[Practice related attempts at a precision diagnosis in gynecological cytology]

In a selected material of 316 cases detailed cytological examinations were made, above all, of categories of the Papanicolaou groups III, IV and V. These are special cases with prediagnostically aggravating factors of various, kinds, without and after irradiation therapy. As a comparison, smear-preparations of the Papanicolaou group IV from screening examinations are stated. We aimed at achieving a precisation of cytodiagnostics, so as to achieve in this way the classification to the Papanicolaou groups with a greater reliability. In order to increase the degree of objectivity, the renewed judgements of the preparations by 2 persons (secondary and tertiary diagnostics) were carried through. After the decolorisation of preparations already diagnosed (primary diagnostics) and subsequent renewed judgement after a PAS-reaction test, a significant precisation of the Papanicolaou group III could be reached by a more exact demonstratability of the cell nucleus structures. A strikingly state-blue stainability of the cell nuclei was found significantly more frequently with histologically confirmed carcinomata, less frequently with so-called preliminary stages. There was no statistically significant difference between the preparations taken from non-radiated cases and the cases with a state following radiatio, as far as a precisation was concerned. The kind of this additional processing of the gynaecological smear preparations is applicable in practice, too. It should, however, be mainly reserved to diagnostically problematical cases.