Postradical Vaginal Trachelectomy Follow-up by Isthmic-Vaginal Smear Cytology: A 13-Year Audit

作者：Ghorab Zeina; Ismiil Nadia; Covens Allan; Nofech Mozes Sharon; Saad Reda S; Dube Valerie; Khalifa Mahmoud A^*

来源：Diagnostic Cytopathology, 2009, 37(9): 641-646.

DOI：10.1002/dc.21059

• trachelectomy
• isthmic cytology
• vaginal cytology
• pap smear
• cervical cancer

Radical trachelectomy is a fertility preserving alternative for early cervical cancer patients. This audit assesses the role of isthmic-vaginal smear in postoperative follow-up. A total of 94 patients were identified generating 913 smears. The final surgical margin m,as at the lower uterine segment in 37 cases (39.4%) and significantly correlated with the presence of lower uterine segment endometrial cells (LUSEC) in smears (P = 0.035). The most common abnormal diagnoses in the presence of LUSEC were ASC-US and AGUS seen in 14.2% and 11.9% of positive smears, respectively. The most common follow-up pattern was initial positive smears, which converted to negative (45.7% of patients), showing that reactive changes are another potential overcall pitfall. The only, 2 central recurrences were successfully diagnosed by smears. This study summarizes our experience, emphasizing the role of isthmic-vaginal smears for early detection of central recurrence and highlighting the role of LUSEC and reactive changes as potential overcall pitfalls. Diagn. Cytopathol. 2009;37:641-646.

• 出版日期2009-9