High-grade squamous intraepithelial lesions and invasive carcinoma following the report of three negative Papanicolaou smears: screening failures or rapid progression?

摘要: The cytologic smears and histopathologic specimens of 18 patients developing cervical intraepithelial neoplasia 3 (CIN3) two invasive squamous carcinoma following the report at least three negative Papanicolaou tests were studied. A median number 9.5 per patient procured over a interval 93.5 mo reviewed. Twenty-eight (22.7%) 123 reportedly revealed lesion (SIL), 17 (13.8%) unsatisfactory, 14 (11.4%) lacked an endocervical component, 37 (30.1%) classified as atypical cells undetermined significance (ASQUS) on reexamination. Fourteen (50%) 28 originally misclassified contained fewer than 100 SIL five (17.8%) severely inflamed. One whose had atrophic cervix, one primarily in thick sheets, small CIN3 resembling metaplasia. Six (30%) single false smear, seven (35%) multiple smears, or more unsatisfactory reported negative, lacking six taken during pregnancy. Thirteen abnormal ASQUS high-grade (HSIL) but never specimen showing only low-grade (LSIL). This study demonstrates that early signs may be difficult to recognize cytologically poor quality inadequate sampling contribute diagnoses.(ABSTRACT TRUNCATED AT 250 WORDS)