Influence of specimen adequacy on the diagnosis of ASCUS

Abstract

The impact of specimen adequacy on the diagnosis of cervical cytology is not fully understood. Virtually, the greatest impact of smear quality limitation factors is on the diagnosis of atypical squamous cells of undetermined significance (ASCUS) because this category is more susceptible to interpretation mistake due to its criteria subjectivity. This study aims to evaluate the impact of smear quality impairing factors on the diagnosis of ASCUS. The 1,507 cases of ASCUS studied were obtained from the Cervical Cancer Screening Program of Paraná (CCSPP). The cases were reviewed by expert cytopathologists and the results were correlated to the specimen adequacy. The results showed that the presence of obscuring blood impairs the correct diagnosis and leads the pathologist to overdiagnose negative smears as ASCUS. The presence of adequate endocervical sampling contributes to a higher rate of correct ASCUS diagnoses but did not influence the pathologist to over- or underestimate the cytological findings.

Unsatisfactory rate in liquid-based cervical samples as compared to conventional smears: A study from tertiary care hospital

“…[ 5 6 ] Despite the elimination of the term “S/L by,” it was recommended that the cytology report should mention the sample adequacy and describe the presence or absence of the endocervical/transformation zone component and any other quality indicators. [ 7 ] Although, it is the responsibility of the sample-taker to ensure that the entire transformation zone has been sampled. [ 8 ]…”

Quality assurance in cervical screening of a high risk population: A study of 65,753 reviewed cases in Parana screening program, Brazil

“…[4][5][6][7][8][9][10] In October 1997, the Cervical Cancer Screening Program of Paraná (CCSPP) was launched with the ultimate goal of significant reduction in mortality rates from uterine cervix cancer. 11 The state of Paraná is located in southern Brazil. It has approximately 9,760,000 habitants (Instituto Brasileiro de Geografia e Estatística).…”

Associação entre a Qualidade da Amostra e a Detecção de Atipias Celulares no Exame Citopatológico do Colo do Útero

“…um dos fatores mais relevantes, em termos de ocorrência, para a limitação na interpretação técnica do exame, correspondeu à ausência ou escassez das células endocervicais e/ou metaplásicas representativas da Zt. sebastião et al 16 avaliando o impacto de fatores que prejudicam a qualidade do esfregaço no diagnóstico de atipias de significado indeterminado em células escamosas (ascus), na unidade de Monitoramento externo da Qualidade do Programa de rastreamento do câncer do colo do útero no Paraná, constataram que a presença de amostragem endocervical adequada contribuiu para uma maior taxa de diagnósticos corretos.…”