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KMID : 0381219710030050328
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Journal of RIMSK
1971 Volume.3 No. 5 p.328 ~ p.333
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CYTOLOGIC DIAGNOSIS OF CERVICAL CARCINOMA
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Abstract
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Exfoliative cytology in competent hands constitutes an excellent medium for detection of early or hidden cancers of the female genital tract since 1943, thanks to Papanicolaou and Traut.
The method is especially effective in detecting in situ carcinoma of the uterine cervix prior to invasion and at a phase when the disease is potentially 100% curable. The following procedures for obtaining cytology material from the female genital tract are recommended: vaginal smear, cervical smear, endocervical scraped smear, endocervical aspiration, vagino-cervico-endocervical smear, and biopsy tissue smear. The Papanicolaou staining procedure is widely employed because of excellent clear staining out of the nuclear and cytoplasmic details.
The criteria for cancer cells constitute nuclear predominence, hyperchromatism, anisokaryosis, mitoses, changes in nucleolus, decrease in or disappearance of cytoplasm, and deformity of cytoplasmic surface etc.
The methods of reporting cytology specimens vary between Papanicolaou and Koss. Papanicolaou recommended a cytological classification of Class I to V. Class I means an absence of abnormal cells. Class II is atypia, Class III suspicious. Class IV indicates strongly suggestive of cancer cell and finally Class V conclusive. Koss, however, prefers a simpler method of reporting based on three groups of findings: negative(Class I and II), suspicious(Class III), or positive(Class IV and V).
The accuracy of cytologic examination varies from one to another. Dockery and Ferguson reported their accuracy to be 86%. Maher and Chung stated to have been correct in 95% of the patients with cervical cancer as proved by subsequent tissue study. While cytological detection may be extremely accurate in competent hands, there is no justification for treating the lesions without confirmation by biopsy. The author would like to stress the usefulness of biopsy smear method in detecting malignancy because of the promptness in establishing diagnosis with the excellent accuracy of 98. 4%.
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KEYWORD
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