Detection of endocervical component by PAPNET system on negative cervical smears

The presence of endocervical component (ECs) on cervical smears is considered essential for determining the adequacy of the Pap smear. The absence of an endocervical component in a negative smear suggests that a repeat Pap smear should be taken. We evaluated 635 manually screened negative cervical smears with a documented endocervical component. On PAPNET review, these cases were scrutinized for endocervical cells, metaplastic squamous cells (MSQ), or both. One-hundred and thirty-eight cases (22%), adequate manually, showed no ECs or MSQs by PAPNET. Twenty-three additional cases with both ECs and MSQ on manual, showed only MSQ by PAPNET, while another 30 cases (5%) with MSQ manually were totally missed by PAPNET. The results of this analysis shows that the endocervical component (ECs, MSQ) is missed by PAPNET in 27% of the cases. Without further improvement, this may pose the greatest deterrent for PAPNET as a primary screening instrument.