Since 01. 01. 2015 the new
Munich nomenclature III for gynaecological diagnostics of the cervix has been
in force. The changes have led to controversial scientific discussions. This
study reports for the first time on the consequences.
The present data are based on
smear screening results for the year 2014. The data of 63 134 patients were
evaluated.
2.27 % of all smears were
remarkable. Group IIa was assigned to 0.91 %. Group II-p was somewhat more
frequently recorded than group IIID1 (0.59 vs. 0.53 %). Groups IIID1 and IIID2
were found in 0.53 and 0.61 %, respectively, of the cases. Agreement with
histology was found in 36.84 and 44.68 %, respectively. Glandular lesions
represented the most frequent changes in group III. Histological clarification
was obtained for 0.18 % of all remarkable findings. The relative incidence of
high-grade precancerous conditions (CIN III) and invasive tumours amounted to
0.1 %.
A close communication between
gynaecologists and cytologists is mandatory for the correct usage of the new
nomenclature. The future annual statistics of the health insurances can now be
analysed in more detail. A statistical classification of glandular epithelial
changes is now also possible for the first time. The heterogeneous group IIa
constitutes an unnecessary uncertainty for patients and physicians. The
splitting of the group IIID does not appear to have any advantage for the
further clinical management. Further studies are needed to show whether or not
the classification can stand up to international comparisons.
Below: Histological clarification of
12 cases with unclear or equivocal findings according to the Munich
nomenclature III (groups III-g [n = 11] and III-p [n = 1]). The cytological
finding III-p correlates with the histological diagnosis of an invasive vaginal
cancer.
Full article at: http://goo.gl/oveUJM
By: Z. Hilal, C. Tempfer, S. Schiermeier, J. Reinecke, C. Ruppenkamp, and Z. Hilal
1ZYDOLAB – Institut für klinische Zytologie
und Immunzytochemie, Dortmund
2Abteilung für Gynäkologie und
Geburtshilfe, Ruhr Universität Bochum, Herne
3Abteilung für Gynäkologie und
Geburtshilfe, Universität Witten/Herdecke, Witten
4Institut für Pathologie,
Universitätsklinikum Düsseldorf, Düsseldorf
Correspondence Dr. med. Ziad Hilal ZYDOLAB –
Institut für klinische Zytologie und Immunzytochemie, Markt 10, 44137 Dortmund, ; Email:ed.balodyz@lalih.z
More at: https://twitter.com/hiv_insight
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