Comparison of Cervical PAP smear, Colposcopic Impression and Histologic Result

Abstract

Objective To evaluate the diagnostic accuracy of cytology and colposcopic impression in women
with abnormal cervical PAP smear using pathological result as the “gold standard”.
Design Retrospective study.
Setting The outpatient colposcopic clinic of Rajavithi Hospital, Thailand.
Cases The cases of 3,399 patients were reviewed. Of these, the mean age of 39.0 years
(range, 16-95 years) had pathological reports.
Result 1,259 patients had PAP smear, colposcopic impression, and pathological reports.
Compared with pathological reports, grading of cytology was concurrent in 43.76% of cases of
abnormal PAP smear, and in 51.90% after colposcopic impression. In 152 patients with PAP
smear class III (these smears were not graded by CIN), the correlation was 63.15% when
comparing cervical intraepithelial neoplasia(CIN) histology with pathological result. The mean
age of women with LSIL, HSIL, and cancer (CA) were 34.7, 38.8, and 48.2 years respectively.
Out of 16 atypical PAP smears 3 were histologically HSIL. 35.49% of LSIL PAP smears were
histologically HSIL and 2.73% CA.
Conclusion We found that cytologic concordance with pathological result was 43.76% and 51.90%
after colposcopic impression. Colposcopy is a better tool for accuracy than PAP smear.