Accuracy of cytology and directed punch biopsy in 112 borderline lesions of the uterine cervix was evaluated by the final histologic diagnoses which were made mostly on many conized and a few hysterectomized cervices.
1. There were 9 cases diagnosed as benign cervicitis in the directed punch biopsy group. Eight of them were of the patients aged over 45. Cytology was positive in all the 9 cases and the cytological diagnoses dgreed with the final diagnoses in 6 cases out of the 9.
2.The accuracy of directed punch biopsy was 71% in dysplasia, 65% in carcinoma in situ (CIS), and 32% in microinvasive carcinoma.
3. The accuracy of cytology was 71% in dysplasia, 44% in CIS, and 36% in microinvasive carcinoma.
Cytology and directed punch biopsy were similar in accuracy of diagnosis of dysplasia and microinvasive carcinoma to each other.
4. The extent of the epthelial lesion was not narrow even in cytologically underdiagnosed cases and there was a tendency that the more advanced the lesion, the wider was the extent of the lesion.
5. There were 5 cytologically false negative cases, all of which were not the cases examined for the first time in our clinic.Four of them had previous pelvic examinations and punch biopsies elsewhere not less than 3 weeks previously.
6.There were several Pap smear examples, of which diagnoses were quite different from those of histology in spite of repeated observations. It was reconfirmed that the time and method of sampling, fixation, and staining were important factors for preparing adequate smears for cytologic diagnosis.
