Title Metoda tekućinske citologije u dijagnostici intraepitelnih i invazivnih lezija vrata maternice Title (english) Liquid based cytology used in the diagnosis of intraepithelial and invasive lesions of the cervix Author Stella Jovanović Mentor Dinka Šundov (mentor)Committee member Katarina Vilović (predsjednik povjerenstva)Committee member Branka Petrić Miše (član povjerenstva)Committee member Renata Beljan Perak (član povjerenstva) Granter University of Split Defense date and country 2024-09-20, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract CILJ ISTRAŽIVANJA: Rana dijagnoza preinvazivnih lezija konvencionalnim Papa testom ima brojna ograničenja, pa je citologija temeljena na tekućini uvedena kao adekvatnija metoda za obradu uzoraka vrata maternice. Glavna svrha ovog istraživanja bila je analizirati učestalost i distribuciju abnormalnih skvamoznih i žljezdanih lezija u uzorcima SurePath LBC-a prema Bethesda kategorijama i dobi pacijenata, kao i usporediti citološke dijagnoze s patohistološkim dijagnozama kao zlatnim standardom. METODE: Od 1. siječnja 2023. do 30. lipnja 2023., 794 abnormalnih uzoraka SurePath LBC-a je uključeno u retrospektivnu analizu koja je provedena na Zavodu za patologiju, sudsku medicinu i citologiju KBC-a Split. Klinički podaci i rezultati morfološke i digitalne FP analize prikupljeni su iz digitalne medicinske dokumentacije Zavoda. REZULTATI: Od 11 210 ispitanica, 794 (7,1%) uzoraka je dijagnosticirano kao abnormalan nalaz prema Bethesda klasifikaciji. U 92,2% uzoraka dijagnosticirana je intraepitelna lezija pločastog epitela. Prema Bethesda kategorijama, najzastupljenija citološka dijagnoza bila je LSIL (47,1%), zatim ASCUS (34,5%), HSIL (13%) i AGC (5%). LSIL se najčešće pojavio u dobnoj skupini od 21 do 30 godina. Medijan životne dobi ispitanica bio je 39 godina, a najveća zastupljenost lezija visokog stupnja prisutna je u dobnoj skupini od 31 do 40 godina. Dokazana je statistički značajna povezanost između Bethesda kategorija i dobi ispitanica (p<0,001) te FP digitalne analize (p=0,054). U 1,4% ispitanica dijagnosticiran je HSIL nakon prethodno negativnog konvencionalnog Papa razmaza. Perzistentan abnormalni citološki nalaz imalo je 45% ispitanica na prvom kontrolnom uzorku, a 10% na slijedećem kontrolnom uzorku. Patohistološki uzorak imalo je 255 (32,1%) ispitanica, a lezija visokog gradusa potvrđena je u 67,8% ispitanica na prvom bioptičkom uzorku te u 88,7% ispitanica na drugom bioptičkom uzorku ili konizatu. ZAKLJUČAK: SurePath LBC metoda predstavlja napredak u području cervikalnog probira. Ovom metodom smanjena je stopa nezadovoljavajućih uzoraka, stanični materijal je optimalno očuvan i obojan, pozadina je čišća, na stakalcu je smanjeno područje za ručni ili digitalni skrining i moguće je kotestiranje ili pomoćno testiranje HPV-a. Napredne metode probira i rano otkrivanje intraepitelnih lezija smanjuju rizik od propuštanja dijagnoze abnormalnosti što kao posljedicu ima rano otkrivanje i liječenje cervikalnih lezija.
Abstract (english) OBJECTIVES: Early diagnosis of preinvasive lesions by conventional pap smear technique has many limitations, so liquid based cytology was introduced as a better tool for processing cervical samples. The main purpose of this study was to analyze the frequency and distribution of abnormal squamous and glandular lesions in SurePath LBC samples according to Bethesda categories and the age of patients, as well as to compare cytological diagnoses to pathohistological diagnosis as a gold standard. METHODES: From January 1st 2023 till June 30th 2023, 794 abnormal SurePath LBC samples were included in this retrospective analysis, which was done at the Department of Pathology, Forensic Medicine and Cytology, University Hospital of Split. Clinical data and results of morphologic and digital FP analysis were collected from the digital medical records of the Department. RESULTS: Out of 11 210 patients, 794 (7,1%) cases were reported as epithelial cell abnormality, according to Bethesda classification. 92.2% of the samples were diagnosed with intraepithelial squamous lesion. The most common cytological diagnosis was LSIL (47.1%), followed by ASCUS (34.5%), HSIL (13%) and AGC (5%). The median age was 39 years and the highest prevalence of high grade lesions was recorded in the age group of 31 to 40 years. There was a statistically significant correlation between Bethesda category and age of the patients (p<0,001) as well as FP digital analysis (p=0,054). HSIL were reported in 1,4% patients with a previously negative conventional Pap smears. 45% of patients had persistent cytological abnormalities at the first citologic follow up and 10% at the second follow up. Histopathologic evaluation was made on 255 (32,1%) patients. High grade lesions were identified by histology in 67,8% of cases, and 88,7% at second biopsy or surcigal material. CONCLUSION: The SurePath LBC technology has brought many benefits in the field of cervical screening, reducing the rate of unsatisfactory samples, offering optimal preservation of cellular material, cleaner background, posibility of digital screening and HPV co-testing or ancillary testing. The improved and early detaction of intraepithelial lesions minimise the risk of missing cases leading to early detection and treatment of cervical lesions.
Keywords
citologija
Papa test
rak vrata maternice
LBC
SurePath
Bethesda
Keywords (english)
cytology
Pap smear
cervical cancer
LBC
SurePath
Bethesda
Language croatian URN:NBN urn:nbn:hr:171:700658 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2024-09-20 06:21:24
