Frequency of endocervical cells in cervical smears and hysterectomy rate of the patients.

Abstract

In gynecologic cytology, different reporting schemes suggest mentioning the presence of endocervical cells or asking for a statement on adequacy. We were interested in the question whether our data could provide a possible basis for discussing a sampling technique with smear takers. At the time of writing, in all cases, both the presence of endocervical cells and hysterectomy are recorded in our laboratory information system. Most smears are taken with cotton swabs, but the sampling technique is often modified according to the clinical situation. In a series of 20,471 cervical/vaginal smears, 2,152 (10.5%) were taken from hysterectomy patients. Among the non-hysterectomy patients, endocervical cells were found in 65% of the cases. Typically, there was a lower frequency of endocervical cells in smears stemming from older women. The frequency decreased from a maximum of 75% in the age group of 40-44 years to 45% in the age group of 65-69 years. With regard to the smear takers, some differences were evident, with age distribution and frequency of hysterectomy being different among the smear takers. In a setting where many smears of hysterectomized patients are examined by cytology, good data quality is required to evaluate the sampling techniques of different smear takers. The age dependence of endocervical cell yield is confirmed. Different age distribution of the patients from different smear takers suggests that the percentage of smears showing endocervical cells cannot be considered an optimal estimator.