Cytological smears of women diagnosed with adenocarcinoma of the uterine cervix - Revista Brasileira de Ginecologia e Obstetrícia

Artigos Originais

Cytological smears of women diagnosed with adenocarcinoma of the uterine cervix

Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(1):40-45

DOI: 10.1590/S0100-72032014000100009

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PURPOSE:

To analyze the cytological findings of women with cervical adenocarcinoma, taking
into account the patient’s history in the year prior to diagnosis and the
histopathological aspects of the lesions.

METHODS:

A retrospective comparative study was conducted using data from women with
cervical adenocarcinoma or squamous carcinoma detected between 2002 and 2008. The
cytological reports were synthesized according to the Bethesda System revised in
2001 and were compared to the histopathological findings of cervical
adenocarcinoma and squamous carcinoma. The distributions of cytological findings
were calculated, as well as the global agreement and chance-corrected agreement
using the Cohen’s Kappa Coefficient. For this purpose, the cytological findings
were grouped according to the epithelial origin, forming the glandular cell and
squamous cell groups, with the histopathologically confirmed tumor types
(adenocarcinoma versus squamous carcinoma) being used as the gold
standard.

RESULTS:

A total of 284 cases of cervical cancer were diagnosed during the study period.
The effectively studied cases were 27 and 54 patients with adenocarcinoma and
squamous carcinoma, respectively. The adenocarcinoma group represented 9.5% of the
total cases diagnosed, and 56.0% of the women in this group were younger than 50
years. Cervical cytology was collected on average 92 days before the cancer
diagnosis (range: 19 days to 310 days). In 41.6% of cases the cytological results
were consistent with glandular alterations such as adenocarcinoma cells or
atypical glandular cells. The global agreement and Cohen’s Kappa Coefficient were
73.7 and 48.7%, suggesting substantial and moderate agreement, respectively.

CONCLUSIONS:

In this population, the cytological smears had an important role in screening
women with adenocarcinoma, although some of them were referred to clarify the
clinical symptoms. The agreement between cytological and histopathological
findings was moderate.

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