NEGATIVE CERVICAL SMEARS BEFORE CIN 3 CARCINOMA - REEVALUATION WITH THE PAPNET TESTING SYSTEM/

OBJECTIVE: To test the effectiveness of the PAPNET testing system in i dentifying false negative smears, using archival cervical cytologic sm ears from women with histologically proven diagnoses of high grade les ions and carcinoma of the uterine cervix. STUDY DESIGN: Forty-six nega tive smears from women who developed a high grade cervical intraepithe lial lesion (CIN 3) or carcinoma of the uterine cervix within three ye ars were retrieved from the archives, plus 20 consecutive control smea rs for each case. The smears were analyzed with the PAPNET testing sys tem, and the selected cells were reviewed by a cytotechnologist using a strict protocol. RESULTS: With the PAPNET testing system, 9 of 46 (2 0%) smears were positive. Seven were reclassified as low grade and two reclassified as high grade squamous intraepithelial lesion (SIL). One of the 31 initially positive smears in the control group of 920 smear s was not recognized as such. In the control group of 889 negative sme ars, 74 newly identified positive cases (1.6%) were detected, all law grade SIL. CONCLUSION: The PAPNET testing system is a goon tool for de tecting false negative smears and, when used as an adjunct to conventi onal screening, can reduce the false negative rate.