Endocervical component in conventional cervical smears: influence on detection of squamous cytologic abnormalities

The objective of this study was to correlate the number of endocervical cells and the number of atypical cells in cervical smears with cytological abnormalities to verify if a higher number of endocervical cells would implicate in a higher number of squamous atypical cells. In this cross sectional study, it was made a blinded review of 294 conventional cervical smears. The consensus diagnoses reached by the blinded review by three observers included 213 low-grade squamous intraepithelial lesions (LSILs) and 81 high-grade squamous intraepithelial lesions (HSILs). In each cervical smear were computed the number of endocervical cells and the number of squamous atypical cells, and it was established the following score: one (0-5 cells); two (6-10 cells); three (11-25 cells); four (26-50 cells); and five (more than 50 cells). Compared to the smears with an account of endocervical cells classified in score 1 (0-5 cells), an account of more than 50 endocervical cells was significantly associated to the presence of at least 10 squamous atypical cells in the cervical smears (OR 2.87 95% CI 1.54-5.35). Data from this study suggest that there is a positive association between the number of endocervical cells and the number of squamous atypical cells suggestive of SIL.