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Routine colposcopic evaluation of patients with persistent inflammatory cellular changes on Pap smear
N C Seçkin1, N O Turhan, S Ozmen
1Fatih University, Faculty of Medicine, Department of Gynecology and Obstetrics, Ankara, Turkey.
Objective:
To assess the rate of undetected dysplasia in patients with two consecutive reports of inflammatory cellular changes without atypia on Pap smears despite anti-inflammatory therapy.
Method:
A prospective randomized study.
Result:
2798 premenopausal non-pregnant patients were evaluated by Pap smears of the cervix. Of these, 397 (14.2%) were reported as 'inflammatory cellular changes'. A total of 238 (8.5%) had persistent inflammatory changes without atypia despite the anti-inflammatory therapy. Fourteen patients refused colposcope. The mean age and parity of the remaining 224 patients were 30.2 +/- 6.3 (18-46) and 1.7 +/- 2.3 (0-6), respectively. When these patients underwent colposcopically-directed biopsies of the cervix, in 51 (22.7%) patients human papillomavirus lesions, dysplasia and in situ cancer were noted. Mean age, parity, age of marriage, prevalence of smoking and contraceptive methods of the two groups of patients (173 vs. 51) did not show statistically significant differences.
Conclusion:
Colposcopically-directed biopsies of the cervix are indicated even when inflammatory cellular changes without atypia persist despite therapy.