medigraphic.com
SPANISH

Revista de Investigación Clínica

Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2011, Number 3

<< Back Next >>

Rev Invest Clin 2011; 63 (3)

Abnormalities in cervical smears stored in plastic bags: Potential cause of false negatives

Ortega-González P, González-Bravo MS, Jiménez-Muñoz-Ledo G, Macías AE
Full text How to cite this article

Language: Spanish
References: 12
Page: 263-267
PDF size: 186.80 Kb.


Key words:

Cervical smear, Cervical cancer, Humidity, Handling of smear, Procedure guidelines.

ABSTRACT

Introduction. Cervical smear is the most economic and efficient diagnostic tool for the screening of cervical cancer. However, since plastic bags have been used in Guanajuato to transport and store smears, we have observed cytological abnormalities which difficult the diagnosis and lead to false negatives. Objective. To describe those abnormalities. Methods. Out of 340 women registered in a primary care center in Mexico, 68 were selected through systematic random sampling during 2007. A cervical smear was obtained and placed on two slides. The first sample was allowed to dry, but the second one was placed into the plastic bag immediately after fixation. After 15 days all the smears were stained with the Papanicolaou technique. A certified pathologist, blinded about the variable of study, interpreted the samples according to the Bethesda system, and evaluated the presence of necrosis, edema, holes, and opportunistic microorganisms. Results. Of the 68 smears exposed to a humid storage, 36 (53%) were inadequate for diagnosis (Fisher’s exact probability ‹ 0.001). From them, 36 (53%) had holes or lagoons, 34 (50%) had edema, 31 (46%) had necrosis, and 15 (22%) had fungus. On the other hand, the 68 dried cervical smears were all adequate for diagnosis and none had the changes or cytological abnormalities.Conclusion. The humid transport and storage of cervical smears produced abnormalities in the normal morphology that could lead to false negative results. The guideline for the handling of cervical smears must stress the importance of allowing the smears to dry completely after fixation and before storing them in plastic bags.


REFERENCES

  1. Lara E, Day EN, Hakama M. Trends in mortality from cervical cancer in the Nordic countries: Association with organized screening programs. Lancet 1987; 20: 1247-9.

  2. Virtej P, Vasiliu C. Cytodiagnosis in cervical neoplasia: from the Babes/Papanicolaou smear to the Acta Bethesda System. Clin Exp Obstet Gynecol 2003; 30: 173-7.

  3. Lazcano-Ponce E, Alonso P, Ruiz-Moreno JA, Hernández-Avila M. Recommendations for cervical cancer screening programs in developing countries. The need for equity and technological development. Salud Pública de Mex 2003; 45: 449-62.

  4. Secretaría de Salud. Sistema Nacional de Información del Cáncer de la Mujer. Programa de prevención y control de cáncer cérvico-uterino. Indicadores, Productividad de citotecnólogo. Disponible en: http://sicam-cacu.salud.gob.mx [Acceso el 18 de agosto 2009].

  5. Randsell IS, Davey DD, Zaleski S. Clinicopathologic correlation of the unsatisfactory Papanicolaou smear. Cancer 1997; 81: 139-43.

  6. Loustalot LM., Espinosa RR, Blas RI, Vite PG, Jerezano de la Rosa O. Manual de Procedimientos para la toma de la muestra de citología cervical. Secretaría de Salud 2000. 10-22.

  7. Dawson-Saunders B, Trapp RG. Probability, sampling and probability distributions. In: Basic and clinical biostatistics. Dawson- Saunders B, Trapp RG. Conneticut USA: Appleton & Lange; 1990: 64-81.

  8. Organización Panamericana de la Salud. Manual de procedimientos del laboratorio de citología. Washington DC: OPS; 2002.

  9. NOM-014-SSA2-1994. Norma Oficial Mexicana para la prevención, tratamiento y control del cáncer del cuello uterino y de mama 2007.

  10. Martínez-Girón R, Ribas-Barceló A, García-Miralles MT. López- Cabanilles D, Tamargo Pelaez ML, Torre-Bayón C, Fernández- Alvarez L. Airborne fungal spores, pollen grains, and vegetable cells in routine Papanicolaou smears. Diagn Cytopathol 2004; 30: 381-5.

  11. Hoda RS, Colello Ch, Roddy M, Houser PM. “Fruiting Body” of Aspergillus Species in a Routine Cerviño-Vaginal Smear (Pap Test). Diagn Cytopathol 2005; 33: 244-5.

  12. Van Hoeven KH, Bertolini PK. Prevalence. Identification and significance of fiber contaminants in cervical smears. Act Cytol 1996: 40; 489-95.




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Rev Invest Clin. 2011;63