Faut-il poursuivre les frottis de dépistage après hystérectomie ?

Mouithys, P; Papadopoulos, C; Allier, Gabriel; Lanta, S.; Delpierre, Cyrille; Najas, S; Boulanger, J. C.

doi:10.1016/s1297-9589(03)00178-4

Cited by 10 publications

(2 citation statements)

References 4 publications

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“…The role of routine follow-up with pap smear in women previously treated with hysterectomy for benign disease is currently on debate. Previous studies reported a 0 to 0.46% of positive vault cytology, 25 , 26 thus some authors assert that there is insufficient evidence to recommend routine vaginal smear screening in women after total hysterectomy for benign disease. 27 The American Society for Colposcopy and Cervical Pathology 28 and the American College of Obstetricians and Gynecologists 29 do not recommend routine vaginal smear screening in women who have had a hysterectomy and who do not have a history of CIN 2, CIN 3, or cervical cancer.…”

Section: Discussionmentioning

confidence: 99%

Abnormal Pap Smear and Diagnosis of High-Grade Vaginal Intraepithelial Neoplasia

et al. 2015

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The aim of this study was to analyze the correlation between the first diagnosis of high-grade Vaginal Intraepithelial Neoplasia (HG-VaIN: VaIN 2–VaIN 3) and the cytological abnormalities on the referral pap smear.All the women with histological diagnosis of HG-VaIN consecutively referred to the Gynecological Oncology Unit of the Aviano National Cancer Institute (Aviano, Italy) from January 1991 to April 2014 and with a pap smear performed in the 3 months before the diagnosis were considered, and an observational cohort study was performed.A total of 87 women with diagnosis of HG-VaIN were identified. Major cytological abnormalities (HSIL and ASC-H) on the referral pap smear were significantly more frequent than lesser abnormalities (ASC-US and LSIL) in postmenopausal women (64.9% vs 36.7%, P = .02) and in women with a previous diagnosis of HPV-related cervical preinvasive or invasive lesions (70.5% vs 39.5%, P = .01). Diagnosis of VaIN 3 was preceded by major cytological abnormalities in most of the cases (72.7% vs 27.3%, P < .001).The diagnosis of HG-VaIN can be preceded by different abnormalities on referral pap smear. Major abnormalities are usually reported in postmenopausal women and in women with previous cervical HPV-related disease. However, ASC-US or LSIL do not exclude HG-VaIN, especially VaIN2. An accurate examination of the whole vaginal walls (or vaginal vault) must be performed in all the women who underwent colposcopy for an abnormal pap smear, and a biopsy of all suspicious areas is mandatory.

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Section: Discussionmentioning

confidence: 99%

Abnormal Pap Smear and Diagnosis of High-Grade Vaginal Intraepithelial Neoplasia

et al. 2015

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“…Only one patient, out of 79 completing a 15-year follow-up study6, had an abnormal smear and a vaginal intraepithelial neoplasia (VAIN) later diagnosed and no patient developed invasive vaginal carcinoma. A French study7, conducted over a 10-year period on 2152 patients, reported only four cases of invasive cancer of the vagina of which one occurring after radical hysterectomy for invasive cancer of the cervix and three after total hysterectomy for cervical intraepithelial neoplasia (CIN). The follow-up of endometrial cancer does not seem to improve the survival.…”

Section: Discussionmentioning

confidence: 99%

What sampling device is the most appropriate for vaginal vault cytology in gynaecological cancer follow up?

Pup¹,

Canzonieri²,

Serraino³

et al. 2012

Radiology and Oncology

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BackgroundIn women with cancer-related hysterectomy, the vaginal vault cytology has a low efficacy - when performed by conventional methods – for the early detection of vaginal recurrence. The amount of exfoliated cells collected is generally low because of atrophy, and the vaginal vault corners can be so narrow that the commonly used Ayres spatula cannot often penetrate deeply into them. This prospective study aimed at identifying the advantages obtained in specimens collection using the cytobrush, as compared to the Ayres’s spatula.Patients and methods.141 gynaecologic cancer patients were studied to compare samplings collected with Ayre’s spatula or with cytobrush. In a pilot setting of 15 patients, vaginal cytology samples obtained by both Ayre’s spatula and cytobrush were placed at the opposite sites of a single slide for quali-quantitative evaluation. Thereafter, the remaining 126 consecutive women were assigned to either group A (spatula) or B (cytobrush) according to the order of entry. The same gynaecologist performed all the procedures.ResultsIn all 15 pilot cases, the cytobrush seemed to collect a higher quantity of material. The comparative analysis of the two complete groups indicated that the cytobrush technique was more effective than the spatula one. The odds ratio (OR) for an optimal cytology using the cytobrush was 2.8 (95% confidence interval -C.I. 1.3–6.2; chi-square test, p=0.008).ConclusionsVaginal vault cytology with cytobrush turned out to better perform than the traditional Ayre’s spatula to obtain an adequate sampling in gynecological cancer patients.

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