2013, Number 3
Comparative Study to Value the Quality of the Cytologic Sample in a Double Gathering Using Polyethylene Brush
Tolentino LJA, Martínez MSE, Álvarez VH, González BJE, Tamariz HE, Camacho AG
Full text
Language: Spanish
References: 9
Page: 223-227
PDF size: 316.74 Kb.
ABSTRACT
Background: Cervical cancer remains a disease that impacts all women with greater social inequality in Mexico and Latin America. Its incidence and mortality remain very high, so screening programs must be reinvented and modernized at all of these sites.Objective: To evaluate cervical cytology in two consecutive shootings with two brushes, trying to determine if the second shot still gets adequate cellular material for cytologic diagnosis.
Material and method: A comparative study was conducted in 209 patients yielding 418 samples that formed the two groups. The lamellae were validated as excellent for their content of metaplastic cells and the presence of enough endocervical cells to give a diagnostic impression.
Results: The average age of the patients was 40.4 years. In the first shot, out of the total of the lamellae, 73.1% were validated as excellent, while 26.9% was rated as good quality. Platelets were not detected absent from cellular material. In the second shot sampling it was found that 65.4% of smears were of excellent quality, whereas 34.6% was considered of good quality. Samples without cellular material were not observed in any of the smears. We used the Kappa statistic to evaluate concordance between both brush cytologies. Agreement was moderate, we obtained a value of 0.61 Kappa. In the first cytological shot, 153 (73.2%) were negative results of malignancy, 6 (2.8%) studies were diagnosed with high-grade intraepithelial lesion, 20 (9.5%) as low-grade squamous intraepithelial lesion, 28 (13.3%) as atypical squamous cells of undetermined significance and two cases (0.9 %) as cervical glandular atypia. For the second shot 163 (77.9%) were negative results, 29 (13.8%) were diagnosed as low-grade squamous intraepithelial lesion, 4 (1.9%) as high-grade intraepithelial lesion, 11 (1.4%) with atypical squamous cells of undetermined significance and two cases (0.9%) were identified as cervical glandular atypia.
Conclusions: Sampling with polyethylene brush always allowed us to obtain cellular material from the transformation zone and endocervix. Similarly, in a second sample we found adequate cellular material in all cases.
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