High Cervical Intraepithelial Neoplasia and Its Abnormal PAP Referral: A 13-Year Analysis [30H

Abstract

INTRODUCTION: The objective of this work is to analyze the referral cytologies of the patients in which a CIN II and/or CIN III is histologically confirmed in the cervical pathology unit (CPU) of the San Borja Arriaran Clinical Hospital (HCSBA). METHODS: Retrospective analysis of the patient records derived from positive PAP, reported between January 2006 and December 2018. The admission cytology and the definitive histological diagnosis were correlated in the HCSBA CPU. RESULTS: During the 13 years of histological diagnoses associated with 6160 positive cytologies were reviewed. 2083 patients with histological diagnosis of CIN2+. Median age 38 years. 15.02% (n=313) made it an atypical PAP in one of its three types: second ASCUS 2.44% (n=51), ASC-H 10.99% (n=229) and AGUS 1.58% (n=33). 16.75% (n=349) came from a CIN I PAP, 64.13% (n=1336) from a CIN II or III Pap smear and the rest for an invasion-suggestive PAP. CONCLUSION: One in three patients referred to the HCSBA from a positive PAP has a high-grade lesion, of which 2/3 were referred from a high-grade cytology; 1/3 come from lower grade cytologies. This distribution differs from that published internationally, a phenomenon of difficult interpretation. It is necessary that specialists CPU are aware of the performance of their laboratories, in order to evaluate the procedures according to the risks of their patients.