Significance of inflammation on class 1 Pap smears - Tips From Other Journals

Date: March, 1991

Moderate or severe inflammation is commonly reported on normal (class I) Papanicolaou (Pap) smears, but the significance of this finding is not clearly understood. Some clinicians believe that cervical atypia can result from cervical infections. However, the finding of inflammation alone has never been shown to indicate a need for further investigation. To determine the prevalence of histologic abnormalities in patients with moderate to severe inflammation on class I cervical smears, Lawley and associates retrospectively reviewed a total of 596 consecutive cervical smears performed during a 13-month period.

A total of 540 smears (90.6 percent) were reported as class I or within normal limits. Moderate to severe inflammation was evident on 106 (19.6 percent) of these smears. Colposcopy was performed in 78 women whose smears showed inflammation; the remaining women were either lost to follow-up or had clinical conditions contraindicating the procedure. Nineteen women (24.4 percent) had normal colposcopic findings. The remaining 59 women (75.6 percent) had colposcopic findings of acetowhite epithelium and subsequently underwent cervical biopsy or endocervical curettage, or both. Twenty-two (28.3 percent) of these women had findings consistent with human papillomavirus, and nine (11.5 percent) had cervical intraepithelial neoplasia.

The study findings indicate that patients with class I Pap smears demonstrating moderate to severe inflammation should be followed-up with colposcopy. (Obstetrics and Gynecology, December 1990, vol. 76, p. 997.)

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