Abstract
To improve the detection rates in the determination of signs consistent with ulcerative cervicitis against signs of intraepithelial neoplasia, in PAP smears. We investigated the frequency of establishing a diagnosis of a simple ulcerative cervicitis by histology in a cohort of 58 females with cervical cytology suggestive of intraepithelial neoplasia. There was found a detection rate of 81.58% in the determination of ulcerative cervicitis by cytology and a rate of 100% in the determination of HPV-infection, CIN1, CIN2 and CIN3 respectively. There was no statistically significant difference between cytology and histology in the diagnosis of ultracerative cervicitis (p>0.5, chi-square). There is an overestimation of the cytological signs in the diagnosis of ulcerative cervicitis 18.42%). There is also an excellent agreement in the diagnosis of HPV-infection and CIN grades (100%) between cytology and histology, discordant with the literature (2.4%-71%).
Highlights
Materials and MethodsUlcerative cervicitis is, like all inflammatory processes, a reaction of the cervical epithelium against damaging factors, which is accompanied by ulceration.Damaging factors can be micro-organisms, iatrogenic or anatomic and chemical
The aim of our study is to increase the detection rate in the determination of features consistent with ulcerative cervicitis against features of Cervical intraepithelial neoplacia (CIN) in cervicovaginal smears, considering that scarce related articles are found in the literature and cytologic interpretation of the entity is poorly qualified
There was a discrepancy between cytology and histology in the diagnosis of ulcerative cervicitis (31 cases to 38 cases)
Summary
Materials and MethodsUlcerative cervicitis is, like all inflammatory processes, a reaction of the cervical epithelium against damaging factors (with the formation of an exudate, protein -, WBC-, and fibrin-rich), which is accompanied by ulceration.Damaging factors can be micro-organisms (trichomonas vaginalis, herpes simplex, candida species, neisseria), iatrogenic or anatomic (biopsy, intrauterine contraceptive device-IUD-, prolapse of the uterus, cysteorthocele) and chemical (chemotherapy). Ulcerative cervicitis is, like all inflammatory processes, a reaction of the cervical epithelium against damaging factors (with the formation of an exudate, protein -, WBC-, and fibrin-rich), which is accompanied by ulceration. Additional causative factors are estrogen depletion (hypoestrogenism), increased flow and alkalinity of cervical mucus, cervical ectopy and obstruction from pessaries or tampons. It may be either acute or chronic. Chronic cervicitis is of more clinicopathologic interest because it causes sterility due to abnormalities of the os, involvement of the endometrium or tubes by inflammation conveyed up from the cervix, and it is partly a risk factor for cervical intraepithelial neoplasia. The aim of our study is to increase the detection rate in the determination of features consistent with ulcerative cervicitis against features of CIN in cervicovaginal smears, considering that scarce related articles are found in the literature and cytologic interpretation of the entity is poorly qualified
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