Guidelines Chap. 3 Appendix 5: Reporting System in France 31.3.2003
Chap. 3 Appendix 5 of 31.3.03
PROPOSITIONS FOR A EUROPEAN CYTOLOGICAL
REPORTING SYSTEM
by M. Fender, J.-J. Baldauf
Comparison of the Alsacian (France) system with the Bethesda system :
In our programme there is no uniform application form but the results transmitted to the monitoring center are standardized using a cytological classification proposed in January 2003, which is closed to Bethesda 2001 (see annexe 1).
Advises for management of abnormal smears are not yet written because national guidelines are waited soon d will be transmitted to Professor SCHENCK by Professor BALDAUF for chapter 8.
We still have 3 classes for specimen adequacy :
- satisfactory for evaluation “S”,
- satisfactory for evaluation but limited “L”,
- unsatisfactory for cytological evaluation “I”.
General categorization :
EVE 10 and EVE 20 are negative for intraepithelial lesion or malignancy.
EVE 30 and higher code for atypical cells.:
EVE 30 and EVE 31 correspond to ASC-US
EVE 32 is clearly ASC-H
EVE 34 is coded when the two type of cells i.e. squamous cells and glandular cells are atypical or when the distinction between the two kinds is not possible.
EVE 35 to EVE 38 correspond to atypic cells with EVE 37 being atypical flandular cells favor neaoplasia.
EVE 40 is LSIL
EVE 50 is HSIL
EVE 60 is carcinoma of the cervix NS,
EVE 61 is squamous cell carcinoma.
EVE 60 is adenocarcinoma of the cervix.
Comment on “discussions on Terminology”.
Cytopathologists participating at our screening programme agree on subjectivity of cytological diagnosis.
They think that the system proposed as a basis for comparability of data from the European cancer screening programs is too complicated to be used in routine screening.
A system more like the Bethesda system would be better. Comparability only needs to be there for prediction of outcomes.
Codage EVE adapté
au système de Bethesda 2001
Eve 00 : Matériel cellulaire non exploitable.
Eve 10 : Frottis normal.
Eve 20 : Remaniements dystrophiques + frottis inflammatoire.
Eve 30 : Atypies malpighiennes sans autre indication.
Eve 31 : ASC – US (plutôt viral).
Eve 32 : ASC –H (haut grade non exclu).
Eve 34 : Atypies malpighiennes et/ou glandulaires.
Eve 35 : Atypies glandulaires sans autre indication.
Eve 36 : Atypies des cellules endocervicales.
Eve 37 : Atypies des cellules endocervicales en faveur d'une néoplasie.
Eve 38 : Atypies des cellules endométriales. Y compris présence de cellules
endométriales chez une femme de plus de 40 ans sans traitement
de substitution.
Eve 40 : LIP de Bas grade.
Eve 50 : LIP de Haut grade.
Eve 60 : Suspicion de carcinome invasif sans autre indication.
Eve 61 : Suspicion de carcinome épidermoïde invasif.
Eve 62 : Suspicion d'adénocarcinome invasif.
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