Advantages of the Short-Term Estrogen Test in Mailing Smear Diagnosis

Abstract

In the diagnosis of Mailing Smears, we are often hampered by most inadequate information accompany ing the smears, by the many factors which induce degenerative cell changes in specimens, and by difficulties inherent in the patients themselves.Inadequate information concerning such things as estrogen deficiency and/or inflammatory changes is a real problem in smear diagnosis. Cell changes causing problems may be classed as degenerative, autolytic or atrophic.Papanicolaou first suggested the administration of estrogen to such patients in order to induce maturation of the normal squamous epithelium, and to reduce the above problems without affecting the cytomorpho-logy of possibly present malignant tumour cells.The authors' purpose in presenting this paper is to evaluate the Short-Term Estrogen Test in 33 women who exhibited degenerative, autolytic, atrophic and inflammatory cell changes in their mailing smears.The method of administration of the Estrogen Test is as follows:1. Oral administration of 3 mg of Estriol daily through 5 days.2.Intramuscular injection of 10 mg long acting Estrogenic substances.In order to evaluate the effectiveness of this test, the authors used 3 indexes, as follows:1. Maturation index.2. EI/KPI Pundel's Index.3. Coincidence of Papanicolaou's classification with histology.If, after estrogen administration, the smear exhibited a good response to all 3 indexes, its response was classed as good. If there was good response to two, the classification was fair, and if to only one, or even to none at all, the classification was poor.The results of this study are as follows: - ESTROGEN TESTS REQUESTED-33 CASES.Good response 20Fair response 5Poor response 5Follow-up failed 39 of the cases with good response had been classed as equivocal smears before this test, but afterwards were classed as having good response, and were clearly diagnosable as malignant smears.The authors therefore recommend this test as a help - ful and useful method of ruling out equivocal maliing smears to make a good diagnosis, and thus avoiding unnecessary biopsies.