
- Management decisions based on colposcopic and histological outcomes.
Main Results:
- Colposcopy identified high-grade lesions in 43% and carcinoma in 1% of patients.
- Histopathology confirmed high-grade lesions in 49% and carcinoma in 4%.
- Common findings contributing to "inconclusive" results included inflammation (27%), small lesions (43%), and endocervical disease (21%).
Conclusions:
- Cytological difficulties leading to "inconclusive" results are often due to inflammation, small lesions, or endocervical disease.
- The term "inconclusive" alone is insufficient to convey the significant risk of high-grade cervical disease.
- Improved reporting is needed to accurately reflect patient risk.