Abstract
Objective
Acetic acid tests are commonly performed for colposcopic evaluation of the cervix. However, it is unclear whether the acetic acid influences normal Papanicolaou (Pap) smear results.
Methods
Patients were routinely seen in our outpatient department between April and May 2009. Two Pap smears were performed in 50 patients. One smear was done before, the other after the acetic acid test. The smears were evaluated by an experienced cytologist. He did not know whether the smear was done with or without acetic acid.
Results
In a normal smear, there was no influence of acetic acid on the cytologic result. In two patients, a smear of Pap III [Bethesda, atypical squamous cells of undetermined significance (ASCUS)] was seen before acetic acid test. This changed to Pap IIID [Bethesda, low-grade squamous epithelial lesions (LSIL)] after acetic acid test.
Conclusions
The acetic acid test does not seem to alter the result of the non-dysplastic smear. In contrast to this, a dysplastic smear seems to be influenced by the acetic acid. This should be evaluated in a further investigation.
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References
Papanicolaou GN (1942) A new procedure for staining vaginal smears. Science 95:438–439
Traut HF, Papanicolaou GN (1943) Cancer of the uterus: the vaginal smear in its diagnosis. Cal West Med 59:121–122
Schenck U, von Karsa L (2000) Cervical cancer screening in Germany. Eur J Cancer 36:2221–2226
Petry KU, Menton S, Menton M, van Loenen-Frosch F, de Carvalho Gomes H, Holz B, Schopp B, Garbrecht-Buettner S, Davies P, Boehmer G, van den Akker E, Iftner T (2003) Inclusion of HPV testing in routine cervical cancer screening for women above 29 years in Germany: results for 8,466 patients. Br J Cancer 88:1570–1577
Ottaviano M, La Torre P (1982) Examination of the cervix with the naked eye using acetic acid test. Am J Obstet Gynecol 143:139–142
Park SY, Follen M, Milbourne A, Rhodes H, Malpica A, MacKinnon N, MacAulay C, Markey MK, Richards-Kortum R (2008) Automated image analysis of digital colposcopy for the detection of cervical neoplasia. J Biomed Opt 13:014029
Doh AS, Nkele NN, Achu P, Essimbi F, Essame O, Nkegoum B (2005) Visual inspection with acetic acid and cytology as screening methods for cervical lesions in Cameroon. Int J Gynaecol Obstet 89:167–173
Griffiths M, Turner MJ, Partington CK, Soutter WP (1989) Should smears in a colposcopy clinic be taken after the application of acetic acid? Acta Cytol 33:324–326
Hilgarth M (2001) Münchner nomenklatur II für die gynäkologische zytodiagnostik. Frauenarzt 39:392–393
Kitchener HC, Symonds P (1999) Detection of cervical intraepithelial neoplasia in developing countries. Lancet 353:856–857
Group IS (2004) Planning and implementing cervical cancer prevention and control programs: a manual for managers. Alliance for cervical cancer prevention 2004
Gaffikin L, Lauterbach M, Blumenthal PD (2003) Performance of visual inspection with acetic acid for cervical cancer screening: a qualitative summary of evidence to date. Obstet Gynecol Surv 58:543–550
Van Le L, Broekhuizen FF, Janzer-Steele R, Behar M, Samter T (1993) Acetic acid visualization of the cervix to detect cervical dysplasia. Obstet Gynecol 81:293–295
Slawson DC, Bennett JH, Herman JM (1992) Are Papanicolaou smears enough? acetic acid washes of the cervix as adjunctive therapy: a HARNET study. (Harrisburg Area Research Network). J Fam Pract 35:271–277
Cecchini S, Bonardi R, Mazzotta A, Grazzini G, Iossa A, Ciatto S (1993) Testing cervicography and cervicoscopy as screening tests for cervical cancer. Tumori 79:22–25
Megevand E, Denny L, Dehaeck K, Soeters R, Bloch B (1996) Acetic acid visualization of the cervix: an alternative to cytologic screening. Obstet Gynecol 88:383–386
Foulks MJ (1998) The Papanicolaou smear its impact on the promotion of women’s health. J Obstet Gynecol Neonatal Nurs 27:367–373
Coste J, Cochand-Priollet B, de Cremoux P, Le Gales C, Cartier I, Molinie V, Labbe S, Vacher-Lavenu MC, Vielh P (2003) Cross sectional study of conventional cervical smear, monolayer cytology, and human papillomavirus DNA testing for cervical cancer screening. BMJ 326:733
Kourounis GS, Michail GD, Ravazoula P (2004) A second Pap smear during colposcopy: is it really worth it? Eur J Gynaecol Oncol 25:475–477
Beilby JO, Bourne R, Guillebaud J, Steele ST (1982) Paired cervical smears: a method of reducing the false-negative rate in population screening. Obstet Gynecol 60:46–48
Luthy DA, Briggs RM, Buyco A, Eschenbach A (1978) Cervical cytology. Increased sensitivity with a second cervical smear. Obstet Gynecol 51:713–717
Davey DD (1997) Quality and liability issues with the Papanicolaou smear the problem of definition of errors and false negative smears. Arch Pathol Lab Med 121:267–269
Charoenkwan K, Ninunanahaeminda K, Khunamornpong S, Srisomboon J, Thorner PS (2008) Effects of gel lubricant on cervical cytology. Acta Cytol 52:654–658
Felix JC, Lonky NM, Tamura K, Yu KJ, Naidu Y, Lai CR, Lonky SA (2002) Aberrant expression of E-cadherin in cervical intraepithelial neoplasia correlates with a false-negative Papanicolaou smear. Am J Obstet Gynecol 186:1308–1314
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Hornemann, A., Husstedt, WD., Hoellen, F. et al. Does acetic acid influence the non-dysplastic Pap smear?. Arch Gynecol Obstet 283, 1309–1312 (2011). https://doi.org/10.1007/s00404-010-1556-4
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DOI: https://doi.org/10.1007/s00404-010-1556-4