Terminology and reporting

TERMINOLOGIA i kategorie wyników bada? wymazów z szyjki

  • Historyczna perspektywa: Kryteria oceny i terminologia stosowane w interpretacji rozmazów cytologicznych i formu?owaniu wyników s? ró?ne w ró?nych krajach co stwarza trudno?ci w porozumiewaniu si? patologów, cytotechników i klinicystów oraz utrudnia epidemiologom efektywne porównanie ró?nych programów cytologicznych. Ró?norodno?c terminologiczna utrudnia merytoryczn? dyskusj? mi?dzy laboratoriami a tak?e post?powanie z pacjentk? i wdra?anie optymalnych metod opieki.
  • W 1988 roku the National Cancer Institute w Stanach Zjednoczonych opracowa? System Bethesda (TBS) czyli system formu?owania wyników bada? cytologicznych szyjki macicy. W 1990 roku program Leonardo da Vinci sponsorowa? przygotowanie porównania terminologii stosowanych w tym zakresie w krajach UE z systemem Bethesda (terminologia ekwiwalentna).
  • Partnerzy zaanga?owani w przygotowanie strony internetowej Eurocytology wybrali terminologi? zaproponowan? przez system Bethesda ze wzgl?du na jego szerokie rozpowszechnienie w ?wiecie. Tam gdzie to potrzebne pozostawiono linki do terminologii ekwiwalentnej.

The main categories of the Bethesda reporting system (2001) are shown below:

SPECIMEN TYPE
2001 Bethesda System Equivalent Terminology

Indicate whether conventional smear, endocervical brush specimen or liquid based cytology (LBC) specimen

Indicate whether conventional smear, endocervical brush specimen or liquid based cytology (LBC) specimen

 

SPECIMEN ADEQUACY
2001 Bethesda System Equivalent Terminology

Satisfactory for evaluation (describe presence or absence of endocervical/transformation zone component and other quality indicators e.g. partially obscuring blood etc)

  • Satisfactory for evaluation
  • Satisfactory for evaluation but limited by (specify reason)

Specimen rejected/not processed (specify reason)

Unsatisfactory for evaluation (specify reason)

Specimen process and examined but unsatisfactory for evaluation of epithelial abnormality because of (specify reason)

 

 

GENERAL CATEGORISATION (optional)
2001 Bethesda System Equivalent Terminology

Negative for intraepithelial lesion

 

Other: see Interpretation/Results

 

Epithelial Cell Abnormality (specify Squamous or Glandular as appropriate)

 

 

INTERPRETATION / RESULTS
2001 Bethesda System Equivalent Terminology

Negative for intraepithelial lesion or malignancy

Negative

 

Within normal limits

 

Benign cellular changes

 

ORGANISMS  DETECTED
2001 Bethesda System Equivalent Terminology

Trichomonas vaginalis

Trichomonas vaginalis

Fungal organisms morphologically consistent with Candida spp

Candida spp

Shift in flora suggestive of bacterial vaginosis

Coccobacilli

Bacteria morphologically consistent with Actinomyces spp

Actinomyces spp

Cellular changes consistent with herpes simplex virus infection

Cellular changes indicate Herpes simplex  virus infection

 

OTHER NON NEOPLASTIC FINDINGS (optional; list not inclusive)
2001 Bethesda System Equivalent Terminology

Reactive cellular changes associated with inflammation /repair

Reactive cellular changes associated with inflammation /repair

Radiation

Radiation

Intrauterine contraceptive device

Intrauterine contraceptive device

Glandular cell status post hysterectomy

Endometrial cells in a post menopausal woman

Endometrial cells (in a woman >40year if age)

Glandular cell inconsistent with stated age and/ clinical status of woman

 

SQUAMOUS EPITHELIAL CELL ABNORMALITIES
2001 Bethesda System Equivalent Terminology

Atypical squamous cells

  • of undetermined significance (ASC-US)

  • cannot exclude HSIL (ASC-H)

Borderline nuclear changes

Low grade Squamous intraepithelial lesions (LSIL) encompassing: HPV/mild dysplasia/CIN1

  • Mild dysplasia/CIN1  with or without HPV

  • Mild dyskariosis suggestive of CIN1(with or without HPV) 

High grade Squamous intraepithelial lesion (HSIL) encompassing: moderate and severe dysplasia, CIS, CIN2 and CIN3

  • Moderate dysplasia/ CIN2
  • Moderate dyskariosis suggestive of CIN2
  • Severe dysplasia/ CIS/ CIN3
  • Severe dyskariosis suggestive of CIN3

With features suspicious for invasion

  • Severe dysplasia/ ?invasive carcinoma
  • Severe dyskariosis/ ?invasive carcinoma
  • Suggests CIN3 but invasive carcinoma not excluded

Squamous cell carcinoma

Invasive Squamous cell carcinoma

 

GLANDULAR EPITHELIAL ABNORMALITIES
2001 Bethesda System Equivalent Terminology

Atypical

  • Endocervical cells (NOS or specify)

  • Endometrial cells (NOS or specify)

  • Glandular cells (NOS or specify)

  • Atypical glandular cells (NOS or specify type)

  • Atypical glandular cells of uncertain significance

  • ? glandular neoplasia

  • Atypical 

  • Endocervical cells (favour neoplastic)

  • Glandular cells (favour neoplastic)

 

Endocervical adenocarcinoma in situ

  • Endocervical adenocarcinoma in situ

  • Suggest adenocarcinoma in situ,invasive adenocarcinoma not excluded

  • ?glandular neoplasia

Adenocarcinoma

  • Endocervical

  • Endometrial

  • Extrauterine

  • Not otherwise specified (NOS)

Adenocarcinoma

  • Endocervical

  • Endometrial

  • Extrauterine

  • Not otherwise specified (NOS)

 

IARC Handbooks of Cancer Prevention

Volume 10 Cervix Cancer Screening
Chapter 2: pp 59-67 historical revue of terminology used to describe cervical smears 
Chapter 2: pp 69-74 comparison of conventional cytology with liquid based cytology

 

 

 

 

X