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2010.07.10 |
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LMP in Cytology |
질문
What is the evidence based reason for needing an LMP before interpreting a cervical smear?
질문의 구체적 내용
We occasionally have clinicians challenging the need for supplying LMP data on cervical smear requisition forms. What is the evidence based reason for needing an LMP before interpreting a cervical smear? I can see justification in knowing the patient's age, menopausal status and pregnancy status in evaluating the squamous component of the smear (which is the only portion of the cervical smear that has been validated for screening).
Apart from the questionable role of deciding the significance of the presence of endometrial cells, how else are people using the LMP? Evaluating maturation? Deciding on the significance of inflammatory cells? Evaluating adequacy (bloody smears in menstrual phase)? Is there published evidence that this is valid?
Comments appreciated.
질문의요지
Dirk Van Niekerk said:> We occasionally have clinicians challenging the need for supplying LMP> data> on cervical smear requisition forms. What is the evidence based> reason for> needing an LMP before interpreting a cervical smear
질문에 대한 답변
Occasionally I might use this datum to help me get off the fence. Forinstance, were I faced with deciding if a cell is a koilocyte or a"boat cell", if I knew the patient was still in the proliferativephase of her cycle, I may nudge her over to the ASC-US category. Also,as you alluded to, I ay be less inclined to use the hated AGUScategory if I know the patient could be normally shedding endometrium. The bottom line is whether the pathologist finds the informationuseful. If you and your colleagues never find it useful, then there isno reason to require it. OTOH, if it is useful to you, then theclinician needs to give you the information. The responsibility forthe interpretation is yours and yours alone, and unless the clinicianwishes to accept partial culpability for your errors, he or she needsto cooperate with you in good faith |
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