Diagnostic Three Slides Pap Test Compared to Punch Biopsy and Endocervical Curettage in Confirmed HSIL+ Diagnosis

• Published in: Diagnostics (Basel) Vol. 11; no. 6; p. 942
• Main Authors: Rubeša-Mihaljević, Roberta, Vrdoljak-Mozetič, Danijela, Dinter, Morana, Verša Ostojić, Damjana, Štemberger-Papić, Snježana, Klarić, Marko
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 25-05-2021; MDPI
• Subjects: Biopsy; Cellular biology; Cervical cancer; Cold; diagnostic Pap test; endocervical curettage; final conus histology; Histology; HSIL; Human papillomavirus; Medical screening; Pap smear; Performance evaluation; punch biopsy; Vagina
• ISSN: 2075-4418; 2075-4418
• DOI: 10.3390/diagnostics11060942

Objective: The aim of the study was to evaluate the accuracy of the diagnostic Pap test (DPT) on three slides and punch biopsy and endocervical curettage (PB/ECC) compared with the final biopsy material in the detection of high-grade squamous intraepithelial lesion (HSIL). Materials and methods: Patients treated with conization after previous DPT and PB/ECC were analyzed. The findings of the DPT and PB/ECC as well as of the endocervical brush cytology and ECC were compared with the final conus histology. Results: 150 patients were analyzed, and final histology verified 145 cases of HSIL and 3 cancers. The percentage of confirmed HSIL cytology was 97%, while for PB/ECC it was 79% with 30/145 false negative results. The correlation between Pap test and PB/ECC showed that the diagnostic accuracy of DPT is significantly higher (p < 0.0001). Endocervical brush cytology confirmed HSIL+ in the endocervical canal in 83% and ECC in 35% of cases (p < 0.0001). Conclusion: The DPT on three slides enables better detection of HSIL compared to PB/ECC, particularly for lesions localized in the endocervical canal sampled with a cytobrush. A high quality DPT could represent a surrogate for PB/ECC and open the possibility of direct access to therapeutic procedure.