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Cellular Debris on Negative Liquid-Based Cytology Cervicovaginal smears

Cytopathology. 2022 Jul 22. doi: 10.1111/cyt.13170. Online ahead of print.


OBJECTIVES: To determine the prevalence of cellular debris (CD) on benign cervicovaginal liquid-based cytology (LBC) smears and which factors predict the presence and larger amount of CD.

METHODS: Cervicovaginal smears evaluated as negative for intraepithelial lesion or malignancy (NILM) between January 1st and March 31st, 2020, were retrospectively reviewed to record the presence and amount of CD. All smears were prepared with the SurePath platform. Patients’ age and past medical and surgical histories were also retrieved. Multivariate regression analyses were performed to find positive predictors of a larger amount of CD.

RESULTS: 349 NILM smears were included in this study. The cohort consisted of 222 cervical smears (CS) and 127 vaginal smears (VS), which were taken from patients who had undergone hysterectomy. Overall, CD was observed in 111 (31.8%) cases. The positive predictors of CD were increasing age, specimen type (VS compared to CS), history of chemotherapy or radiation therapy (CRT), and more than mild background inflmmation. Among VS group, CD was present in 64 cases (50.4%) regardless of the time between the specimen collection and hysterectomy. Positive predictors in the VS group were age and more than mild inflammation. Contrary, in the CS group, the prevalence of CD was 21.2%, and age was the only positive predictor. Histories of CRT, conization and inflammation were not statistically significant positive predictors for CD among CS.

CONCLUSIONS: CD can be seen in as much as 50% of NILM smears taken after hysterectomy, regardless of the time since hysterectomy. Increasing age is a positive predictor of the presence and a larger quantity of CD. These findings are helpful when evaluating smears with moderate to abundant debris in the background with questionable cellular atypia.

PMID:35867812 | DOI:10.1111/cyt.13170

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