This research compared the effectiveness of Papanicolaou (Pap) smears with biopsies for diagnosing atypical squamous cells of undetermined significance (ASCUS) accurately in postmenopausal women. Another goal was to determine the diagnostic value of Kiel(Ki)–67 expression to exclude negatives in atypical Pap smears of postmenopausal women.
Materials and Methods:
A prospective study was conducted in the departments of gynecology and pathology of the Indira Gandhi Medical College and Research Institute, in Puducherry, India. Eighty postmenopausal women were examined with liquid-based cytology (LBC), and this was compared with conventional cytology for detection of histologically confirmed cases. Ki-67 immunocytochemistry (ICC) was performed on atypical smears of postmenopausal women to determine its diagnostic value for detecting abnormal smears.
Results:
There was a reduction in the frequency of ASCUS in LBC, compared to conventional Pap smears in postmenopausal women. The specificity of LBC (82.7%) was higher than conventional Pap smears (51.7%) for diagnosing ASCUS accurately. Ki-67 ICC staining in atypical smears showed 100% sensitivity and specificity as diagnostic biopsy shows.
Conclusions:
In comparison to a conventional Pap smear, a liquid-based Pap smear has high specificity, and Ki-67 expression with LBC can exclude false positivity, which can substantially reduce diagnostic biopsies and subsequent Pap smears in postmenopausal women with atypical Pap smears.
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