Effects of Menstrual Cycle on Various Morphologies of High-Grade Squamous Intraepithelial Lesions in SurePath™ Liquid-Based Cervical Cytology

Gynecologic Cytopathology

Okodo M.a· Okayama K.b· Tsukakoshi N.a· Misawa Y.a· Tanabe K.a· Teruya K.c· Ito C.d· Ishii Y.d· Fujii M.a· Oda M.e

Author affiliations

aDepartment of Medical Technology, Faculty of Health Sciences, Kyorin University, Mitaka-shi, Japan
bDepartment of Medical Technology, Faculty of Health Sciences, Gunma Paz University, Takasaki-shi, Japan
cDepartment of Health and Welfare, Faculty of Health Sciences, Kyorin University, Mitaka-shi, Japan
dDepartment of Clinical Laboratory, Genki Plaza Medical Center for Health Care, Tokyo, Japan
eDepartment of Gynecology, Genki Plaza Medical Center for Health Care, Tokyo, Japan

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Article / Publication Details

First-Page Preview

Abstract of Gynecologic Cytopathology

Received: March 04, 2022
Accepted: May 01, 2022
Published online: June 14, 2022

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 1

ISSN: 0001-5547 (Print)
eISSN: 1938-2650 (Online)

For additional information: https://www.karger.com/ACY

Abstract

Introduction: The morphology of high-grade squamous intraepithelial lesion (HSIL) on Papanicolaou (Pap) smears widely varied, including syncytial aggregates, sheets, and scattered single cells, and no particular cellular pattern is consistently observed. Therefore, this study aimed to determine whether the menstrual cycle affects the cellular pattern of HSILs, an effort to avoid false negatives due to the oversight of scattered small single HSIL cells in the cytological triage of human papillomavirus-positive women. Methods: A total of 147 HSIL samples of liquid-based cytology (LBC) in patients with cervical intraepithelial neoplasia grade 2 or 3 were obtained, and then, the relationship between cellular patterns, such as single-cell-like and syncytial aggregates, and menstrual cycles classified into six phases was analyzed. If a syncytial aggregate was present, the number of cells constituting the aggregate was visually counted under the microscope. Results: HSILs in scattered single cells and small sheets of <6 on LBC samples accounted for 43% (23/54) during the late proliferative phase of the menstrual cycle. A moderately strong statistically significant association was observed between cellular patterns and menstrual cycles (χ2 [3] = 9.423, p < 0.05) (Cramer’s V = 0.253). The value of adjusted residuals showed a statistically significant increased proportion of single-cell-like patterns during the late proliferative phase (p < 0.01). Conclusions: The present study demonstrated that HSIL cells in Pap smears in the late proliferation phase have a high frequency of single-cell-like patterns. In human papillomavirus-positive Pap smears with a clean background and predominantly superficial cells, careful microscopic observation by targeting single HSIL cells can potentially reduce false negatives.

© 2022 S. Karger AG, Basel

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First-Page Preview

Abstract of Gynecologic Cytopathology

Received: March 04, 2022
Accepted: May 01, 2022
Published online: June 14, 2022

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 1

ISSN: 0001-5547 (Print)
eISSN: 1938-2650 (Online)

For additional information: https://www.karger.com/ACY

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