Fransiska Dale

Pd. 6
I/M Final Product

The diagnoses in the following tables are unsatisfactory, negative for intraepithelial lesion
or malignancy (NILM), atypical squamous cells of undetermined significance (ASCUS), atypical
glandular cells (AGC), low-grade squamous intra-epithelial lesion (LSIL), atypical squamous
cells cannot exclude high-grade squamous intra-epithelial lesion (ASC-H), low-grade
squamous intra-epithelial lesion cannot exclude high-grade squamous intra-epithelial lesion
(LSIL-H), high-grade squamous intra-epithelial lesion (HSIL), high-grade squamous intra-
epithelial lesion with glandular involvement (HSIL-GI), and carcinoma.

Table 1. Distributions of diagnoses made on 400 Pap tests taken prior to the biopsy proven high-
grade squamous intra-epithelial lesion (HSIL) for 284 patients.

Prior Pap Diagnosis Number (%)

Unsatisfactory 1 (.3%)
NILM 39 (9.8%)
ASCUS 64 (16%)
AGC 5 (1.3%)
LSIL 84 (21.0%)
ASC-H 47 (11.8%)
LSIL-H 34 (8.5%)
HSIL 102 (25.5%)
HSIL-GI 24 (6%)
Total 400 (100%)

Table 2. Distributions of diagnoses made on 468 Pap tests taken prior to the biopsy proven high-
grade squamous intra-epithelial lesion with glandular involvement (HSIL-GI) for 284 patients.

Prior Pap Diagnosis Number (%)

Unsatisfactory 6 (1.3%)
NILM 31 (6.6%)
ASCUS 69 (14.7%)
AGC 8 (1.7%)
LSIL 40 (8.5%)
ASC-H 78 (16.7%)
LSIL-H 35 (7.5%)
HSIL 151 (32.3%)
HSIL-GI 44 (9.4%)
Carcinoma 6 (1.3%)
Total 468 (100%)
Table 3. The P value calculated for each prior Pap diagnosis from the group proven HSIL and the
group proven HSIL-GI using Fishers exact test.

Prior Pap Diagnosis P value

Unsatisfactory .13
NILM .10
ASCUS .64
AGC .78
LSIL < .0001
ASC-H .042
LSIL-H .62
HSIL .030
HSIL-GI .076
Carcinoma .033

Results:

When analyzing the control group of Pap tests from patients ultimately diagnosed with
HSIL and the experimental group of Pap smears from patients ultimately diagnosed with
glandular involvement by HSIL, it was found that the difference was not statistically significant.
The statistical comparison yielded a P value of 0.076, which is higher than the <0.05 value
necessary for the data to be deemed statistically significant in the scientific world, though this
indicates that the comparison might have been significant in a study which included a larger
number of patients. Interestingly, it was found that the difference between diagnoses of LSIL (P
value of <0.0001), ASC-H (P value of 0.042), HSIL (P value of 0.030) and Carcinoma (P value
of 0.033) were found to be statistically significant. This means that patients with glandular
involvement by HSIL often receive different Pap test diagnoses than those who have HSIL
without glandular involvement, and are more likely to receive a diagnosis of HSIL. We believe
this is because patients with glandular involvement by HSIL have more extensive disease,
allowing HSIL to be more readily identified on a Pap test.