Analysis of cytological false negatives of carcinoma of cervix

Authors : Riti T.K Sinha, Riti T.K Sinha, Nitin M GanGane, Nitin M GanGane

DOI : 10.18231/j.jdpo.2019.043

Volume : 4

Issue : 3

Year : 2019

Page No : 204-214

Introduction: Cervical carcinoma is one of the leading malignancies affecting the women of India.
Since the Papanicolaou(Pap) test can very effectively detect the prolonged phase of carcinoma in situ,
current policy suggests that all women should have this test done at regular intervals. Monitoring
cytohistological discrepancies is a useful quality assurance tool in cytology laboratory. Cervical cancer
has been successfully reduced by routine screening and medical intervention.
Aims and objectives: This present study was done to study the prevalence of cytohistological discrepancy
in histologically proven cases of carcinoma cervix and to identify the causes for false negativity in the
cytological examination in histologically proven cases of carcinoma cervix.
Materials and Methods: This study was conducted in the Department of Pathology, Mahatma Gandhi
Institute o f Medical Sciences, Sevagram, Maharashtra. This study was done on 209 biopsy proven cases
of carcinoma cervix over a period of two years. The original cytological diagnosis of smears available in
these cases were co-related with the biopsy results.
Results: In the pre-review, in 80.3% cases the diagnosis of carcinoma was rendered on initial screening
in cytology. Cytohistological discrepancies were observed in 19.6% accounting for a false negative rate of
19.6% and a false negative fraction 0.196 %. After post review, the false negative rate reduced to 11.62%
and the frequency of the different types of errors were calculated.
Conclusion: The level of agreement between cytology and the histology diagnosis may be used as a
measure of laboratory quality. To the best of our knowledge, data on factors associated with cytohistologic
discrepancy in Pap smear are limited. Therefore, we conducted this study to evaluate the factors associated
with cytohistologic discrepancy in Pap smears and to determine the rate of cytohistologic discrepancy and
ways to reduce the false negatives.

Keywords: Carcinoma cervix, False negatives, Rescreening.


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