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Research paper
Published online: 2021-04-22
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Evaluation of the consistency ratios of cervical smear, cervical biopsy and conization results

Nadi Keskin1, Ismail Biyik1, Onur Ince1, Hazal Gokten1, Sercan Simsek2, Cenk Soysal1, Ozlem Erten1
DOI: 10.5603/GP.a2021.0051
·
Pubmed: 33914320
Affiliations
  1. Kütahya Sağlık Bilimleri Üniversitesi, Evliya Çelebi Yerleşkesi Tavşanlı Yolu 10. Km Kütahya, Turkey
  2. Kutahya Evliya Celebi Education and Research Hospital, Turkey

open access

Ahead of Print
ORIGINAL PAPERS Gynecology
Published online: 2021-04-22

Abstract

Objectives: Possible discrepancies between the cervical smear, biopsy histology and loop electrosurgical excision procedure (LEEP) results of the same patient is a matter of debate in the literature. In this study, we investigate the degree to which these results differ, and the clinical reasons for these differences.

Material and methods: With a retrospective design, cervical smear, cervical biopsy and LEEP results of patients were compared in terms of consistency. One hundred sixty-four patients who underwent till LEEP procedure due to pathologic initial smear and biopsy results between January 2015 and March 2020 were included in the study.

Results: Exact diagnosis discrepancy and high grade squamous intraepithelial lesion (HSIL) discrepancy were 78.9% and 50.0% between smear and cervical biopsy, 64.6% and 31.7% between cervical smear and LEEP and 43.8% and 28.1% between cervical biopsy and LEEP results, respectively. Age did not affect the consistency rates of pathologic results between smear-biopsy (p = 0.408) and biopsy-LEEP (p = 0.590). However, the probability of the consistency of smear and LEEP results exhibited a statistically significant linear relation with age (OR = 1.043, p = 0.015). HPV infections did not affect the discrepancy between smear-biopsy (p = 0.533), smear-LEEP (p = 1.000) and biopsy-LEEP (p = 0.529)

Conclusions: Smear technique has a serious discrepancy and under-diagnosis problem when its results are compared with biopsy and LEEP. The consistency between smear and LEEP results appears to improve with age. When HSIL is evaluated in terms of detection, this discrepancy decreases. A smear test can detect HSIL and carcinoma with a higher accuracy than low-grade lesions.

Abstract

Objectives: Possible discrepancies between the cervical smear, biopsy histology and loop electrosurgical excision procedure (LEEP) results of the same patient is a matter of debate in the literature. In this study, we investigate the degree to which these results differ, and the clinical reasons for these differences.

Material and methods: With a retrospective design, cervical smear, cervical biopsy and LEEP results of patients were compared in terms of consistency. One hundred sixty-four patients who underwent till LEEP procedure due to pathologic initial smear and biopsy results between January 2015 and March 2020 were included in the study.

Results: Exact diagnosis discrepancy and high grade squamous intraepithelial lesion (HSIL) discrepancy were 78.9% and 50.0% between smear and cervical biopsy, 64.6% and 31.7% between cervical smear and LEEP and 43.8% and 28.1% between cervical biopsy and LEEP results, respectively. Age did not affect the consistency rates of pathologic results between smear-biopsy (p = 0.408) and biopsy-LEEP (p = 0.590). However, the probability of the consistency of smear and LEEP results exhibited a statistically significant linear relation with age (OR = 1.043, p = 0.015). HPV infections did not affect the discrepancy between smear-biopsy (p = 0.533), smear-LEEP (p = 1.000) and biopsy-LEEP (p = 0.529)

Conclusions: Smear technique has a serious discrepancy and under-diagnosis problem when its results are compared with biopsy and LEEP. The consistency between smear and LEEP results appears to improve with age. When HSIL is evaluated in terms of detection, this discrepancy decreases. A smear test can detect HSIL and carcinoma with a higher accuracy than low-grade lesions.

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Keywords

cervical smear; cervical biopsy; LEEP; conization; discrepancy

About this article
Title

Evaluation of the consistency ratios of cervical smear, cervical biopsy and conization results

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Research paper

Published online

2021-04-22

DOI

10.5603/GP.a2021.0051

Pubmed

33914320

Keywords

cervical smear
cervical biopsy
LEEP
conization
discrepancy

Authors

Nadi Keskin
Ismail Biyik
Onur Ince
Hazal Gokten
Sercan Simsek
Cenk Soysal
Ozlem Erten

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