Цитологические признаки вовлеченности крипт при цервикальной интраэпителиальной неоплазии

Abstract

Objective. To determine the cytological criteria of crypt lesion by cervical intraepithelial neoplasia (CIN). Patients and methods. The retrospective cohort study included 76 women who underwent a comprehensive medical evaluation after screening tests: cervical cytology test, colposcopy, biopsy and histological examination of the cervix, polymerase chain reaction (PCR) test for human papillomavirus (HPV). Cytological material was obtained using an endocervical brush (Cytobrush); it was stained by the Pappenheim method and examined by light microscopy; the Bethesda system was used. Results. Cytological examination of the cervical smears (cervical ectopy and endocervix) in 59 (78%) women revealed squamous epithelial cells with features typical for dysplasia of different severity: mild – LSIL (low-grade squamous intraepithelial lesions) and severe – HSIL (high-grade squamous intraepithelial lesion). Smears of 31 (53%) women also showed cylindrical (glandular) epithelial cells with signs of pronounced proliferation: 2 (9.5%) with LSIL and 29 (76.3%) with HSIL. Histological examination of the cervix in all 59 women revealed dysplasia of varying severity. Features of endocervical crypt involvement were detected in 28 women: 1 (4.8%) with LSIL and 27 (71.1%) with HSIL. The sensitivity and specificity of cytological diagnosis of cervical crypt involvement in LSIL were 100 and 95%, in HSIL – 87 and 67%, respectively. Conclusion. The cytological feature of crypt involvement by CIN is the presence in cervical mucus smears of clusters and papillary structures of proliferating, immature cylindrical epithelial cells, partially with cellular and nuclear polymorphism. Key words: crypts, cervical intraepithelial neoplasia, cytological examination