[Negative smear in cervical carcinoma in situ (author's transl)]

In 100 patients which had shown ca-in-situ in the conization specimen during a preoperative colposcopic and cytologic investigation separate smears were taken from the anterior lip, the posterior lip and from the cervical canal. The three slides in each case have been examined to determine the frequency of negative smears, especially those of the endocervix, and to evaluate any relationship between those findings and the localization and the extent of the lesion. 22% of these patients belonged to the age group of 20-29 years, 3% were older than 60 years. Depending on the microscopic description we differentiated between small, circumscript lesions (17 cases), intracervical lesions (24) and extended lesions (59). In only 49% of the cases all three smears had been positive (Pap III-V). In 23% of the cases the endocervical smear was negative. In small, circumscript lesions at least one negative smear was found in 80% of the cases. In the extended lesions one third had at least one negative slide. In 25% of the patients with an intracervical lesion the endocervical smear was negative. Re-evaluation of the negative smears has shown an examiner's failure in about one third of these, due to several factors. In 24 patients the triple cervical smear technique had been applied at least twice. One third of the slides exhibited differences concerning negativity and positivity between the first and the second preparation.