The Influence of Inflammation in VCE Smears on the Cytological Detection of High Grade Squamous Intraepithelial Lesions

CILJ ISTRAŽIVANJA: Utvrditi otežava li prisustvo upale ili povećanog broja granulocita detekciju HSIL lezija. USTROJ STUDIJE: Retrospektivna presječna poredbena studija. ISPITANICI I METODE: Studijom su obuhvaćene ispitanice u kojih je na Kliničkom zavodu za kliničku citologiju KBC Osijek u razdoblju od 2007. do kraja 2016. godine izvršen citološki pregled VCE razmaza, uz uvjet da su u vremenskom intervalu od najduže 6 mjeseci nakon citološke dijagnoze imale patohistološki verificiranu HSIL leziju. Histološki nalazi učinjeni su na Zavodu za patološku anatomiju i sudsku medicinu KBC Osijek. REZULTATI: Istraživanje je provedeno na 1296 ispitanica. Prisustvo upale u razmazu ima 370 (28,5 %) ispitanica. Povećan broj granulocita u razmazima je nađen u 170 (13,1 %) ispitanica, značajno češće kod ispitanica s citološkim dijagnozoma ASC-H, CIN 1, ASC i AGC te kod ispitanica kojima je nalaz negativan. Kod ispitanica s detektiranom upalom u razmazu su značajno češće nađeni G. vaginalis, HPV i T. vaginalis. Citološka dijagnoza CIN 2 patohistološki je potvrđena u 39,3 % slučajeva, a CIN 3 u 67 % slučajeva. Nema statistički značajne razlike u citološkoj dijagnostici HSIL lezija obzirom na prisustvom upale i granulocita. ZAKLJUČAK: Unatoč činjenici da upala i granulociti mogu djelovati kao opskurirajući čimbenici, nema statistički značajne razlike u citodijagnostici HSIL lezija u razmazima s ili bez upale, odnosno s ili bez povećanog broja granulocita.OBJECTIVES: The goal of this research was to determine whether the presence of inflammation or an increased number of granulocytes makes it difficult to detect HSIL lesions. STUDY DESIGN: A retrospective cross-sectional comparative study. PARTICIPANTS AND METHODS: The study included subjects on whom was performed a cytological review of VCE smear at the Department of Clinical Cytology, Clinical Hospital Center Osijek in the period from 2007 to the end of 2016, provided that in the time interval of 6 months after the cytological diagnosis they had pathohistologically verified HSIL lesion. Histological findings were made at the Department of Pathology and Judicial Medicine, Clinical Hospital Center Osijek. RESULTS: The study was conducted on 1296 respondents. Inflammation was found in 370 (28.5%) respondents. Increased number of granulocytes was found in the smears of 170 (13.1%) subjects, significantly more frequently in the examinees with cytological diagnosis ASCH, CIN 1, ASC, AGC and in subjects with negative findings. B. vaginalis, G. vaginalis, HPV and T. vaginalis were more commonly found in the smear with signs of inflammation. Cytological diagnosis CIN 2 was confirmed patohistologically in 39.3% cases and CIN 3 in 67% cases. There are no statistically significant differences in the cytological diagnosis of HSIL lesions with regard to the presence of inflammation and granulocytes. CONCLUSION: Despite the fact that the inflammation and granulocytes can act as obscuring factors, there is no statistically significant difference in the cytodiagnosis of HSIL lesions in smears with or without inflammation and with or without an increased number of granulocytes