REALISED DIAGNOSTIC VALUE OF VAGINAL CYTODIAGNOSTIC OF PATIENTS WITH INVASIVE CERVICAL CARCINOMA, AFTER SURGICAL THERAPY AND IRRADIATION. ( 1989 – 2006 ; N = 4.558 ) ( BAYES )
Findings of vaginal cytological smears of the patients during the follow up after the surgical and/or radiation therapy of Invasive uterine cervical carcinoma (1989 – 2006)) N = 4.558.
Correlation with eventual histopathological examinations.
|
Findings Total |
C L A S S I F I C A T I O N G R O U P S |
||||
I |
III + IV + V |
III |
IV |
V |
|
|
1 |
2 |
3 |
4 |
5 |
6 |
|
4.558 |
4.407 |
151 |
36 |
35 |
80 |
|
100% |
97% |
3% |
|
|
|
|
|
|
100% |
24% |
23% |
53% |
|
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
11 |
12 |
13 |
14 |
15 |
16 |
|
Without |
98% |
4.331 |
|
79% |
119 |
|
72% |
26 |
|
80% |
28 |
|
81% |
65 |
|
|
With |
2% |
76 |
100% |
21% |
32 |
100% |
28% |
10 |
100% |
20% |
7 |
100% |
19% |
15 |
100% |
|
Nonmal.. |
|
7 |
8% |
|
5 |
16% |
|
3 |
30% |
|
1 |
14% |
|
1 |
7% |
|
Malign. |
|
69 |
92% |
|
27 |
84% |
|
7 |
70% |
|
6 |
86% |
|
14 |
93% |
Without = Wiyhout
eventual histopathological finding
.
With =
Wiyh eventual histopathological finding .
Nonmal. = nonmalignant
eventual histopathological finding.
Malign. =
nonmalignant eventual histopathological finding.
I.-
Negative cytological findings ; III = positive cytological findings with
smallest degree of certainty
IV = positive
cytological findings with small degree of certainty
V
=
positive cytological findings with full degree
of certainty
C o m m e n t s :
1.- From a total of 4.558 vaginal smears only 151 or 3% are cytologicaly positive.
2.- Among the positive findings, there is a rather great percentage of findings with small degree of certainty (24%+23%= 47%), and only a half (53%)with classification group V (full degree of certainty).
3.- In spite of negative cytological findings 76 or 2% cervical biopsy were done.
4.- From those 76 patients, 7 or 8% are confirmed as negative, but in 69 or 91% biopsies malignoma was found and they are false negative..
5.- In spite of 151 patients with positive cytological finding, in 119 patients or 79% eventual cervical biopsy was not done.
6.- Only in 32 patients with positive cytological finding, cervical biopsy was done. 5 or 16% cytological findings are false poitive.
7.- From 36 patients with positive cytological findings with classification group III in 26 (72%) eventual cervical biopsy was not done.
8.- Only in 10 (28%) of these patients a cervical biopsy was done. 3 (30%) of these cytological findings were false positive.
9.- From 35 patients with positive cytological findings with class.group IV in 28 (80%) eventual cervical biopsy was not done.
10.- Only in 7 (20%) of these patients a cervical biopsy was done. 1 (14%) of these cytological findings was false positive.
11.- From 80 patients with positive cytological findings with class.group V in 65 (81%) eventual cervical biopsy was not done.
12.- Only in 15 (19%) of these patients a cervical biopsy was done. 1 (7%) of these cytological findings was false positive.
REALISED DIAGNOSTIC VALUE OF VAGINAL CYTODIAGNOSTIC OF PATIENTS WITH
INVASIVE CERVICAL CARCINOMA, AFTER SURGICAL THERAPY AND IRRADIATION.
( 1989 – 2006 ; N = 4.558 ) ( BAYES )
- as false positive cytological findings (compartement “B” ) are calculated also positive cytological findings
( Classification groups III,IV and V) without consecutive histopathological examination(65+28+26=119).
& As benign are calculated biopsed patients with benign histopathological diagnoses (7 patients) and all cytologicaly
negative patients, without consecutive histopathological
examination.(compartement “D”)
General Positive Predictive Value ( GPPV ) =A:(A+B) =27:(27+124)= 27:151= 0.18
Class.Group V Positive Predictive Value ( PPVV) = AV : (AV +BV) =14:(14+66)=14:80= 0.16
Class.Group
IV Positive Predictive Value (PPVIV) = AIV:
(AIV+BIV) =6:(6+29) = 6:35=
0.21
Class.Group III Positive Predictive Value (PPVIII) =AIII : (AIII+BIII) = 7:(7+29)= 7:36= 0.19
S E N S I T I V I T Y = A : ( A + C ) = 27:(2 7+69)= 27:96 = 0,28
Coments of the results showed on Bayes grid.
1.- The percentage of positive cytological findings with full degree of certainty (Clasification group V) is very low. It is only a half of positive findings, or 53%. There is not such low percentage for positive findings with full degree of certainty in any of other localisations.
(See Cumulative survey of histopathological and cytological findings 1989-2006
click:Abbreviated contents ; click : Cytology,Topography : I stratum) < www.cumulativesurvey.com.mk >
2.- Maybe, not all 119 (65+28+26 in compartement “B”) from 124, not biopsied patients after positive cytological result, are not really benign. Maybe some of them were additionally treated without biopsy, because they refused biopsy or the biopsy was dificult.Maybe some of those patients didn’t appear after the cytologic examination, or for any other reason.
Anyway, the Positive predictive value of 0.18 is very low, to be usefull.
3.- The Sensitivity of 0.28 is also unacceptably low.