The role of cytology in the detection of preinvasive and invasive vulvar changes depending of the sampling method
Aim: Exfoliative cytology of vulvar samples is used in diagnostics and follow up of vulvar changes, especially those in which biopsy is not indicated. Traditionally, samples were taken by spatula and the cellularity of the samples was low. To improve cellularity, taking samples by endocervical brush...
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Hrvatski liječnički zbor
2021
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oai:doaj.org-article:f61bda6bc8804a6892f1a46ef1be10532021-12-01T12:51:46ZThe role of cytology in the detection of preinvasive and invasive vulvar changes depending of the sampling method10.26800/LV-143-1-2-20024-34771849-2177https://doaj.org/article/f61bda6bc8804a6892f1a46ef1be10532021-02-01T00:00:00Zhttps://lijecnicki-vjesnik.hlz.hr/lijecnicki-vjesnik/uloga-citologije-u-otkrivanju-preinvazivnih-i-invazivnih-promjena-stidnice-ovisno-o-nacinu-uzimanja-uzorka/https://doaj.org/toc/0024-3477https://doaj.org/toc/1849-2177Aim: Exfoliative cytology of vulvar samples is used in diagnostics and follow up of vulvar changes, especially those in which biopsy is not indicated. Traditionally, samples were taken by spatula and the cellularity of the samples was low. To improve cellularity, taking samples by endocervical brush was introduced. Material and methods: In the retrospective study 1866 vulvar samples taken in the period from July 1, 2011 to December 31, 2013 were analyzed. Cellularity of the samples, as well as the atypical squamous cells (ASC) to squamous intraepithelial lesion or carcinoma (SIL+) ratio, and the cytohistologic correlation were analyzed. Results: In the vulvar disease specialized unit most samples were taken by endocervical brush, and the less unsatisfactory because of scantness samples (3.4%), as well as the satisfactory but scant samples (5.6%) were detected; the highest proportion of scant samples was detected in the outpatient gynaecology services(13.7% and 25.3%) where samples were taken traditionally by spatula. ASC:SIL+ ratio within fully satisfactory samples was the lowest in the other oncologic units(1.9:1), in the vulvar disease unit it was 2.6:1, in other clinic units it was 3.5:1, while in the outpatient gynaecology services it was 2.3:1. In the group of satisfactory but scant samples the ratio ASC:SIL+ was ranging from 5: 1 to 11:0 depending of the infirmary in which the samples were taken. Cytohistologic correlation in 159 cases was high in the detection of the preinvasive (94.1%) and invasive (100.0%) lesions, but with low specificity(35.4%). Conclusion: Vulvar samples taken by endocervical brush are significantly more cellular than the spatula taken samples, and cytologic interpretation of these samples is more adequate with lower ASC:SIL ratio. Cytologic vulvar samples cannot replace biopsy, but can be helpful in the patients with indistinctive lesions, or in controlling patients with confirmed disease.Ana BarišićJoško ZekanVesna MahovlićLada Škopljanac-Mačina Sanda RajhvajnDanijela Jurič Helena LovrićJoško LešinDamir BabićHrvatski liječnički zborarticlevulvar neoplasms – pathology; vulva – cytologypathology; squamous intraepithelial lesions – pathology; carcinomasquamous cell – pathology; precancerous conditions – pathology; vaginal smears – instrumentationMedicine (General)R5-920ENHRLiječnički vjesnik, Vol 143, Iss 1-2, Pp 6-13 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
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EN HR |
| topic |
vulvar neoplasms – pathology; vulva – cytology pathology; squamous intraepithelial lesions – pathology; carcinoma squamous cell – pathology; precancerous conditions – pathology; vaginal smears – instrumentation Medicine (General) R5-920 |
| spellingShingle |
vulvar neoplasms – pathology; vulva – cytology pathology; squamous intraepithelial lesions – pathology; carcinoma squamous cell – pathology; precancerous conditions – pathology; vaginal smears – instrumentation Medicine (General) R5-920 Ana Barišić Joško Zekan Vesna Mahovlić Lada Škopljanac-Mačina Sanda Rajhvajn Danijela Jurič Helena Lovrić Joško Lešin Damir Babić The role of cytology in the detection of preinvasive and invasive vulvar changes depending of the sampling method |
| description |
Aim: Exfoliative cytology of vulvar samples is used in diagnostics and follow up of vulvar changes, especially those in which biopsy is not indicated. Traditionally, samples were taken by spatula and the cellularity of the samples was low. To improve cellularity, taking samples by endocervical brush was introduced. Material and methods: In the retrospective study 1866 vulvar samples taken in the period from July 1, 2011 to December 31, 2013 were analyzed. Cellularity of the samples, as well as the atypical squamous cells (ASC) to squamous intraepithelial lesion or carcinoma (SIL+) ratio, and the cytohistologic correlation were analyzed. Results: In the vulvar disease specialized unit most samples were taken by endocervical brush, and the less unsatisfactory because of scantness samples (3.4%), as well as the satisfactory but scant samples (5.6%) were detected; the highest proportion of scant samples was detected in the outpatient gynaecology services(13.7% and 25.3%) where samples were taken traditionally by spatula. ASC:SIL+ ratio within fully satisfactory samples was the lowest in the other oncologic units(1.9:1), in the vulvar disease unit it was 2.6:1, in other clinic units it was 3.5:1, while in the outpatient gynaecology services it was 2.3:1. In the group of satisfactory but scant samples the ratio ASC:SIL+ was ranging from 5: 1 to 11:0 depending of the infirmary in which the samples were taken. Cytohistologic correlation in 159 cases was high in the detection of the preinvasive (94.1%) and invasive (100.0%) lesions, but with low specificity(35.4%). Conclusion: Vulvar samples taken by endocervical brush are significantly more cellular than the spatula taken samples, and cytologic interpretation of these samples is more adequate with lower ASC:SIL ratio. Cytologic vulvar samples cannot replace biopsy, but can be helpful in the patients with indistinctive lesions, or in controlling patients with confirmed disease. |
| format |
article |
| author |
Ana Barišić Joško Zekan Vesna Mahovlić Lada Škopljanac-Mačina Sanda Rajhvajn Danijela Jurič Helena Lovrić Joško Lešin Damir Babić |
| author_facet |
Ana Barišić Joško Zekan Vesna Mahovlić Lada Škopljanac-Mačina Sanda Rajhvajn Danijela Jurič Helena Lovrić Joško Lešin Damir Babić |
| author_sort |
Ana Barišić |
| title |
The role of cytology in the detection of preinvasive and invasive vulvar changes depending of the sampling method |
| title_short |
The role of cytology in the detection of preinvasive and invasive vulvar changes depending of the sampling method |
| title_full |
The role of cytology in the detection of preinvasive and invasive vulvar changes depending of the sampling method |
| title_fullStr |
The role of cytology in the detection of preinvasive and invasive vulvar changes depending of the sampling method |
| title_full_unstemmed |
The role of cytology in the detection of preinvasive and invasive vulvar changes depending of the sampling method |
| title_sort |
role of cytology in the detection of preinvasive and invasive vulvar changes depending of the sampling method |
| publisher |
Hrvatski liječnički zbor |
| publishDate |
2021 |
| url |
https://doaj.org/article/f61bda6bc8804a6892f1a46ef1be1053 |
| work_keys_str_mv |
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