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  • Artigos Originais

    Cytological smears of women diagnosed with adenocarcinoma of the uterine cervix

    Rev Bras Ginecol Obstet. 2014;36(1):40-45

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    Artigos Originais

    Cytological smears of women diagnosed with adenocarcinoma of the uterine cervix

    Rev Bras Ginecol Obstet. 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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