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Cytopathology. 2019 Sep 19. doi: 10.1111/cyt.12774. [Epub ahead of print]

Reappraisal of cytology-histology correlation in cervical cytology based on the recent American Society of Cytopathology Guidelines (2017) at a cancer research centre.

Author information

1
Scientist-C, Division of Cytopathology, ICMR-National Institute of Cancer Prevention and Research, Noida, India.
2
Scientist-E, Division of Clinical Oncology, ICMR-National Institute of Cancer Prevention and Research, Noida, India.
3
Scientist-D, Division of Clinical Oncology, ICMR-National Institute of Cancer Prevention and Research, Noida, India.
4
Scientist-F, Division of Cytopathology, ICMR-National Institute of Cancer Prevention and Research, Noida, India.
5
Scientist-G & Director, ICMR-National Institute of Cancer Prevention and Research, Noida, India.
6
Professor & Incharge, Department of Pathology, Faculty of Dentistry, Jamia Millia Islamia (Central University), Delhi, India.
7
Scientist-G & Coordinator, Division of Cytopathology, ICMR-National Institute of Cancer Prevention and Research, Noida, India.

Abstract

OBJECTIVE:

To assess the impact of recently published American Society of Cytopathology (ASC) guidelines (2017) on the conduct of cervical CHC.

METHODS:

A retrospective review was conducted for cervical biopsies with their corresponding conventional cervical smears over a seven-and-half year period (January 2011-June 2018). As per the ASC guidelines, a discrepancy assessment grid was prepared. Major cytologic-histologic discordance was defined as a diagnosis of HSIL or CIN2+ in one of the tests with negative result in the other. Smears and biopsies of all discordant cases were reviewed for reasons of overcall and undercall.

RESULTS:

Of the 341 cervical biopsies with corresponding Pap smear, cytologic-histologic agreement was noted in 249 (73%) cases. Major discordance was observed in 22 cases (6.4%); 16 undercalls and six overcalls on cytology, while minor discrepancies were noted in 70 cases. Atypical metaplasia and repair changes were the main reasons for overcall while small HSIL cells in atrophic smear and scant HSIL cells were important causes of undercall on cytology review. Using the ASC guidelines, we could improvise upon the existing CHC methodology for categorization of cyto-histological pairs of cases with a cytological diagnosis of atypical glandular cells.

CONCLUSION:

The present study demonstrates, for the first time, that the recent ASC guidelines facilitate cervical CHC, especially for categorization of cases with atypical glandular cells on cytology. Uniform application of these guidelines would standardize the conduct of cervical CHC internationally and provide scope for inter-laboratory comparison of data as well as enhance self and peer learning.

KEYWORDS:

Cervical cancer; Cytologic-histologic Correlation; Guidelines; Sensitivity

PMID:
31535740
DOI:
10.1111/cyt.12774

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