Clinicopathologic Importance of Women with Squamous Cell Carcinoma Cytology on Siriraj Liquid-Based Cervical Cytology

Objectives: The purposes of this study were to determine the prevalence and predictive value to detectsignificant neoplasia and invasive lesions, and to evaluate the correlation between clinical and histopathology ofwomen with squamous cell carcinoma (SCCA) on Siriraj liquid-based cervical cytology (Siriraj-LBC).
Methods:The computerized database of women who underwent Siriraj-LBC at Siriraj Hospital, Mahidol Universityfrom January 2007 to December 2010 were retrieved. The hospital records of women with SCCA cytology werereviewed.
Results: The prevalence of SCCA cytology was 0.07%. A total of 86 women, mean age was 58.1 years.Sixty-one women (70.9%) were post-menopausal. Overall significant pathology and invasive gynecologic cancerwere detected in 84 women (97.7%) and 71 women (82.5%), respectively. The positive predictive values fordetection of significant neoplasia and invasive lesion were 97.7% and 82.6%, respectively. The cervical cancerwas diagnosed in 69 women and among these 58 women were SCCA. Thirteen women (15.1%) had cervicalintraepithelial neoplasia (CIN) 3 and two women (2.3%) had cervicitis. The sensitivity and specificity of colposcopyfor cervical cancer detection in SCCA cytology were 83.3% and 75%, respectively. Median follow up period was17.6 months and 64 patients were alive without cytologic abnormality.
Conclusions: The final histopathology ofSCCA cytology in our populations demonstrated a wide variety, from cervicitis to invasive cancer and the mostcommon diagnosis was invasive cervical cancer. Colposcopy with biopsy and/or endocervical curettage and loopelectrosurgical excision procedure should be undertaken to achieve histologic diagnosis.