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Sample records for abnormal cervical cytology

  1. Abnormal cervical cytology and health care use

    Frederiksen, Maria Eiholm; Baillet, Miguel Vázquez-Prada; Dugué, Pierre-Antoine;

    2015-01-01

    OBJECTIVE: This study aimed to assess the long-term use of health care services in women with abnormal cytology results compared to women with normal cytology results. METHODS: We did a nationwide population-based study, using women aged 23 to 59years participating in the national organized......" the cytology result and for the 5-year period "after" the result. RESULTS: During the "before" period exposed women had more contacts to GPs, more contacts to psychologists/psychiatrist, and more hospital admissions than non-exposed women. In both exposed and non-exposed women, health care use increased from...... the "before" to the "after" period. This increase was significantly higher for exposed than non-exposed women regarding contacts to GP, admissions to hospitals, and drug use. CONCLUSION: Women with abnormal cytology results constitute a selected group with a higher health care use than other women even before...

  2. The management of women with abnormal cervical cytology in pregnancy.

    Flannelly, Grainne

    2010-02-01

    The management of women with abnormal cytology in pregnancy represents both a diagnostic and a therapeutic challenge for colposcopists. The emphasis should be on diagnosis and confirmation of cervical precancer (Cervical intraepithelial neoplasia (CIN) or Adenocarcinoma in situ (AIS), thus excluding invasive cancer). Following an initial assessment, careful follow-up is essential. This must include colposcopy and take into account the physiological changes of the cervix during pregnancy and the puerperium. The management of women with invasive cancer diagnosed during pregnancy depends on the gestation at diagnosis and requires careful assessment and multidisciplinary planning.

  3. Comparison of Efficacy in Abnormal Cervical Cell Detection between Liquid-based Cytology and Conventional Cytology.

    Tanabodee, Jitraporn; Thepsuwan, Kitisak; Karalak, Anant; Laoaree, Orawan; Krachang, Anong; Manmatt, Kittipong; Anontwatanawong, Nualpan

    2015-01-01

    This study was conducted to 1206 women who had cervical cancer screening at Chonburi Cancer Hospital. The spilt-sample study aimed to compare the efficacy of abnormal cervical cells detection between liquid-based cytology (LBC) and conventional cytology (CC). The collection of cervical cells was performed by broom and directly smeared on a glass slide for CC then the rest of specimen was prepared for LBC. All slides were evaluated and classified by The Bethesda System. The results of the two cytological tests were compared to the gold standard. The LBC smear significantly decreased inflammatory cell and thick smear on slides. These two techniques were not difference in detection rate of abnormal cytology and had high cytological diagnostic agreement of 95.7%. The histologic diagnosis of cervical tissue was used as the gold standard in 103 cases. Sensitivity, specificity, positive predictive value, negative predictive value, false positive, false negative and accuracy of LBC at ASC-US cut off were 81.4, 75.0, 70.0, 84.9, 25.0, 18.6 and 77.7%, respectively. CC had higher false positive and false negative than LBC. LBC had shown higher sensitivity, specificity, PPV, NPV and accuracy than CC but no statistical significance. In conclusion, LBC method can improve specimen quality, more sensitive, specific and accurate at ASC-US cut off and as effective as CC in detecting cervical epithelial cell abnormalities. PMID:26514540

  4. Histological Correlation of Glandular Abnormalities in Cervical Liquid-Based Cytology

    Yosuke Kawakami

    2011-01-01

    Full Text Available Conventional Papanicolaou smear method is still commonly used for cervical cancer screening in Japan, despite the liquid-based cytology (LBC that has become a global tendency in the world recently. One of the obstacles in the way of popularization of this method seems to be the confusion as to diagnosis upon cervical glandular lesions. We performed comparison study between LBC and conventional Papanicolaou smear about cytological diagnosis using split-sample method in 4522 patients. In 13 cases analyses, which were reported with either AGC or adenocarcinoma by either method, LBC tends to be milder than that by conventional smear, however, the credibility of LBC is considered to be near to that of conventional smear with regard to screening for glandular abnormalities. These results indicate that cervical cancer screening should shift to LBC under the enough experience and appropriate dealing with the cytological diagnosis.

  5. High prevalence of HPV in non-cervical sites of women with abnormal cervical cytology

    Human papillomaviruses (HPV) are causally associated with ano-genital and a subset of head and neck cancers. Rising incidence of HPV+ anal cancers and head and neck cancers have now been demonstrated in the developed world over the last decade. The majority of published data on HPV prevalence at the anal and oro-pharyngeal sites are from studies of higher-risk populations. There is a paucity of data on the prevalence of HPV at non-cervical sites in lower risk, non-HIV+ women and this study was designed to provide initial pilot data on a population of women recalled for colposcopy as part of the UK cervical screening programme. 100 non-HIV+ women with abnormal cervical cytology, attending clinic for colposcopic examination were recruited. Swabs from the oro-pharyngeal, anal and cervical sites were taken and DNA extracted. HPV detection and genotyping were performed using a standardised, commercially available PCR-line blot assay, which is used to genotype 37 HPV subtypes known to infect the ano-genital and oro-pharyngeal areas. Strict sampling and laboratory precautions were taken to prevent cross-contamination. There was a very high prevalence of HPV infection at all three sites: 96.0%, 91.4% and 92.4% at the cervix, anus and oro-pharynx, respectively. Multiple HPV subtype infections were dominant at all 3 mucosal sites. At least one or more HR genotype was present at both the cervix/anus in 39/52 (75.0%) patients; both the cervix/oro-pharynx in 48/56 (85.7%) patients; and both the anus/oro-pharynx in 39/52 (75.0%) patients. HPV 16 infection was highly dominant across all mucosal sites, with over a 2-fold increase over the next most prevalent subtype (HPV 31). Women with abnormal smears have widespread infection with high-risk HPV at the cervical, anal and oro-pharyngeal mucosal sites and may represent a higher risk population for HPV disease in the future

  6. High prevalence of HPV in non-cervical sites of women with abnormal cervical cytology

    Vaughan Katie

    2011-11-01

    Full Text Available Abstract Background Human papillomaviruses (HPV are causally associated with ano-genital and a subset of head and neck cancers. Rising incidence of HPV+ anal cancers and head and neck cancers have now been demonstrated in the developed world over the last decade. The majority of published data on HPV prevalence at the anal and oro-pharyngeal sites are from studies of higher-risk populations. There is a paucity of data on the prevalence of HPV at non-cervical sites in lower risk, non-HIV+ women and this study was designed to provide initial pilot data on a population of women recalled for colposcopy as part of the UK cervical screening programme. Methods 100 non-HIV+ women with abnormal cervical cytology, attending clinic for colposcopic examination were recruited. Swabs from the oro-pharyngeal, anal and cervical sites were taken and DNA extracted. HPV detection and genotyping were performed using a standardised, commercially available PCR-line blot assay, which is used to genotype 37 HPV subtypes known to infect the ano-genital and oro-pharyngeal areas. Strict sampling and laboratory precautions were taken to prevent cross-contamination. Results There was a very high prevalence of HPV infection at all three sites: 96.0%, 91.4% and 92.4% at the cervix, anus and oro-pharynx, respectively. Multiple HPV subtype infections were dominant at all 3 mucosal sites. At least one or more HR genotype was present at both the cervix/anus in 39/52 (75.0% patients; both the cervix/oro-pharynx in 48/56 (85.7% patients; and both the anus/oro-pharynx in 39/52 (75.0% patients. HPV 16 infection was highly dominant across all mucosal sites, with over a 2-fold increase over the next most prevalent subtype (HPV 31. Conclusions Women with abnormal smears have widespread infection with high-risk HPV at the cervical, anal and oro-pharyngeal mucosal sites and may represent a higher risk population for HPV disease in the future.

  7. Cervical acid phosphatase detection: A guide to abnormal cells in cytology smear screening for cervical cancer

    Deb Prabal; Iyer Venkateswaran; Bhatla Neerja; Markovic O; Verma Kusum

    2008-01-01

    Background: Cervical acid phosphatase-Papanicolaou (CAP-PAP) test has recently been described for detection of acid phosphatase enzyme in abnormal squamous cells, and has been proposed as a biomarker-based technology for the screening of cervical cancer. Materials and Methods: Eighty-one consecutive cervical smears were subjected to routine Papanicolaou (Pap) staining as well as CAP-PAP, which combined cytochemical staining for acid phosphatase with modified Pap stain. Statistical evaluation ...

  8. Correlative analysis between abnormal cervical cytology and pathology of vaginoscopic biopsy or conization

    Li Cai-juan; Lang Jing-he; Cheng Xue-mei; Wang You-fang

    2006-01-01

    Objectives: To evaluate the predictive value of cervical intraepithelial neoplasia (CIN)Ⅲ/ carcinoma in situ (CIS) by correlating analysis between abnormal cervical cytologic findings and pathological diagnosis of vaginoscopic biopsies or conization.Methods: Routine cervical cytology screening was performed in 31,634 cases by fluid-based thin-layer method (ThinPrep cytology test, TCT), 948 patients had both abnormal squamous cell appearance by TCT and pathological diagnosis of vaginoscopic biopsies and /or cervical conization. The predictive value of CINⅢ/CIS were studied retrospectively by correlating analysis of different cytology abnormalities and pathology diagnosis.Results: Cytologically, 1,260 out of 31,634 TCT tests showed abnormal squamous cells appearance, including atypical squamous cell of undetermined significance (ASCUS) 675 cases(2.13%), low squamous intraepithelial lesion (L-SIL) 379 cases(1.20%), high squamous intraepithelial lesion (H-SIL)176 cases(0.56%),cancer 30 cases (0.09%). Among 948 patients with pathological diagnosis, there were CINⅡ-Ⅲ in 70 cases(7.38%) and CINⅢ/CIS in 56 cases.(5.91%). The relative risks (RR) of different precancerous TCT results in predicting CIN Ⅲ/CIS validated by pathology are as follow: AUSCUS 14.7% (95% confidence interval (CI) 8.0-27.0), Lsil 13.9% (95% CI 6.3-30.9), Hsil 126.1 (95% CI 60.6-218.6). The RR of AUSCUS group is not significantly different from that of L-SIL group(P =0.951). However, the RR of CINⅢ/CIS morbidity between the H-SIL or cancer group and the ASCUS or L-SIL group are significantly different (all P value <0.01).Conclusion: Vaginoscopic biopsy could verify pathological CINⅡ-Ⅲ and CINⅢ/CIS from cases with abnormal TCT results. There is significantly greater risk of being CINⅢ/CIS validated by vaginoscopic biopsy in the H-SILpatients,while ASCUS and L-SIL group have the coequal risk.

  9. Prevalence and molecular epidemiology of human papillomavirus infection in Italian women with cervical cytological abnormalities

    Angelo Meloni

    2014-03-01

    Full Text Available Background. Human papillomavirus (HPV infection is the most common sexually transmitted infection and high-risk HPV types are a necessary cause for the development of cervical cancer. The present study investigated the HPV-type specific prevalence in 650 women, aged 15-76 years, with cytological abnormalities and the association between HPV infection and cervical disease in a subset of 160 women for whom cytological results for Pap-Test were available, during the period 2008-2011 in Cagliari (Southern Italy.Design and Methods. HPV-DNA extraction was performed by lysis and digestion with proteinase K and it was typed by using the INNOLiPA HPV Genotyping Assay.Results. Overall the HPV prevalence was 52.6%; high-risk genotypes were found in 68.9% of women and multiple-type infection in 36.1% of HPV-positive women. The commonest types were HPV-52 (23.4%, HPV-53 (15.7%, HPV-16 (15.4% and HPV-6 (12.4%. Among the women with cytological diagnosis, any-type of HPV DNA was found in 49.4% of the samples and out of these 93.7% were high-risk genotypes. Genotype HPV 53 was the commonest type among women affected by ASCUS lesions (21.4%, genotype 52 in positive L-SIL cases (22.5%, genotype 16 H-SIL (27.3%.Conclusions. This study confirmed the high prevalence of HPV infection and high-risk genotypes among women with cervical abnormalities while, unlike previously published data, genotype HPV-52 was the most common type in our series. These data may contribute to increase the knowledge of HPV epidemiology and designing adequate vaccination strategies.

  10. The importance of immediate verification of a cervical cytological abnormality with histology

    C Kabaca

    2013-01-01

    Full Text Available Background: A serious proportion of the patients with invasive cervical cancer can be women who have had abnormal smear findings known for at least 6 months. Aims: The aims of the study were to evaluate the cervical cytohistopathologic correlation in the population studied, and to discuss the acceptability of immediate histological verification for minor Papanicolaou smear abnormalities. Materials and Methods: A total of 443 patients who were admitted with abnormal smear results and had undergone immediate colposcopy, cervical biopsy and endocervical curretage in the gynecologic oncology clinic between the years of 2003-2009 were enrolled into the present retrospective study. One-way analysis of variance and independent t-tests were used to study the results. Results: The distribution of abnormal smear results were documented as 46.27%, 29.57%, 13.76%, 7.67%, 1.58%, 0.67%, and 0.45% for atypical squamous cells of undetermined significance (ASC-US, low-grade squamous intraepithelial lesion (LSIL, high-grade squamous intraepithelial lesion (HSIL, atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (ASC-H, squamous cell carcinoma (SCC, atypical glandular cell (AGC, and adenocarcinoma, respectively. The percentages of cervical intraepithelial neoplasia grade 2-3 (CIN 2-3 and greater lesions were 70.49%, 35.29%, 15.26%, and 9.75% for HSIL, ASC-H, LSIL, and ASC-US, respectively. Moreover, 38.36% of all the CIN 2-3 or cancer (n = 104 cases originated from those with low grade referral diagnosis (ASC-US and LSIL. Conclusions: The majority of cases in the study were predominantly ASC-US and LSIL and approximately 40% of all the high grade lesions came from those with low grade referral diagnosis. This shows poor cytohistopathological correlation and calls the triage of minor cytological abnormalities into question.

  11. Histological Correlation of Glandular Abnormalities in Cervical Liquid-Based Cytology

    Yosuke Kawakami; Tamaki Toda; Toshinao Nishimura; Junichi Sakane; Kazuya Kuraoka; Kazuhiro Takehara; Tomoya Mizunoe; Kiyomi Taniyama

    2011-01-01

    Conventional Papanicolaou smear method is still commonly used for cervical cancer screening in Japan, despite the liquid-based cytology (LBC) that has become a global tendency in the world recently. One of the obstacles in the way of popularization of this method seems to be the confusion as to diagnosis upon cervical glandular lesions. We performed comparison study between LBC and conventional Papanicolaou smear about cytological diagnosis using split-sample method in 4522 patients. In 13 ca...

  12. Cervical cytology in serous and endometrioid endometrial cancer.

    Roelofsen, Thijs; Geels, Yvette P; Pijnenborg, Johanna M A; van Ham, Maaike A P C; Zomer, Saskia F; van Tilburg, Johanna M Wiersma; Snijders, Marc P M L; Siebers, Albert G; Bulten, Johan; Massuger, Leon F A G

    2013-07-01

    The aim of this study was to determine the frequency of abnormal cervical cytology in preoperative cervical cytology of patients diagnosed with uterine papillary serous carcinoma (UPSC) and endometrioid endometrial carcinoma (EEC). In addition, associations between abnormal cervical cytology and clinicopathologic factors were evaluated. In this multicentre study, EEC patients diagnosed at two hospitals from 1999 to 2009 and UPSC patients diagnosed at five hospitals from 1992 to 2009, were included. Revision of the histologic slides was performed systematically and independently by 3 gynecopathologists. Cervical cytology within six months before histopathologic diagnosis of endometrial carcinoma was available for 267 EEC and 80 UPSC patients. Cervical cytology with atypical, malignant, or normal endometrial cells in postmenopausal women was considered as abnormal cytology, specific for endometrial pathology. Abnormal cervical cytology was found in 87.5% of UPSC patients, compared with 37.8% in EEC patients. In UPSC, abnormal cytology was associated with extrauterine spread of disease (P=0.043). In EEC, abnormal cytology was associated with cervical involvement (P=0.034). In both EEC and UPSC patients, abnormal cervical cytology was not associated with survival. In conclusion, abnormal cervical cytology was more frequently found in UPSC patients. It was associated with extrauterine disease in UPSC patients, and with cervical involvement in EEC patients. More prospective research should be performed to assess the true clinical value of preoperative cervical cytology in endometrial cancer patients. PMID:23722512

  13. THE SPECTRUM OF CERVICAL CYTOLOGICAL ABNORMALITIES IN KUWAIT USING THE REVISED 2001 BETHESDA SYSTEM

    Thoppil Reba

    2014-08-01

    Full Text Available Cervical carcinoma is one of the most common female malignancies in developing countries. There are few reports describing the profile of abnormal Pap smears from countries in the Middle East. The pattern of cervical intraepithelial lesions and carcinoma detected in Pap smears of women in Kuwait is reported. A total of 12800 cervical smears reported in the department of Pathology, Maternity Hospital, and ministry of Health were studied from January 2010 to December 2012. There were 523(4.12% abnormal Pap smears. They were further classified as Atypical Squamous cells of undetermined significance (ASCUS (118 cases, 0.93%, Atypical Squamous cells cannot exclude a HSIL (ASC-H (24 cases, 0.19%, Low Grade Squamous Intraepithelial Lesion (LSIL (172 cases, 1.35%, High Grade Squamous Intraepithelial Lesion (HSIL (91 cases, 0.72% Squamous cell carcinoma (21cases, 0.17% Atypical Glandular Cells (AGC-NOS (53cases, 0.42% Atypical Glandular Cells - favor neoplastic (23 cases, 0.18% Endocervical adenocarcinoma in situ (01 case, 0.01% Endocervical adenocarcinoma (01 case, 0.01% Endometrial adenocarcinoma (19 cases, 0.15%. This study reveals the wide range of cervical epithelial cell abnormalities present in the population. The information provided in this study emphasizes the need for a national cervical screening program to estimate the actual magnitude of the problem, identify ‘at risk ’women and decrease the mortality from cervical cancer.

  14. Polymerase chain reaction and conventional DNA tests in detection of HPV DNA in cytologically normal and abnormal cervical scrapes

    Kalia, A.; Jalava, T.; Nieminen, P.;

    1992-01-01

    Med.mikrobiologi, polymerase chain reaction, DNA tests, human papillomavirus (HPV), cervical smear, hybridisation, cytologi, affiProbe HPV test, ViraType test......Med.mikrobiologi, polymerase chain reaction, DNA tests, human papillomavirus (HPV), cervical smear, hybridisation, cytologi, affiProbe HPV test, ViraType test...

  15. Human papillomavirus infection and anxiety: analyses in women with low-grade cervical cytological abnormalities unaware of their infection status.

    Candice Y Johnson

    Full Text Available BACKGROUND: Women testing positive for human papillomavirus (HPV infection experience increased levels of anxiety that have been attributed to fears of stigmatization and developing cervical cancer. The objective of this study was to investigate the association between HPV infection and anxiety in women who were unaware they had been tested specifically for HPV, to determine if any anxiety experienced by HPV-positive women could be due to causes other than learning of test results. METHODS: This study was nested within a randomised controlled trial of management of women with abnormal cervical cytology conducted in the United Kingdom with recruitment between 1999 and 2002. At baseline, prior to having a sample taken for HPV testing, the results of which were not disclosed, women were assessed for anxiety using the Hospital Anxiety and Depression Scale and asked about fears of developing cervical cancer ("cancer worries"; this assessment was repeated at 12, 18, 24, and 30 months of follow-up. Logistic regression and generalized estimating equations were used for the cross-sectional (baseline and longitudinal analyses, respectively. RESULTS: Among the 2842 participants, there was no association between HPV status and anxiety among white women. Among non-white women, however, anxiety was less common among HPV-positive than HPV-negative women (adjusted odds ratio 0.41, 95% confidence interval 0.22 to 0.77. Among non-smokers, cancer worry was more common in HPV-positive than HPV-negative women; the opposite association was observed among ex-smokers. CONCLUSIONS: Associations between HPV status and anxiety may be explained by factors other than learning of test results and may vary by ethnicity and lifestyle factors.

  16. Management of Cervical Cytology with HPV Test

    2009-10-15

    Dr. Stewart Massad, a professor in the Division of Gynecologic Oncology at Washington University in Saint Louis and a board member of the American Society for Colposcopy and Cervical Cancer Prevention (ASCCP), talks about ASCCP's 2006 Consensus Guidelines on the management of abnormal cervical cytology and histology.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  17. Prevalence and cumulative incidence of abnormal cervical cytology among HIV-infected Thai women: a 5.5-year retrospective cohort study

    Thamkhantho Manopchai

    2011-01-01

    Full Text Available Abstract Background Cervical cancer is one of the most common AIDS-related malignancies in Thailand. To prevent cervical cancer, The US Public Health Service and The Infectious Disease Society of America have recommended that all HIV-infected women should obtain 2 Pap smears 6 months apart after the initial HIV diagnosis and, if results of both are normal, should undergo annual cytological screening. However, there has been no evidence in supporting whether this guideline is appropriate in all settings - especially in areas where HIV-infected women are living in resource-constrained condition. Methods To determine the appropriate interval of Pap smear screenings for HIV-infected Thai women and risk factors for subsequent abnormal cervical cytology, we assessed the prevalence, cumulative incidence and associated factors of cervical cell abnormalities (atypical squamous cell of undetermined significance or higher grades, ASCUS+ among this group of patients. Results The prevalence of ASCUS+ was 15.4% at the first visit, and the cumulative incidence of ASCUS+ gradually increased to 37% in the first 3.5 years of follow-up appointments (first 7 times, and tended to plateau in the last 2 years. For multivariate correlation analysis, women with a CD4 count P = 0.043. There were no associations of subsequent ASCUS+ with age, pregnancy, contraceptive method, highly active anti-retroviral treatment, assumed duration of infection, or the CD4 count nadir level. Conclusion There are high prevalence and cumulative incidence of ASCUS+ in HIV-infected Thai women. With a high lost-to-follow-up rate, an appropriate interval of Pap smear screening cannot be concluded from the present study. Nevertheless, the HIV-infected Thai women may require more than two normal semi-annual Pap smears before shifting to routinely annual cytologic screening.

  18. Study of the abnormal cervical-vaginal cytology of sexually active young women living within the Waterloo region.

    Redmond, M; Schumacher, B

    1990-01-01

    618 women aged 13-36 attending a family planning clinic took part in a sexual health survey during 1985 and 1986. They were followed up for one year in order to ascertain whether an increase in atypical and dysplastic pap smears was linked to a certain lifestyle. The routine examination included a pap smear, a cervical swab for gonorrhea and other vaginal flora. Cultures for herpes and chlamydia were done. Benign atypia infection was treated followed by repeat pap smears 6-8 weeks and 2-3 months later. 7% of the women were virgins, 72% had smoked, and 62% presently smoked (an average of 9 cigarettes daily). Average age at first intercourse, was 16, and partners ranged from 1 to 35. Condom use was most prevalent: 15% used it "always", 20% "often", and 36% "occasionally". The oral contraceptive use pattern was: 60% "always" used it and 10% "often" relied on it. 1/4th used the rhythm method. 90% had never been pregnant, 9% had, and 1% were unsure. of 49 pregnancies 41 ended in abortion. After examining 581, 4 cases condylomata and 1 case of genital herpes were found. 60% of the women had normal cervical cytology, 32% showed atypia, and 8% displayed dysplasia. 22% of the atypias were linked to inflammation and 6% were related to yeast. 9% of repeat atypia or dysplasia was less severe by biopsy, while 54% turned out to be more severe than the pap smear results, although they tend to indicate more severe changes. 8% showed less severe cytology, and 59% more severe cytological changes. 78% of the group with mild dysplasia had smoked, as opposed to 22% that had "never smokes". Those with mild dysplasia were 4 times more likely to smoke at the time of their initial visit (79%) than nonsmokers (21%). 54% of those with normal pap smear reported "often" or "always" using condoms, whereas only 10% of the group with dysplasia reported similar use pattern. These findings uphold the practice of following the repeated atypical, or initial dysplastic pap smear results with

  19. Differential cytology of cervical neoplasias

    Koenig, Rainer; Bergander, S.

    1990-11-01

    In the context of the early recognition of cervical cancer the cytology has to detect tumor positive cases among a bulk of un suspicious specimens. Unfortunately there is a group of cases with a vague diaxosis, the so called PAP-ill-group. There are many reasons for the recent impossibility of a safe conclusion from the PAP-Ill-smears to their histological diagnoses (Pig. 1). Today for an exact statement a cone biopsy and a microscopical investigation of its histological sections for such caseS are necessary. That results in a high medical and economical expense and, last not least, that means a higher risk of complications and of future family planning problems for the women affected.

  20. Human Papillomavirus Infection and Anxiety: Analyses in Women with Low-Grade Cervical Cytological Abnormalities Unaware of Their Infection Status

    Johnson, Candice Y; Sharp, Linda; Cotton, Seonaidh C; Harris, Cheryl A.; Gray, Nicola M; Little, Julian; ,

    2011-01-01

    Background Women testing positive for human papillomavirus (HPV) infection experience increased levels of anxiety that have been attributed to fears of stigmatization and developing cervical cancer. The objective of this study was to investigate the association between HPV infection and anxiety in women who were unaware they had been tested specifically for HPV, to determine if any anxiety experienced by HPV-positive women could be due to causes other than learning of test results. Methods Th...

  1. Cytological diagnosis in cervical cancer

    Mariana Bratu; Florentina Pricop; Ovidiu Toma; Dragos Crauciuc; Eduard Crauciuc

    2010-01-01

    Aim. The cytological test has multiple valences, allowing the early discovery and location of feminine genital cancer. Material and methods. In the period of time between 2001 and 2009, the study made within the Obstetrics and Gynecology Department of „Sf. Apostol Andrei” Emergency Hospital in Galaţi, revealed that from 415 cases with a changed PAP smear, the cytological diagnosis showed cancerous and pre-cancerous lesions in 53 patients (12.8%). We harvested cytological smears fo...

  2. DETECTION OF ABNORMAL CERVICAL CYTOLOGY BY PAP’S SMEAR AND COMPARISON BETWEEN RURAL AND URBAN WOMEN

    Neelam

    2013-10-01

    Full Text Available ABSTRACT : BACKGROUND: This study was carried out in department of ob stetrics and gynaecology G.R. Medical College Gwalior (MP. AIMS AND OBJECTIVES: To study the incidence of malignant and pre malignant cases of cancer cervix in women attending outdoor patient department of G R medical college Gwalior. To find out the role of PAP's smear in early detection of premalignant and early carcinoma cervix and to compare the results between urban and rural women. MATERIAL AND METHOD: a total of 400 subjects were selected attending outdoor patient department of G R medical college G walior with equal number of urban and rural areas. Information about age, parity, age at marriage, complaints, clinical findings, Pap’s smears were prepared and histological interpretations were recorded. RESULTS : Maximum number of patients was in the age group of 31 - 40 years. Mean age at marriage was 17.5 years for woman of rural areas and that for urban woman was 21.5 years. In the rural patients highest number were P2 - P4 (53% followed by > P4 (46.5%. In urban patients too maximum number of patients had parity between P2 - P4 (69.5% followed by > P4 (28.5%. Grand multiparity was seen in 20.5% among rural women as compared to 1.5 % among urban women. Among the rural patients use of barrier method of contraception was only 12% while in urban areas it was 3 0%. Percentage of couples who were not using any contraception was 47.5% in rural area and 33% in urban area. The most common presenting complaint was white discharge among both rural and urban groups (75% vs. 72%. The most common clinical finding was cer vical erosion (57.5% Histopathological interpretation of Pap’s smear revealed cervical squamous epithelial lesions (LSIL and HSIL in 10.5% smears of rural and 4.5% smears of urban women. A total of 4% smears were found positive for malignancy in rural wo men as compared to 1.5% smears in urban women

  3. Rastreamento anterior para câncer de colo uterino em mulheres com alterações citológicas ou histológicas Previous screening for cervical cancer among women with cytological and histological abnormalities

    C Rama

    2008-06-01

    do último exame citológico anterior.OBJECTIVE: To examine previous Pap smear history in women screened for cervical cancer with cytological or histological abnormalities. METHODS: Cross-sectional study in a sample of 5,485 women (15-65 years old who self-referred to cervical cancer screening in Sao Paulo and Campinas, Southeastern Brazil, between February 2002 and March 2003. A behavioral questionnaire was applied and cervical specimens were obtained for testing by Pap smears or liquid-based cytology. Women who had abnormal cytology were referred for colposcopic examination and, if abnormal, for cervical punch biopsy. To explore factors associated to cervical abnormalities Pearson's chi-was conduted square test at a 5% significance level. RESULTS: Cytological abnormalities were found in 354 women (6.4% and included 41 high-grade squamous intra-epithelial lesions and 3 carcinomas; 92.7% were normal results. Colposcopy was performed in 289 women, and 145 (50.2% showed abnormal results. Punch biopsies showed 14 cervical intraepithelial neoplasias grade 3 and 4 carcinomas. Previous Pap smears were reported in all women who had cytology suspected of carcinoma, 97.6% of those with high-grade squamous intra-epithelial lesions, all women with histological diagnosis of carcinoma and 92.9% of those who had cervical intraepithelial neoplasias grade 3 histologically. Previous Pap smear in the last tree years was reported by 86.5% and 92.8% of women with abnormal cytology and biopsy, respectively. CONCLUSIONS: There was no statistically significant difference regarding the number of Pap tests and time since their last test between women with histologically diagnosed carcinoma and cervical intraepithelial neoplasia grade 3 compared with those with normal cytology.

  4. Abnormal Cervical Cancer Screening Test Results

    ... AQ FREQUENTLY ASKED QUESTIONS FAQ187 GYNECOLOGIC PROBLEMS Abnormal Cervical Cancer Screening Test Results • What is cervical cancer screening? • What causes abnormal cervical cancer screening test ...

  5. CERVICAL CYTOLOGICAL SCREENING AND MANAGEMENT IN PREGNANT AND POSTPARTUM WOMEN

    Gui-fang He; Mei-lu Bian; Ying Wang; Xiao-yan Liu

    2005-01-01

    Objective To examine and follow up cervical cytology of pregnant and postpartum women and study their cytopathologic characteristics, so as to determine screening and managing programs for abnormal cervical cytology.Methods Totally 5296 patients in pregnancy and postpartum, in which 3729 by computer-assisted cytology test and 1567 by liquid-based monolayers cytology test, were examined and diagnosed by the Bethesda System made in 2001. Those proven epithelial abnormalities patients were followed up until the lesions regressed to normal. The remaining patients,who exhibited persistent abnormalities or progression, were given further examinations.Results The positive rate of cervical cytological test was 8.72% (462/5296), including squamous carcinoma (SCA) 1case (0.02%), high grade squamous intraepithelial lesion (HSIL) 34 cases (0.64%), low grade squamous intraepithelial lesion (LSIL) 145 cases (2.74%), atypical glandular cells (AGC) 5 cases (0.09%), atypical squamous cells cannot exclude HSIL (ASC-H) 14 cases (0.26%), atypical squamous cells of undetermined significance (ASC-US) 263 cases (4.97%). The 419 proven cytological abnormality cases were followed up successfully. The total transnegative rate in three months was 73.74% (309/419), in which 303 cases (72.32%) persisted normal status for more than six months after regression. And the transnegative rate of ASC-US, ASC-H, AGC, LSIL, and HSIL were 79.56%, 64.29%, 100%,72.14% and 44.12%, respectively. Forty-six cases received biopsy directed by colposcopy. The distribution of coincidence of cytopathologic and histopathologic diagnosis was: SCA 1 case (100%), HSIL 10 cases (76.92%), LSIL 13 cases (65%), ASC-H 2 cases (50%), ASC-US 3 cases (37.50%), total 29 cases (63.04%).Conclusions We should cast more attention to screening cervix lesions in pregnant and postpartum women. Their cytopathologic characteristics are liable to make the clinician give a false positive diagnosis. So we propose to follow up them closely

  6. Letter: Contraceptive choice and cervical cytology.

    Leppaluoto, P

    1974-02-15

    In the evaluation of biological potentials of contraceptives in the genesis of cervical cancer, cytology seems to have been given due attention while information on the clinical condition and specific treatment of the target organ, the cervix, is repeatedly neglected. "Cancer does not develop in a healthy cervix" is an old dogma derived from impressions gained by clinical examination of the organ. This concept is supported by epidemiologic studies indicating that cancer is extremely rare in cervices restored to a normal condition by cauterization. It may be postulated that this type of treatment destroys the permissive target cells of the cervix, thus indirectly rendering possible coitus-associated and contraceptive-associated(?) mutagen(s) invalid. Also, in comparative studies, an evaluation should be made of the significance of a higher incidence of cervical ectopy reported in women receiving oral hormonal contraceptives. The importance of ectopy in the genesis of cervical malignancy has been derived from the presumption that permissive cervical cells are thus created and exposed to vaginal contents which may harbor the mutagens(s). Therefore, it would seem not only desirable but imperative to include the neglected parameters of clinical condition and of specific treatment (both past and present) of the uterine cervix in the structure of studies like the recent one in this Journal on "Contraceptive choice and cervical cytology", by Drs. Shulman and Merritt. Still another parameter which might prove to be of significance is the predominant type of vaginal flora, which can be assessed readily in the routine examination of Papanicolaou smears. It may be that vaginal contents, which would seem to be somewhat different in wearers of the intrauterine contraceptive device as compared to "pill" users, might play a part in the advent of cervical malignancy as a medium of or for coitus-associated mutagens(s). PMID:4855868

  7. The cytological diagnosis and prognosis of malignization of cervical epithelium of uterus in pregnant women.

    Sumenko V.V.

    2007-01-01

    The investigation is dedicated to the study of the pathological alterations of cervical epithelium of uterus, proliferative activity in the lesion focuses and the improvement of cytological diagnosis of the state of cervical epithelium of uterus. The correlation between the proliferative processes in abnormal epithelium of uterine cervix and some pathological factors of the pregnant women organism was studied. The criteria for prognosis of the cervical epithelial dysplasia in pregnant women w...

  8. Impact of technology on cytology outcome in cervical cancer screening of young and older women

    Møller, Johanne Cecilie Rask; Lynge, Elsebeth; Franzmann, Maria;

    2014-01-01

    Little is known about age-dependent variation in outcomes of cervical cytology with modern technologies. This population-based study evaluated age-dependent changes after routine implementation of ThinPrep and SurePath technology in two independent laboratories, and controlled for time trends in ...... unchanged technology no trends in abnormality proportions were observed. The impact of LBC implementation on cytological abnormality proportions varied considerably across age groups.......Little is known about age-dependent variation in outcomes of cervical cytology with modern technologies. This population-based study evaluated age-dependent changes after routine implementation of ThinPrep and SurePath technology in two independent laboratories, and controlled for time trends in a...... technology phase. The study included 489,960 cytological samples with no recent abnormality from women aged 23-59 years, routinely screened between 1998 and 2007. Implementation of SurePath liquid-based cytology (LBC) was followed by an increase in abnormal cytology in women aged 23-29 years from 4.6 to 6...

  9. Outcomes in cervical screening using various cytology technologies

    Barken, Sidsel S; Rebolj, Matejka; Lynge, Elsebeth;

    2013-01-01

    Unlike for human papillomavirus screening, little is known about the possible age-dependent variation in the outcomes of cervical cytology screening. The aim of our study was to describe age-related outcomes of five cytological technologies in a population-based screening program targeting women...... signed out as normal, (3) liquid-based cytology (LBC) with 50% automatically signed out as normal, (4) LBC with 25% automatically signed out as normal, and (5) LBC with 25% automatically signed out as normal and with 16 preselected areas for attention in manual reading. We calculated proportion of...... aged 23-59 years. All cervical cytology from women residing in Copenhagen has been analyzed in the laboratory of the Department of Pathology, Hvidovre University Hospital. We studied five technology phases: (1) conventional cytology with manual reading, (2) conventional cytology with 50% automatically...

  10. Integrated cervical smear screening using liquid based cytology and bioimpedance analysis

    Das, Lopamudra; Sarkar, Tandra; Ashok K Maiti; Naskar, Sukla; Das, Soumen; Chatterjee, Jyotirmoy

    2014-01-01

    Objective: To minimize the false negativity in cervical cancer screening with Papanicolaou (Pap) test, there is a need to explore novel cytological technique and identification of unique and important cellular features from the perspectives of morphological as well as biophysical properties. Materials and Methods: The present study explores the feasibility of low-cost cervical monolayer techniques in extracting cyto-pathological features to classify normal and abnormal conditions. The cervica...

  11. Integrated cervical smear screening using liquid based cytology and bioimpedance analysis

    Lopamudra Das; Tandra Sarkar; Maiti, Ashok K.; Sukla Naskar; Soumen Das; Jyotirmoy Chatterjee

    2014-01-01

    Objective: To minimize the false negativity in cervical cancer screening with Papanicolaou (Pap) test, there is a need to explore novel cytological technique and identification of unique and important cellular features from the perspectives of morphological as well as biophysical properties. Materials and Methods: The present study explores the feasibility of low-cost cervical monolayer techniques in extracting cyto-pathological features to classify normal and abnormal conditions. The cer...

  12. Detecting uterine glandular lesions: Role of cervical cytology

    Bansal, Baneet; Gupta, Parikshaa; Gupta, Nalini; Rajwanshi, Arvind; Suri, Vanita

    2016-01-01

    Background: The sensitivity of cervical cytology for detection of glandular lesions is reported to be low. We conducted this study to assess the diagnostic accuracy of cervical Papanicolaou (Pap) smears for uterine glandular lesions and to compare the diagnostic utility of conventional and liquid-based cytology (LBC) smears for glandular lesions. Materials and Methods: Archived histopathology records of all cases reported as endocervical and endometrial adenocarcinoma in the study period were identified and the available corresponding Pap smears (in preceding 1 year) were retrieved. In addition, the Pap smears reported as glandular cell abnormalities (GCA) during the same study period were retrieved. The overall prevalence of GCA, sensitivity, and specificity of Pap smears for the detection of GCA was calculated. The diagnostic accuracy of conventional and LBC smears for the diagnosis of GCA was also compared. Results: The prevalence of GCA in our study was 0.32%. The overall specificity of Pap smears for the diagnosis of GCA was 60.8%, this was not significantly different between conventional and LBC smears (P = 0.4). The overall sensitivity of Pap smears for the detection of GCA was 41.8%; LBC smears had significantly better sensitivity as compared to conventional smears for the detection of endometrial as compared to endocervical adenocarcinoma (P Pap smears is low. The specificity of Pap smears, for diagnosis of GCA, was found to be moderate. However, the overall sensitivity of Pap smears for the detection of GCA was low, though better for LBC as compared to conventional smears. PMID:27014363

  13. CpG methylation in human papillomavirus (HPV) type 31 long control region (LCR) in cervical infections associated with cytological abnormalities.

    László, Brigitta; Ferenczi, Annamária; Madar, László; Gyöngyösi, Eszter; Szalmás, Anita; Szakács, Levente; Veress, György; Kónya, József

    2016-08-01

    The mechanisms that regulate papillomavirus gene expression include DNA methylation. The transcription of papillomavirus oncogenes E6 and E7 is controlled by certain regulatory elements in the LCR, which include binding sites for the E2 protein, a viral regulator of oncogene expression. In HPV-31-infected exfoliated cervical cells, the CpG methylation of the entire LCR was determined by next-generation sequencing after bisulfite modification. Six of the 22 cases had methylated CpG sites in the HPV-31 LCR, including position 7479 and/or 7485, at the promoter distal E2 binding site, thus suggesting a potential regulatory mechanism for papillomavirus transcription. PMID:27098644

  14. CD-ROM transnational training program in cervical cytology (CYTOTRAIN).

    Marsan, C; Coleman, D V; Branca, M; Cochand-Priollet, B; Molinié, V

    2001-01-01

    The Transnational Training Programme in Cervical Cytology (CYTOTRAIN) is a 3-yr project funded by the European Commission to harmonize training and quality standards in cervical screening across the European Union. The aim of the program is to develop new approaches in initial and continuing vocational training, particularly in the area of life-long learning with the aim of meeting national, regional, and local needs. We present a new approach to training in cervical cytology, using an interactive program of cytological images. The method used to prepare the program and the problems encountered are described. The authors have the feeling that giving details of the organizational and management structure adopted for the project implementation might help other pathologists realize more or less similar CD-ROM training programs in their own field of activity. PMID:11135473

  15. Two cytological methods for screening for cervical cancer

    Kirschner, B.; Simonsen, K.; Junge, J.

    2008-01-01

    INTRODUCTION: Denmark has had an organized screening programme for cervical cancer since the 1960s. In spite of this, almost 150 Danish women die from the disease each year. There are currently two different methods for preparation of cervical samples: conventional Papanicolaou smear and liquid......-based cytology. MATERIALS AND METHODS: In 2002, the Department of Pathology, Hvidovre Hospital changed over from the conventional Papanicolaou smear screening method to SurePath liquid-based cytology. This article is based on a retrospective comparison on data from the population screening programme for cervical...... cancer in the Municipality of Copenhagen. RESULTS: The number of tests with the diagnosis of "normal cells" decreased 1% after the conversion to liquid-based cytology, whilst the number of tests with "atypical cells" and "cells suspicious for malignancy" increased by 64.3% and 41.2% respectively...

  16. Association of Trichomonas vaginalis and cytological abnormalities of the cervix in low risk women.

    Gilbert G G Donders

    Full Text Available OBJECTIVE: Is Trichomonas vaginalis (TV an inducing factor for the development of (pre-cancerous lesions of the cervix? DESIGN: Cross sectional study. SETTING: Screening healthy Belgian women with low infection risk. SAMPLE: 63,251 consecutive liquid based cervical samples. METHODS: Real time quantitative PCR for presence of TV, 18 HPV types and Pap smear analysis of cytologic abnormalities. MAIN OUTCOME MEASURES: Association of TV and HPV with cervix dysplasia. RESULTS: The overall prevalence of TV DNA was 0.37%, of low risk HPV 2%, of high risk HPV 13.2%, and 8.8 % had cytological abnormalities. Both LR-HPV and HR-HPV were significantly associated with all cytological abnormalities. Presence of TV was associated with LR- and HR-HPV, ASC-US and HSIL, but not with other abnormalities. All women with TV and HSIL also had HR-HPV, while the latter was present in only 59% of women with TV and ASC-US. Amongst HPV negative women, TV was found in 1.3% of women with ASC-US, but only in 0.03% of women with normal cytology (OR 4.2, CL95% 2.1-8.6. In HR-HPV positive women, presence of TV increased the likelihood of cytological abnormalities somewhat (P=0.05, mainly due to an increase in ASC-US and LSIL, but not HSIL. CONCLUSIONS: We conclude that TV infection is associated with both LR and HR-HPV infection of the cervix, as well as with ASC-US and HSIL. TV is a concomitant STI, but is not thought to be a co-factor in the causation of HSIL and cervical cancer. However, TV may cause false positive diagnoses of ASC-US.

  17. The cytological diagnosis and prognosis of malignization of cervical epithelium of uterus in pregnant women.

    Sumenko V.V.

    2007-01-01

    Full Text Available The investigation is dedicated to the study of the pathological alterations of cervical epithelium of uterus, proliferative activity in the lesion focuses and the improvement of cytological diagnosis of the state of cervical epithelium of uterus. The correlation between the proliferative processes in abnormal epithelium of uterine cervix and some pathological factors of the pregnant women organism was studied. The criteria for prognosis of the cervical epithelial dysplasia in pregnant women were elaborated on this basis of our data. The pathological processes in cervical epithelium were revealed in 309 pregnant women in the first trimester (mean age of women was 26,17±0,83 years. The hormonal state of pregnant women was studied on the basis of colpocytological picture and the colpocytological types which indicate the unfavorable prognosis with a certain degree of validity were determined. The mathematic model for all cytological groups of pregnant women for prognosis of inflammatory processes, epithelial dysplasia and preinvasive cervical cancer was created. The simple and comprehensible prognostic scheme for diagnosis of epithelial dysplasia and preinvasive cervical cancer was developed.

  18. Liquid-based cytology versus conventional cytology for evaluation of cervical Pap smears: Experience from the first 1000 split samples

    Vikrant Bhar Singh

    2015-01-01

    Full Text Available Context and Aim: Screening programs using conventional cytology conventional Pap smear (CPS have successfully reduced cervical cancer, but newer tests like liquid-based cytology (LBC and human papillomavirus testing might enhance screening. The main aim of the present study was to assess the diagnostic accuracy of LBC versus CPS using "split samples." Materials and Methods: This was a prospective study comprising of 1000 consecutive cervical "split samples" over a period of 1 year. Split sample was obtained using cervex-brush. CPS was prepared from the brush and the brush head was suspended in the LBC vial and processed by SurePath™ LBC. Results: There were 4.3% unsatisfactory (U/S cases in CPS and 1.7% in LBC; the main cause is insufficient cells, and excess of blood in CPS. About 25/100 (2.5% split samples had epithelial abnormalities both in CPS and LBC (1.2%-atypical squamous cells of undetermined significance; 0.4%-low grade squamous intraepithelial lesion; 0.2%-high grade squamous intraepithelial lesion; 0.5%-squamous cell carcinoma; 0.1%-atypical glandular cells favouring neoplasia; 0.2%-adenocarcinoma. Inflammatory organisms were almost equally identified in both techniques but were better seen in LBC samples. Conclusions: LBC technique leads to significant reduction of U/S rate. LBC samples offered better clarity, uniform spread of smears, less time for screening and better handling of hemorrhagic and inflammatory samples. LBC had equivalent sensitivity and specificity to CPS.

  19. APPLICATION OF THE 2014 BETHESDA SYSTEM FOR REPORTING OF CERVICAL/VAGINAL CYTOLOGICAL LESIONS

    Pratima

    2015-12-01

    Full Text Available Pap smear (Conventional smear is the most widely used cervical cancer screening test in the world. Negative intraepithelial lesion for malignancy, squamous intraepithelial lesion and cervical cancer remain important health problems for women worldwide. In developing countries like India, there is a great need for mass screening program for cervical lesion. AIMS AND OBJECTIVES To assess the clinician utility of The 2014 Bethesda System Reporting of cervical and vaginal epithelial abnormalities. MATERIAL AND METHODS All the cervical/vaginal cytology smears reported were retrieved and reviewed in the duration from 2007, 2008, 2009 and 2014. RESULTS A total number of 1700 cases of Pap smears were retrieved during period of study, out of which 90.0% were satisfactory for evaluation; 35.5% were within normal limit and 55.6% were NILM. A few (8.14% of the cases were reported as squamous intraepithelial lesion; 0.5% as atypical squamous cells and 0.19% were reported as atypical glandular cells. CONCLUSION Pap smear is a proven tested tool for making an early diagnosis and treating cervical cancer in early stage. Thus, Pap smear is simple, less expensive diagnostics tool suitable for implementation in India.

  20. ABC3 Part I: a review of the guidelines for terminology, classification and management of cervical cytology in England.

    Smith, J H F

    2012-12-01

    The provision of guidance on cytology reporting and evaluation, first outlined in 1995 with the publication of Achievable Standards, Benchmarks for Reporting, and Criteria for Evaluating Cervical Cytopathology (ABC), and subsequently revised and expanded in a second edition in 2000, has been pivotal to the success of the National Health Service Cervical Screening Programme (NHSCSP), ensuring that standards are upheld, and that rigorous evaluation and quality assurance take place. In the last decade, major changes to the NHSCSP, notably the adoption of revised age ranges and screening intervals for all women in England, implementation of liquid-based cytology and, most recently, the decision to introduce high-risk human papillomavirus (HR-HPV) testing for triage of low-grade and borderline (equivalent to 'atypical') cytological abnormalities and test of cure after treatment of cervical intraepithelial neoplasia (CIN) determined that an updated version of ABC was required. The third edition of ABC recommends adoption, with minor modification, of the revised British Society for Clinical Cytology terminology and provides guidance on the management of abnormal cytology results linked to this terminology taking account of HR-HPV testing. To accommodate these changes, expanded result codes, which are electronic codes used to transfer management information to central computers for follow-up, call and recall of individual women, have been developed. Further guidance on specimen adequacy is also provided. Revised performance indicators are described and explained in a separate article by R. Blanks in this issue of Cytopathology. All the changes in ABC3 are designed to support the mission statement of the NHSCSP that 'the objective of cervical screening is to reduce cervical cancer incidence and mortality by screening with a high sensitivity for the detection of CIN2 or worse, whilst maintaining a high specificity'. PMID:23173804

  1. Anal Human Papillomavirus (HPV) Prevalences and Factors Associated with Abnormal Anal Cytology in HIV-Infected Women in an Urban Cohort from Rio de Janeiro, Brazil

    Cambou, Mary C.; Luz, Paula M.; Lake, Jordan E.; Levi, José Eduardo; Coutinho, José Ricardo; de Andrade, Angela; Heinke, Thais; Derrico, Mônica; Veloso, Valdilea G.; Friedman, Ruth K; Grinsztejn, Beatriz

    2015-01-01

    Identifying factors, including human papillomavirus (HPV) genotypes, associated with abnormal anal cytology in HIV-infected women have implications for anal squamous cell cancer (SCC) prevention in HIV-infected women. Anal and cervical samples were collected for cytology, and tested for high-(HR-HPV) and low-risk HPV (LR-HPV) genotypes in a cross-sectional analysis of the IPEC Women's HIV Cohort (Rio de Janeiro, Brazil). Multivariate log-binomial regression models estimated prevalence ratios ...

  2. COMPARATIVE STUDY OF CYTOLOGIC AND COLPOSCOPIC FINDINGS IN PRECLINICAL CERVICAL CANCER

    Penagaluru

    2015-11-01

    Full Text Available BACKGROUND The cytologic diagnosis of cervical smears has become a very important screening test for the detection of pre-invasive and invasive cervical epithelial abnormalities. MATERIALS AND METHODS It is a prospective study conducted for a period of 1 year in 100 women who fulfilled the inclusion criteria. Colposcopy, PAP smear and biopsy were done. RESULTS Majority 70.5% i.e., (12/17 of CIN occurred in the age group of 30-49 years. Among the 9 women who took OCP, 12% (2/17 had CIN. Incidence of CIN in the permanently sterilized group was 59% (10/17 and among IUCD user was 5.9% (1/17. Among women who were diagnosed to have CIN, 70.5% (12/17 complained of excessive vaginal discharge 11.7% (2/17 of women had post-coital bleeding. PAP smear had a sensitivity of 29% and a specificity of 88% which was attributed to the high number of false, negative smears. Colposcopy showed a sensitivity of 82% and a specificity of 81%. Sensitivity was more than pap smear but specificity was less than pap smear. Accuracy of Colposcopy was found to be 82% which was comparatively more accurate than pap smear (78%. CONCLUSIONS COLPOSCOPY offers an excellent tool in evaluating cervical lesions. It is an easy and perspective method and its importance lies in teaching, diagnosis and management of cervical lesions, both neoplastic and non-neoplastic.

  3. Accurate assessment of cell density in low cellular liquid-based cervical cytology

    Siebers, A.G.; Laak, J.A.W.M. van der; Huberts-Manders, R.; Vedder, J.E.M.; Bulten, J.

    2013-01-01

    A. G. Siebers, J. A. W. M. van der Laak, R. Huberts-Manders, J. E. M. Vedder and J. Bulten Accurate assessment of cell density in low cellular liquid-based cervical cytology Objective: Scant cellularity is the most important source of unsatisfactory liquid-based cytology. Although still being debate

  4. Screening for cervical cancer precursors with p16/Ki-67 dual-stained cytology

    Ikenberg, Hans; Bergeron, Christine; Schmidt, Dietmar;

    2013-01-01

    Pap cytology is known to be more specific but less sensitive than testing for human papillomavirus (HPV) for the detection of high-grade cervical intraepithelial neoplasia (CIN2+). We assessed whether p16/Ki-67 dual-stained cytology, a biomarker combination indicative of transforming HPV infections...

  5. Cytological Analysis for Human Papillomavirus DNAs in Cervical Intraepithelial Neoplasia by In situ Hybridization

    Nagai, Nobutaka; Takehara, Kazuhiro; Murakami, Takahiro; Ohama, Koso

    1994-01-01

    Human papillomavirus (HPV) type 16 and 18 DNAs are reported to be associated with uterine cervical cancer. In order to investigate the relationship between the presence of HPV DNA and cervical intraepithelial neoplasia (CIN), we attempted the cytological detection of HPV DNAs in uterine cervical smear samples. The samples included those of severe dysplasia and carcinoma in situ (CIS). They were analysed by DNA-DNA in situ hybridization using biotinylated HPV DNA probes.  The results of in sit...

  6. Cytological Analysis for Human Papillomavirus DNAs in Cervical Intraepithelial Neoplasia by In situ Hybridization

    Nagai, Nobutaka; Takehara, Kazuhiro; Murakami, Takahiro; Ohama, Koso

    1994-01-01

    Human papillomavirus (HPV) type 16 and 18 DNAs are reported to be associated with uterine cervical cancer. In order to investigate the relationship between the presence of HPV DNA and cervical intraepithelial neoplasia (CIN), we attempted the cytological detection of HPV DNAs in uterine cervical smear samples. The samples included those of severe dysplasia and carcinoma in situ (CIS). They were analysed by DNA-DNA in situ hybridization using biotinylated HPV DNA probes.   The results of i...

  7. Abnormal feeling in swallowing: a complication of cervical spondylopathy

    Objective: To study the relationship between abnormal feeling in swallowing and cervical spondylopathy and improve the understanding of cervical spondylopathy complicated by abnormal feeling in swallowing. Method: The study group included 11 patients who were clinically diagnosed as cervical spondylopathy in our hospital from 1996 to 2002. On Toshiba 500 mA KXO-15C radiography system, patient swallowing dense barium was examined in several projections. Results: Hyperostosis of vertebral body resulted in local compression of the laryngopharynx and the posterior wall of upper esophageal tube, causing abnormal feeling in swallowing. Conclusion: Abnormal feeling in swallowing could be one of the clinical symptoms of cervical spondylopathy

  8. Hybrid capture vs. PCR screening of cervical human papilloma virus infections. Cytological and histological associations in 1270 women

    Tsivilika Angeliki

    2010-02-01

    Full Text Available Abstract Background We evaluated two molecular methods of HPV detection and their correlation with cytological and histological diagnosis in a large sample of Greek women. Methods All women with liquid-based cytology performed at a University Hospital between 2000 and 2003 were included. The Hybrid Capture 2 (HC2 kit and in house Polymerase Chain Reaction (PCR were used for HPV DNA detection. Cervical biopsy was performed for women with ASCUS+ cytology, HPV detection, or abnormal colposcopy. Positive (PLR and negative (NLR likelihood ratios were calculated for cytology and HPV molecular testing for the prediction of CIN2 and greater histology. Results Of the 1270 women evaluated 241 (18.5% had abnormal cytology. Cytology diagnosed high-grade squamous intraepithelial lesion (HSIL or invasive carcinoma in 21(1.7% cases whereas 26 (2% women had CIN2+ or greater histology. PCR detected HPV in 397/1270 (31.3% and HC2 in 260/1270 (20.4% samples. Both molecular tests exhibited high reproducibility (Cohen's kappa value 0.691, 95% CI: 0.664 - 0.718. Positive likelihood ratios (PLR of 9.4, 3.8 and 3.4 and negative likelihood ratios of 0.13, 0.21, and 0 were noted for ≥ LSIL, any positive HC2 or any positive PCR-HPV testing, for predicting CIN2+ histology, respectively. All CIN 3+ lesions harbored high risk oncogenic HPV type infections. Conclusions HPV infection was found in a large proportion of this population and was associated with CIN 2/3 lesions and infiltrating carcinomas. Thin prep testing and HPV detection by HC2 or PCR performed very well with regards to identifying high grade lesions in an environment with experienced examiners.

  9. Hybrid capture vs. PCR screening of cervical human papilloma virus infections. Cytological and histological associations in 1270 women

    We evaluated two molecular methods of HPV detection and their correlation with cytological and histological diagnosis in a large sample of Greek women. All women with liquid-based cytology performed at a University Hospital between 2000 and 2003 were included. The Hybrid Capture 2 (HC2) kit and in house Polymerase Chain Reaction (PCR) were used for HPV DNA detection. Cervical biopsy was performed for women with ASCUS+ cytology, HPV detection, or abnormal colposcopy. Positive (PLR) and negative (NLR) likelihood ratios were calculated for cytology and HPV molecular testing for the prediction of CIN2 and greater histology. Of the 1270 women evaluated 241 (18.5%) had abnormal cytology. Cytology diagnosed high-grade squamous intraepithelial lesion (HSIL) or invasive carcinoma in 21(1.7%) cases whereas 26 (2%) women had CIN2+ or greater histology. PCR detected HPV in 397/1270 (31.3%) and HC2 in 260/1270 (20.4%) samples. Both molecular tests exhibited high reproducibility (Cohen's kappa value 0.691, 95% CI: 0.664 - 0.718). Positive likelihood ratios (PLR) of 9.4, 3.8 and 3.4 and negative likelihood ratios of 0.13, 0.21, and 0 were noted for ≥ LSIL, any positive HC2 or any positive PCR-HPV testing, for predicting CIN2+ histology, respectively. All CIN 3+ lesions harbored high risk oncogenic HPV type infections. HPV infection was found in a large proportion of this population and was associated with CIN 2/3 lesions and infiltrating carcinomas. Thin prep testing and HPV detection by HC2 or PCR performed very well with regards to identifying high grade lesions in an environment with experienced examiners

  10. Comparison of three human papillomavirus DNA assays and one mRNA assay in women with abnormal cytology

    Rebolj, Matejka; Lynge, Elsebeth; Ejegod, Ditte;

    2014-01-01

    no follow-up, 232 (63%) had cervical cancer. The sensitivity for ≥CIN3 was 95% (95% CI: 88-99) for HC2, 94% (95% CI: 87-98) for cobas, 93% (95% CI: 85-97) for CLART, and 87% (95% CI: 78-93) for APTIMA. In women of age above 30 years......, the sensitivities were 98% (95% CI: 87-100), 93% (95% CI: 80-98), 90% (95% CI: 77-97), and 93% (95% CI: 80-98), respectively. One woman with cervical cancer tested negative on CLART and one on cobas; HC2 and APTIMA were positive in all three cancer cases. The specificity for ...OBJECTIVE: To compare the clinical characteristics of four human papillomavirus (HPV) assays: hybrid capture 2 (HC2), cobas, CLART, and APTIMA in Danish women with abnormal cytology. METHODS: SurePath samples from 367 consecutive women from Copenhagen, with atypical squamous cells of undetermined...

  11. Value of human papillomavirus typing for detection of anal cytological abnormalities

    Livia Bravo Maia

    2013-01-01

    Full Text Available Purpose: The objective of this study was to evaluate anal cytology and human papillomavirus (HPV typing in patients with human immunodeficiency virus infection. Materials and Methods: Anal samples were collected from 61 patients (44 men and 17 women and analyzed by PapilloCheck test and conventional cytology. Results: Of all anal samples, 37.7% had cytological abnormalities, 47.54% were negative and 14.75% were unsatisfactory. High-risk HPV, multiple high-risk HPV and HPV 16 infection was detected in 91.13%, 78.26% and 47.82% of the samples with cytological abnormalities and in 47.54%, 6.89% and 3.44% of the negative samples, respectively. High-risk HPV infection was significantly more frequent in anal samples with cytological abnormalities than in negative samples (P = 0.0005, Fisher′s test, particularly multiple high-risk HPV infection (P < 0.0001 and HPV 16 infection (P = 0.0002. Conclusions: High-risk HPV, multiple high-risk HPV and HPV 16 infections are significantly associated with anal cytological abnormalities. Furthermore, the frequency of HPV infection in anal cytological samples suggests that high-risk HPV detection has high sensitivity, but low specificity for detection of anal cytological abnormalities, but multiple high-risk HPV typing and HPV 16 typing have a lower sensitivity and high specificity. Results suggest that HPV typing may be useful as an adjunct to cytology to screen patients for high-resolution anoscopy and biopsy.

  12. Cervical cancer screening: on the way to a shift from cytology to full molecular screening.

    Dijkstra, M G; Snijders, P J F; Arbyn, M; Rijkaart, D C; Berkhof, J; Meijer, C J L M

    2014-05-01

    Cytology-based nation-wide cervical screening has led to a substantial reduction of the incidence of cervical cancer in western countries. However, the sensitivity of cytology for the detection of high-grade precursor lesions or cervical cancer is limited; therefore, repeated testing is necessary to achieve program effectiveness. Additionally, adenocarcinomas and its precursors are often missed by cytology. Consequently, there is a need for a better screening test. The insight that infection with high-risk human papillomavirus (hrHPV) is the causal agent of cervical cancer and its precursors has led to the development of molecular tests for the detection of hrHPV. Strong evidence now supports the use of hrHPV testing in the prevention of cervical cancer. In this review, we will discuss the arguments in favor of, and concerns on aspects of implementation of hrHPV testing in primary cervical cancer screening, such as the age to start hrHPV-based screening, ways to increase screening attendance, requirements for candidate hrHPV tests to be used, and triage algorithms for screen-positive women. PMID:24445150

  13. What women want. Women's preferences for the management of low-grade abnormal cervical screening tests: a systematic review

    Frederiksen, Maria Eiholm; Lynge, E; Rebolj, M

    2012-01-01

    Please cite this paper as: Frederiksen M, Lynge E, Rebolj M. What women want. Women's preferences for the management of low-grade abnormal cervical screening tests: a systematic review. BJOG 2011; DOI: 10.1111/j.1471-0528.2011.03130.x. Background If human papillomavirus (HPV) testing will replace...... cytology in primary cervical screening, the frequency of low-grade abnormal screening tests will double. Several available alternatives for the follow-up of low-grade abnormal screening tests have similar outcomes. In this situation, women's preferences have been proposed as a guide for management...... decisions. Objectives To determine women's preferences for the follow-up of low-grade cervical screening abnormalities. Search strategy Using Medical Subject Headings (MeSH) terms, PubMed was searched for articles published up to December 2010. The reference lists of the retrieved studies were consulted...

  14. Value of human papillomavirus typing for detection of anal cytological abnormalities

    Livia Bravo Maia; Larissa Cardoso Marinho; Tânia Wanderley Paes Barbosa; Lara Franciele Ribeiro Velasco; Patrícia Godoy Garcia Costa; Fabiana Pirani Carneiro; Paulo Gonçalves de Oliveira

    2013-01-01

    Purpose: The objective of this study was to evaluate anal cytology and human papillomavirus (HPV) typing in patients with human immunodeficiency virus infection. Materials and Methods: Anal samples were collected from 61 patients (44 men and 17 women) and analyzed by PapilloCheck test and conventional cytology. Results: Of all anal samples, 37.7% had cytological abnormalities, 47.54% were negative and 14.75% were unsatisfactory. High-risk HPV, multiple high-risk HPV and HPV 16 infection was d...

  15. Role of cytology, colposcopy and biopsy in the detection of cervical intraepithelial neoplasia

    Pooja H. Khakhla

    2013-08-01

    Results: Colposcopy was well-correlated with histology in 69.70% cases. Cytology was well-correlated with histology in 65.15% of cases & with major discrepancy in 18.18% cases. Conclusion: The incidence of cervical cancer will continue to be very high in our population because of the constant high incidence of early marriage, multiparity, poor nutrition, poor hygiene, and low living standards. Thus there is a need for screening of these patients for cervical cancer and till date exfoliative Cytology has been found to be the Gold Standard for detection of early malignancy. Universal cytologic screening of all sexually active women should be done, especially in cases of parous women in lower socio-economic groups. Treatment & follow-up of dysplasia could prevent malignancies in future. [Int J Reprod Contracept Obstet Gynecol 2013; 2(4.000: 550-554

  16. Exfoliative cytology in study of radiosensitivity of uterine cervical cancer, (2)

    In this paper, we discuss the possibility of cytological judgment of radiosensitivity of uterine cervical cancer by comparison between pre- and post-irradiation smears given 1,000 rads by telecobalt external test irradiation. The estimation of radiation effects on nuclei and the cytological presumption of histological typing in pre-irradiation smears have brought about satisfactory results; agreement between histological and cytological judgements of radiosensitivity was about 96.8%. Cytological criteria of good sensitivity are as follows; Disparity in size of chromatin particles and irregular distribution. Irregularity of nuclear membrane with nuclear wrinkling with diminution of thickness of nuclear membrane. Mature squamous cell carcinoma without pearl formation. Those of poor sensitivity are as follows; Existence of many unchanged viable cells and less disturbances of chromatines. Existence of cells exibiting adenocarcinoma and carcinoma of intermediate type. Clusters of cyanophilic cells having lacy, indistinct cell borders. (auth.)

  17. P16INK4a: a potential diagnostic adjunct for prediction of high-grade cervical lesions in liquid-based cytology: with HPV testing and histological correlation.

    Wong, Y P; Abdul Raub, S H; Mohd Dali, A Z H; Kassim, F; Visvalingam, V; Zakaria, Z; Kamaluddin, M A; Noor Akmal, S

    2016-08-01

    Human papillomavirus (HPV) is a necessary cause of cervical cancer and its precursors. Increased expression of high-risk hrHPV viral oncogenes in abnormal cells might increase the expression of p16INK4a. We aimed to determine the role of p16INK4a in detecting hrHPV-transformed epithelial cells in liquid-based cervical cytology, and compared the results with hrHPV DNA testing by realtime polymerase chain reaction (RT-PCR). Fifty-seven cytological samples were tested for p16INK4a immunomarker and hrHPV DNA. Test performance of both tests was determined by comparing sensitivity, specificity and predictive values using available histological follow-up data as gold standard. Of 57 samples, 36 (63.2%) showed immunoreactivity for p16INK4a and 43 (75.4%) were hrHPV-infected. A fairly low concordance rate (k = 0.504) between p16INK4a immunolabelling and hrHPV DNA status was noted. For prediction of cervical intraepithelial neoplasia (CIN) II and worse lesions, p16INK4a had a sensitivity and specificity of 93.5% and 60%; whereas hrHPV DNA testing had a sensitivity and specificity of 100% and 20%. Dual testing by combining p16INK4a and hrHPV showed sensitivity and specificity of 100% and 33.3%. In conclusion, p16INK4a is useful in predicting severity of the cytological abnormalities. Although p16INK4a is more specific but less sensitive than hrHPV in detecting high-grade cervical lesions, a combination of both tests failed to demonstrate significant improvement in diagnostic sensitivity, specificity and predictive value. Larger-scale prospective studies are required to assess further whether this biomarker should be routinely used as primary screening tool independently or in combination with hrHPV testing to improve diagnostic accuracy in cervical cytology. PMID:27568665

  18. Abnormal anal cytology risk in women with known genital squamous intraepithelial lesion.

    do Socorro Nobre, Maria; Jacyntho, Claudia Marcia; Eleutério, José; Giraldo, Paulo César; Gonçalves, Ana Katherine

    2016-01-01

    The purpose of this study was to assess the risk of abnormal anal cytology in women with known genital squamous intraepithelial lesion. This study evaluated 200 women with and without genital squamous intraepithelial lesion who were recruited for anal Pap smears. Women who had abnormal results on equally or over atypical squamous cells of undetermined significance were classified as having abnormal anal cytology. A multiple logistic regression analysis (stepwise) was performed to identify the risk for developing abnormal anal cytology. Data were analyzed using the SPSS 20.0 program. The average age was 41.09 (±12.64). Of the total participants, 75.5% did not practice anal sex, 91% did not have HPV-infected partners, 92% did not have any anal pathology, and 68.5% did not have anal bleeding. More than half (57.5%) had genital SIL and a significant number developed abnormal anal cytology: 13% in the total sample and 17.4% in women with genital SIL. A significant association was observed between genital squamous intraepithelial lesion and anal squamous intraepithelial lesion (PR=2.46; p=0.03). In the logistic regression model, women having genital intraepithelial lesion were more likely to have abnormal anal Pap smear (aPR=2.81; p=0.02). This report shows that women with genital squamous intraepithelial lesion must be more closely screened for anal cancer. PMID:27037113

  19. HPV-DNA testing and Ki-67 immunocytochemistry in liquid based cervical cytology in prostitute women

    Esin ATİK

    2006-09-01

    Full Text Available HPV causes several changes in the function of host genes, and these interactions cause deregulation of the cell cycle manifested by abnormal expression of cell cycle associated proteins, such as Ki-67. The detection of Ki-67 can play a role in screening and diagnosis of HPV infection with risk of progression towards dysplasia and carcinoma. To show this relation in prostitute women, cervical cells were collected in the PapSpin Collection Fluid. A starting volume of 1000 µl for each sample, and a 200 µl cell suspension were used to prepare each sample for thin layer liquid based cytology and then they were stained by Papanicolaou method. The cytological results were classified according to the Bethesda 2001 system. From the remaining cell suspension of 800 µl, a 400 µl sample was used for HPV-DNA detection by PCR, a 50 µl alliquot was used to make thin layer preparations for immunocytochemistry. Single antigen staining was performed with Ki-67 protein. Cells were considered immunopositive if the nuclei were stained. All cells in one high power field (x400 were counted, and the fraction of immunopositive cells on the slide was calculated. This fraction was expressed as the number of positive cells per 1000 cells to facilitate comparisons of differential cell counts. HPV types 6 and 32 in the study, and HPV types 6 and 51 in the control group were detected. The mean Ki-67 values were 2.7±1.2 and 3.6±4.1 in HPV positive and negative cases respectively. There was a positive correlation only with nuclear changes and HPV positivity (x2=28.8, p<0.001. There was not any significant correlation between HPV or Ki-67 and leukocytosis. An association with HPV and contraception, smoking, and concurrent genital infection was not found. The prevalence of HPV types in different geographical locations and races may indicate different etiologies of cervical cancer. Our results suggest that Ki-67 immunocytochemistry is not useful as a surrogate marker for

  20. Imaging cervical cytology with scanning near-field optical microscopy (SNOM) coupled with an IR-FEL.

    Halliwell, Diane E; Morais, Camilo L M; Lima, Kássio M G; Trevisan, Julio; Siggel-King, Michele R F; Craig, Tim; Ingham, James; Martin, David S; Heys, Kelly A; Kyrgiou, Maria; Mitra, Anita; Paraskevaidis, Evangelos; Theophilou, Georgios; Martin-Hirsch, Pierre L; Cricenti, Antonio; Luce, Marco; Weightman, Peter; Martin, Francis L

    2016-01-01

    Cervical cancer remains a major cause of morbidity and mortality among women, especially in the developing world. Increased synthesis of proteins, lipids and nucleic acids is a pre-condition for the rapid proliferation of cancer cells. We show that scanning near-field optical microscopy, in combination with an infrared free electron laser (SNOM-IR-FEL), is able to distinguish between normal and squamous low-grade and high-grade dyskaryosis, and between normal and mixed squamous/glandular pre-invasive and adenocarcinoma cervical lesions, at designated wavelengths associated with DNA, Amide I/II and lipids. These findings evidence the promise of the SNOM-IR-FEL technique in obtaining chemical information relevant to the detection of cervical cell abnormalities and cancer diagnosis at spatial resolutions below the diffraction limit (≥0.2 μm). We compare these results with analyses following attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectroscopy; although this latter approach has been demonstrated to detect underlying cervical atypia missed by conventional cytology, it is limited by a spatial resolution of ~3 μm to 30 μm due to the optical diffraction limit. PMID:27406404

  1. Enterobius vermicularis infestation masquerading as cervical carcinoma: A cytological diagnosis.

    Raju, Kalyani; Verappa, Seema; Venkataramappa, Srinivas Murthy

    2015-01-01

    Although prevalence of Enterobius vermicularis (EV) infestation in Intestines ranges from 35% to 70%, its prevalence in female genital tract is not known despite several incidental findings. Acute inflammatory cells in the background of cervical Pap smear indicate infestation and should not be neglected as contamination. A 40-year-woman presented with white vaginal discharge persistent for past 1 year. Local examination showed hypertrophied cervix with eversion of both lips and hard consistency of the anterior lip of cervix. A clinical diagnosis of cervical carcinoma was made. However, cervical Pap smear indicated EV eggs in an inflammatory background, treatment to which resulted in completely recovery. PMID:26283859

  2. Anal cytology in women with cervical intraepithelial or invasive cancer: interobserver agreement

    Sandra A. Heráclio

    2015-10-01

    Full Text Available ABSTRACTIntroduction:Incidence rates of anal cancer have been rising worldwide in the last 20 years. Due to embryological, histological and immunohistochemical similarities between the anal canal and the cervix, routine screening with anal cytology for precursor lesions in high-risk groups has been adopted. Objective: To determine interobserver agreement for the diagnosis of anal neoplasia by anal cytology.Material and methods:A cross-sectional observational study was conducted in 324 women with cervical intraepithelial or invasive cancers, for screening of anal cancer, from December 2008 to June 2009. Three hundred twenty-four cytological samples were analyzed by three cytopathologists. Cytological evaluation was based on the revised Bethesda terminology; samples were also classified into negative and positive for atypical cells. We calculated the kappa statistic with 95% confidence interval (95% CI to assess agreement among the three cytopathologists.Results:Interobserver agreement in the five categories of the Bethesda terminology was moderate (kappa for multiple raters: 0.6. Agreement among cytopathologists 1, 2 and 3 with a consensus diagnosis was strong (kappa: 0.71, 0.85 and 0.82, respectively.Conclusion:Interobserver agreement in anal cytology was moderate to strong, indicating that cervical cytomorphological criteria are reproducible also in anal samples.

  3. Quantitative Detection of Screening for Cervical Lesions with ThinPrep Cytology Test

    Hong-xin ZHANG; Yi-min SONG; Su-hong LI; Yu-hui YIN; Dong-ling GAO; Kui-sheng CHEN

    2010-01-01

    OBJECTIVE To investigate the available parameters in gynecological screening for cervical lesions by liquid-based cytology technology (ThinPrep Cytology Test, TCT) and The Bethesda System (TBS), also with computer image analysis. METHODS With application of the image analysis system, all grades of cervical lesion cells were detected quantitatively and sorted in atypical squamous cells of undetermined significance (ASCUS), atypical squamous cells-cannot exclude HSIL (ASC-H), low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL) and cervical squamous cell carcinoma (SCC) with the mean optical density (MOD), average grey (AG), positive units (PU), and nucleus to cytoplasmic ratio (N:C). Differences between each group of cells were compared and analyzed statistically.RESULTS Apart from four stereologic parameters in LSIL and HSIL groups there were no differences among them, in the other groups, there was statistically significant in differences between MOD, AG and PU values. Differences between them in the ratio of nucleus to cytoplasm were highly statistically signifi cant. CONCLUSION Stereological indexes may serve as a screening tool for cervical lesions. The image analysis system is expected to become a new means of cytological assisted diagnosis.

  4. Comparative cervical cytology and conception rate in postpartum dairy cows

    Rahim Ahmadi, Mohammad; NAZIFI, Saeed; Reza Ghaisari, Hamid

    2006-01-01

    During the early postpartum period, multiple bacterial species invade the uterus of cows. Phagocytosis by polymorphonuclear cells is a primary mechanism involved in the elimination of bacteria and improvement of conception rate. Therefore, a relationship could exist between endometrial cytology and conception rate of postpartum dairy cows. In this study 50 postpartum healthy Holstein Frisian dairy cows were selected. They had a normal parturition history and had no mucopurulent discharge from...

  5. Abnormal cervical smears in the unchanged uterine cervix: difficulties in the screening, diagnosis, and treatment of cervical intraepithelial neoplasias and microinvasive cancer

    L. I. Korolenkova

    2011-01-01

    Full Text Available The author analyzes an algorithm for identifying and treating w omen with cervical intraepithelial neoplasias (CIN and microinv asive cancer of the cervix uteri in cases of the hidden area of transformation and in the absence of visible cervical changes. There are excep- tional difficulties of making the diagnosis of epithelial damages due to the incomplete reproducibility of cytological abnormal ities and the low informative value of a histological study of scrapes from the cervical canal. To avoid hypodiagnosis, it is justifiable to prefer human papillomavirus testing (Hybrid Capture 2 (HC2 to repeat smears for the choice of a management tactic. Conization is recommend ed as a diagnostic and/or therapeutic procedure when the viral load is high in over 35-year-old patients with abnormal smears anda hidden transformation area.

  6. Cytological patterns of cervical pap smears with histopathological correlation

    Bhagya Lakshmi Atla

    2015-08-01

    Conclusion: Pap smear is simple, inexpensive and can be performed in the outpatient department. Hence, it should be recommended routinely as a method of improving reproductive health, early detection of premalignant and malignant cervical lesions. [Int J Res Med Sci 2015; 3(8.000: 1911-1916

  7. Comparison of conventional Papanicolaou cytology samples with liquid-based cervical cytology samples from women in Pernambuco, Brazil

    M.O.L.P. Costa

    2015-01-01

    Full Text Available In the present study, we compared the performance of a ThinPrep cytological method with the conventional Papanicolaou test for diagnosis of cytopathological changes, with regard to unsatisfactory results achieved at the Central Public Health Laboratory of the State of Pernambuco. A population-based, cross-sectional study was performed with women aged 18 to 65 years, who spontaneously sought gynecological services in Public Health Units in the State of Pernambuco, Northeast Brazil, between April and November 2011. All patients in the study were given a standardized questionnaire on sociodemographics, sexual characteristics, reproductive practices, and habits. A total of 525 patients were assessed by the two methods (11.05% were under the age of 25 years, 30.86% were single, 4.4% had had more than 5 sexual partners, 44% were not using contraception, 38.85% were users of alcohol, 24.38% were smokers, 3.24% had consumed drugs previously, 42.01% had gynecological complaints, and 12.19% had an early history of sexually transmitted diseases. The two methods showed poor correlation (k=0.19; 95%CI=0.11–0.26; P<0.001. The ThinPrep method reduced the rate of unsatisfactory results from 4.38% to 1.71% (χ2=5.28; P=0.02, and the number of cytopathological changes diagnosed increased from 2.47% to 3.04%. This study confirmed that adopting the ThinPrep method for diagnosis of cervical cytological samples was an improvement over the conventional method. Furthermore, this method may reduce possible losses from cytological resampling and reduce obstacles to patient follow-up, improving the quality of the public health system in the State of Pernambuco, Northeast Brazil.

  8. Psychosocial impact of alternative management policies for low-grade cervical abnormalities: results from the TOMBOLA randomised controlled trial.

    Linda Sharp

    Full Text Available BACKGROUND: Large numbers of women who participate in cervical screening require follow-up for minor cytological abnormalities. Little is known about the psychological consequences of alternative management policies for these women. We compared, over 30-months, psychosocial outcomes of two policies: cytological surveillance (repeat cervical cytology tests in primary care and a hospital-based colposcopy examination. METHODS: Women attending for a routine cytology test within the UK NHS Cervical Screening Programmes were eligible to participate. 3399 women, aged 20-59 years, with low-grade abnormal cytology, were randomised to cytological surveillance (six-monthly tests; n = 1703 or initial colposcopy with biopsies and/or subsequent treatment based on colposcopic and histological findings (n = 1696. At 12, 18, 24 and 30-months post-recruitment, women completed the Hospital Anxiety and Depression Scale (HADS. A subgroup (n = 2354 completed the Impact of Event Scale (IES six weeks after the colposcopy episode or first surveillance cytology test. Primary outcomes were percentages over the entire follow-up period of significant depression (≥ 8 and significant anxiety (≥ 11; "30-month percentages". Secondary outcomes were point prevalences of significant depression, significant anxiety and procedure-related distress (≥ 9. Outcomes were compared between arms by calculating fully-adjusted odds ratios (ORs for initial colposcopy versus cytological surveillance. RESULTS: There was no significant difference in 30-month percentages of significant depression (OR = 0.99, 95% CI 0.80-1.21 or anxiety (OR = 0.97, 95% CI 0.81-1.16 between arms. At the six-week assessment, anxiety and distress, but not depression, were significantly less common in the initial colposcopy arm (anxiety: 7.9% vs 13.4%; OR = 0.55, 95% CI 0.38-0.81; distress: 30.6% vs 39.3%, OR = 0.67 95% CI 0.54-0.84. Neither anxiety nor depression differed between arms at subsequent time

  9. Canine cerebrospinal fluid total nucleated cell counts and cytology associations with the prevalence of magnetic resonance imaging abnormalities

    Hugo TB

    2014-08-01

    Full Text Available Timothy B Hugo, Kathryn L Heading, Robert H Labuc Melbourne Veterinary Specialist Centre, Glen Waverley, Vic, Australia Introduction: The combination of cerebrospinal fluid (CSF analysis and magnetic resonance imaging (MRI are often used to investigate intracranial disease in dogs. The aim of this retrospective study was to determine if the total nucleated cell count (TNCC or cytology findings in abnormal CSF are associated with the prevalence of MRI abnormalities. Materials and methods: For each case, the TNCC was categorized into one of three groups: A (<25×106/L; B (25–100×106/L; and C (>100×106/L. Cytology findings were categorized by the predominant cell type as lymphocytic, monocytoid, neutrophilic, or eosinopilic. MRI descriptions were classified as either normal or abnormal, and abnormal studies were further evaluated for the presence of specific characteristics (multifocal or diffuse disease versus focal disease, positive T2-weighted hyperintensity, positive FLAIR hyperintensity, contrast enhancement, mass effect, and the presence of poorly or well-defined lesion margins. Results: Forty-five dogs met the inclusion criteria and MRI abnormalities were found in 29/45 (64% dogs. TNCCs were not associated with the prevalence of MRI abnormalities or specific characteristics. Cytology categories were significantly associated with the prevalence of MRI abnormalities (P<0.001. Specifically, monocytoid cytology was 22.8 times more likely to have an abnormal MRI than lymphocytic cytology. CSF cytology was not significantly associated with specific abnormal MRI characteristics. Conclusion: There are minimal associations between CSF abnormalities and the prevalence of MRI abnormalities. These results support the continued importance of utilizing both tests when investigating intracranial disease. When CSF analysis must be performed initially, this study has demonstrated that an abnormal CSF with a monocytoid cytology supports the value of

  10. Cervical cancer screening in immigrant women in Italy: a survey on participation, cytology and histology results.

    Campari, Cinzia; Fedato, Chiara; Iossa, Anna; Petrelli, Alessio; Zorzi, Manuel; Anghinoni, Emanuela; Bietta, Carla; Brachini, Angela; Brezzi, Silvia; Cogo, Carla; Giordano, Livia; Giorgi, Daniela; Palazzi, Mauro; Petrella, Marco; Schivardi, Maria R; Visioli, Carmen B; Giorgi Rossi, Paolo

    2016-07-01

    Cervical cancer screening programmes in Italy actively invite all 25-64-year-old resident women for the Pap test every 3 years irrespective of their citizenship. Immigrant women come from countries where screening is absent or poorly implemented and the prevalence of human papillomavirus is often high. These women therefore have significant risk factors for cervical cancer. The Italian Group for Cervical Cancer Screening promoted a survey of all the screening programmes on the participation and the positivity and detection rates in Italian and foreign women in 2009-2011. Aggregated data for participation, cytology results, compliance with colposcopy and histology results were collected, distinguishing between women born in Italy and abroad. All comparisons were age adjusted. Forty-eight programmes out of 120 participated in the immigrant survey, with 3 147 428 invited and 1 427 412 screened Italian women and 516 291 invited and 205 948 screened foreign women. Foreign women had a slightly lower participation rate compared with Italians (39.9 vs. 45.4%), whereas compliance with colposcopy was similar (90%). Foreigners showed a higher risk of pathological findings than Italians: cytology positivity [relative risk (RR)=1.25, 95% confidence interval (CI) 1.24-1.27] and detection rate for cervical intraepithelial neoplasia grade 2 (CIN2) (RR=1.39, 95% CI 1.31-1.47), CIN3 (RR=2.07, 95% CI 1.96-2.18) and cancer (RR=2.68, 95% CI 2.24-3.22). The ratio between cancer and CIN was higher in immigrants (0.06 vs. 0.04, P<0.01). Foreign women had a higher risk of cervical precancer and cancer. Because of their high risk and because opportunistic screening does not cover this often disadvantaged group, achieving high participation in screening programmes for foreigners is critical to further reducing the cervical cancer burden in Italy. PMID:26207563

  11. Cervical cytology as a diagnostic tool for female genital schistosomiasis: Correlation to cervical atypia and Schistosoma polymerase chain reaction

    Pavitra Pillay

    2016-01-01

    Full Text Available Background: Female genital schistosomiasis (FGS is a tissue reaction to lodged ova of Schistosoma haematobium in the genital mucosa. Lesions can make the mucosa friable and prone to bleeding and discharge. Women with FGS may have an increased risk of HIV acquisition, and FGS may act as a cofactor in the development of cervical cancer. Objectives: To explore cytology as a method for diagnosing FGS and to discuss the diagnostic challenges in low-resource rural areas. The correlation between FGS and squamous cell atypia (SCA is also explored and discussed. Cytology results are compared to Schistosoma polymerase chain reaction (PCR in vaginal lavage and urine and in urine microscopy. Materials and Methods: In a clinical study, 394 women aged between 16 and 23 years from rural high schools in KwaZulu-Natal, South Africa, underwent structured interviews and the following laboratory tests: Cytology Papanicolaou (Pap smears for S. haematobium ova and cervical SCA, real-time PCR for Schistosoma-specific DNA in vaginal lavage and urine samples, and urine microscopy for the presence of S. haematobium ova. Results: In Pap smears, S. haematobium ova were detected in 8/394 (2.0%. SCA was found in 107/394 (27.1%, seven of these had high-grade squamous intraepithelial lesion (HSIL. Schistosoma specific DNA was detected in 38/394 (9.6% of vaginal lavages and in 91/394 (23.0% of urines. Ova were found microscopically in 78/394 (19.7% of urines. Conclusion: Schistosoma PCR on lavage was a better way to diagnose FGS compared to cytology. There was a significant association between S. haematobium ova in Pap smears and the other diagnostic methods. In low-resource Schistosoma-endemic areas, it is important that cytology screeners are aware of diagnostic challenges in the identification of schistosomiasis in addition to the cytological diagnosis of SCA. Importantly, in this study, three of eight urines were negative but showed Schistosoma ova in their Pap smear, and

  12. Screening for Cervical Cancer

    ... cervical cancer: • Cytology: This test, also called a Pap test or Pap smear, looks for abnormal changes in cells in ... women ages 21 to 65, screening with a Pap test every 3 years has the highest benefits ...

  13. [Health technology assessment report. Use of liquid-based cytology for cervical cancer precursors screening].

    Ronco, Guglielmo; Confortini, Massimo; Maccallini, Vincenzo; Naldoni, Carlo; Segnan, Nereo; Sideri, Mario; Zappa, Marco; Zorzi, Manuel; Calvia, Maria; Giorgi Rossi, Paolo

    2012-01-01

    OBJECTIVE OF THE PROJECT: Purpose of this Report is to evaluate the impact of the introduction of liquid-based cytology (LBC) in cervical cancer screening in terms of efficacy, undesired effects, costs and implications for organisation. EFFICACY AND UNDESIRED EFFECTS: LBC WITH MANUAL INTERPRETATION: The estimates of cross-sectional accuracy for high-grade intraepithelial neoplasia (CIN2 or more severe and CIN3 or more severe) obtained by a systematic review and meta-analysis published in 2008 were used. This review considered only studies in which all women underwent colposcopy or randomised controlled trials (RCTs) with complete verification of test positives. A systematic search of RCTs published thereafter was performed. Three RCTs were identified. One of these studies was conducted in 6 Italian regions and was of large size (45,174 women randomised); a second one was conducted in another Italian region (Abruzzo) and was of smaller size (8,654 women randomised); a third RCT was conducted in the Netherlands and was of large size (89,784 women randomised). No longitudinal study was available. There is currently no clear evidence that LBC increases the sensitivity of cytology and even less that its introduction increases the efficacy of cervical screening in preventing invasive cancers. The Italian randomised study NTCC showed a decrease in specificity, which was not observed in the other two RCTs available. In addition, the 2008 meta-analysis observed a reduction - even if minimal - in specificity just at the ASC-US cytological cut-off, but also a remarkable heterogeneity between studies. These results suggest that the effect of LBC on specificity is variable and plausibly related to the local style of cytology interpretation. There is evidence that LBC reduces the proportion of unsatisfactory slides, although the size of this effect varies remarkably. LBC WITH COMPUTER-ASSISTED INTERPRETATION: An Australian study, based on double testing, showed a statistically

  14. Serum alpha-antitrypsin in patients with lung cancer or abnormal sputum cytology

    Harris, C.C.; Cohen, M.H.; Connor, R.; Primack, A.; Saccomanno, G.; Talamo, R.C.

    1976-10-01

    Scrum alpha/sub 1/-antitrypsin Pi types and trypsin inhibitory capacity (TIC) were measured in 72 patients with lung cancer and in 196 patients with abnormal sputum cytology but no clinical evidence of lung cancer to determine if a genetic deficiency of alpha/sub 1/-antitrypsin (AAT) predisposes to lung cancer. The distributions of Pi types in these two groups of patients and healthy adults are similar. Serum TIC and AAT concentrations are elevated in lung cancer patients. However, patients with abnormal sputum cytology and no clinical lung cancer have normal levels of serum TIC and AAT. A genetic deficiency of AAT probably does not produce a state of increased susceptibility to the carcinogenic effects of respiratory carcinogens such as tobacco smoke.

  15. ROLE OF SONOGRAPHY IN EVALUATION OF CERVICAL LYMPH NODES AND COMPARISON WITH THEIR CYTOLOGICAL FINDINGS

    Sikarwar

    2015-02-01

    Full Text Available This study was conducted in department of radio - diagnosis, G.R. Medical College, Gwalior for period of one year (October 2013 - September 2014. Ultrasound evaluation of cervical lymph - nodes was done using high frequency (7.5 - MHz linear transducer in 100 p atients. Various Parameters such as size, shape (L/S ratio, hilar echogenicity, micro calcification, color flow pattern and R.I. (resistive index were applied to assess the lymph nodes. Fine needle aspiration cytology of these lymph nodes was done under ultrasound guidance and sent for cytological evaluation. Finally results of ultrasound and cytology compared. In this study ultrasound examination of total 100 patients with subsequent F.N.A.C of cervical lymph node was done. Out of 100 pt 74 were having b enign and 26 were having malignant etiology. In this study we found size criterion has sensitivity of 84.6%, specificity 67.5% PPV 47.8% NPV 92.5%.L/S ratio criterion has sensitivity 88.6%, specificity 75.6%, PPV 56.1%, and NPV 94.9%. Hilar echogenicity cr iterion has sensitivity 76%, specificity 82.4%, PPV 60.6%, NPV 91.9%. Using micro - calcification criterion we got sensitivity of 30.7%, specificity 97.2%, PPV 80%, NPV 80%. Peripheral vascularity criterion has sensitivity of 84.6%, specificity 70.2%, PPV 50 %and NPV 92.8%. Finally R.I. value has sensitivity 92.3% specificity 71.6% PPV 53% and NPV 96.3%. AIMS AND OBJECTIVES: Sonographic examination of cervical lymph nodes. To do FNAC of cervical lymph nodes. Comparison of ultrasound findings of cervical lymph node with Cytological findings. To assess sensitivity, specificity, positive predictive value, and negative predictive value of ultrasound in diagnosing malignant and benign nature of cervical lymph node. The aim of this study is to evaluate the role of u ltrasound in differentiation of normal/reactive nodes from malignant one. MATERIAL AND METHODS: This is a prospective study conducted in department of radio diagnosis, G

  16. 液基细胞学筛查宫颈癌临床研究应用%Liquid-based cytology screening for cervical cancer of clinical research and application

    李彩华

    2010-01-01

    Objective To make a comparative study between the Liquid-based cervical cytology and the Papanicolaou stain cytology,to evaluate the sensitivity of Liquid-based cytology to cervical pathology screening and its clinical value.Methods To apply the cytological analysis on 511 patients in two ways by using the TBS standards to let the two results be analyzed and compared with each other.Results Among the patients who are abnormal both in the Liquid-based cytology and the Papanicolaou cytology,the positive rate of the Liquid-based cytology is obviously higher than the Papanicolaou cytology' s,compared to the tissue biopsy.Conclusion Liquid-based cytology has a higher sensitivity compared with Papanicolaou cytology.It be can able to enhance the rate of detecting,thus achieve the goal of early detection,diagnosis and treatment.%目的 将宫颈液基细胞学与巴氏细胞学染色进行比较研究,评价液基细胞学对宫颈病变筛查的敏感性与临床价值.方法 对511例患者经过两种方法进行细胞学分析采用TBS标准,将其结果进行比较分析.结果 在液基细胞学与巴氏细胞学两种方法均见异常的患者中,以组织学活检做对照,液基细胞学阳性率明显高于巴氏细胞学.结论 液基细胞学与巴氏细胞学诊断相比,具有更高的敏感性,能提高检出率,从而使患者得到早发现、早诊断及早治疗.

  17. COMPARISON BETWEEN DNA DETECTION TEST OF HUMAN PAPILLOMA VIRUS AND THE HYBRID CAPTURE SYSTEM WITH CYTOLOGY IN CERVICAL SMEARS.

    Maristela Gabriel

    2006-06-01

    Full Text Available The Human Papilloma Virus (HPV has significant importance in invasive cervical cancer etiology of and its precursory injuries. Thus, it is necessary the application of molecular methodologies for the precocious diagnosis of this infection. This research has evaluated the effectiveness of Hybrid Capture System (HCS in detecting pathogenic types of HPV. HCS was compared with empirical established cytological criteria in specimens with cellular alterations that were suggestive of HPV infection. The presence of HPV was also evaluated in cytological normal specimens with inflammation and Cervical Intraepithelial Neoplasia (CIN. One hundred and eight women, suspected of HPV infection (clinical or cytological suspicion, were selected. Results demonstrated that both methods were complementary, since Hybrid Capture confirmed results of the cytology. The two methods may be used together to improve the diagnosis. Furthermore, the use of Hybrid Capture test in HPV diagnosis allows the identification of the risk that the virus proportionate.

  18. Application of Bethesda system for conventional cervical cytology: a study of 340 cases

    Lalji G. Valiya

    2015-09-01

    Results: Overall incidence of unsatisfactory smears was 9.4%, of squamous cell abnormality was 4.1% and of glandular cell abnormality was 1.2%. Highest frequency of epithelial cell abnormalities (squamous as well as glandular was seen in 61-70 years age-group women (35.71% and in women presented with complaints of post-menopausal bleeding (22.5%. Conclusions: The study had shown a relatively low prevalence of epithelial abnormalities in cervical smears. The 2001 Bethesda system seems to reduce the number of cervical smear diagnoses of Atypical Squamous Cells (ASC, without causing any impairment in the diagnosis of High grade Squamous Intraepithelial Lesion (HSIL thus decreasing the number of unnecessary interventions. [Int J Res Med Sci 2015; 3(9.000: 2252-2258

  19. Mycoplasma genitalium infection is associated with microscopic signs of cervical inflammation in liquid cytology specimens.

    Dehon, Patricia M; McGowin, Chris L

    2014-07-01

    Cervicitis is a common clinical finding often attributed to sexually transmitted infections (STIs), but no etiologic agent is identified in the majority of cases. In this study, we comparatively assessed inflammation among the common infectious etiologies of cervicitis and assessed the potential value of liquid cytology specimens for predicting STIs. Among 473 Louisiana women at low risk for acquiring STIs, the prevalences of Mycoplasma genitalium, Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis in liquid-based cytology specimens were 1.5, 2.1, 0.6, and 4.4%, respectively. N. gonorrhoeae and human papillomavirus 18 (HPV18) infections were significantly more common among subjects infected with M. genitalium. Using direct microscopy, we observed significant increases in leukocyte infiltrates among subjects with monoinfections with M. genitalium or C. trachomatis compared to women with no detectable STIs. Inflammation was highest among subjects with M. genitalium. Using a threshold of ≥ 2 leukocytes per epithelial cell per high-powered field, the positive predictive values for M. genitalium, C. trachomatis, N. gonorrhoeae, and T. vaginalis were 100, 70, 67, and 20%, respectively. Several novel M. genitalium genotypes were identified, all of which were predicted to be susceptible to macrolide antibiotics, suggesting that different strains may circulate among low-risk women and that macrolide resistance is substantially lower than in high-risk populations. This study highlights the capacity of M. genitalium to elicit cervical inflammation and, considering the strong epidemiologic associations between M. genitalium and human immunodeficiency virus (HIV), provides a potential mechanism for acquisition and shedding of HIV via chronic leukocyte recruitment to the cervical mucosa. PMID:24759719

  20. Bonafide, type-specific human papillomavirus persistence among HIV-positive pregnant women: predictive value for cytological abnormalities, a longitudinal cohort study

    Angela RI Meyrelles

    2016-02-01

    Full Text Available This study investigated the rate of human papillomavirus (HPV persistence, associated risk factors, and predictors of cytological alteration outcomes in a cohort of human immunodeficiency virus-infected pregnant women over an 18-month period. HPV was typed through L1 gene sequencing in cervical smears collected during gestation and at 12 months after delivery. Outcomes were defined as nonpersistence (clearance of the HPV in the 2nd sample, re-infection (detection of different types of HPV in the 2 samples, and type-specific HPV persistence (the same HPV type found in both samples. An unfavourable cytological outcome was considered when the second exam showed progression to squamous intraepithelial lesion or high squamous intraepithelial lesion. Ninety patients were studied. HPV DNA persistence occurred in 50% of the cases composed of type-specific persistence (30% or re-infection (20%. A low CD4+T-cell count at entry was a risk factor for type-specific, re-infection, or HPV DNA persistence. The odds ratio (OR was almost three times higher in the type-specific group when compared with the re-infection group (OR = 2.8; 95% confidence interval: 0.43-22.79. Our findings show that bonafide (type-specific HPV persistence is a stronger predictor for the development of cytological abnormalities, highlighting the need for HPV typing as opposed to HPV DNA testing in the clinical setting.

  1. Bonafide, type-specific human papillomavirus persistence among HIV-positive pregnant women: predictive value for cytological abnormalities, a longitudinal cohort study

    Meyrelles, Angela RI; Siqueira, Juliana D; dos Santos, Pâmela P; Hofer, Cristina B; Luiz, Ronir R; Seuánez, Héctor N; Almeida, Gutemberg; Soares, Marcelo A; Soares, Esmeralda A; Machado, Elizabeth S

    2016-01-01

    This study investigated the rate of human papillomavirus (HPV) persistence, associated risk factors, and predictors of cytological alteration outcomes in a cohort of human immunodeficiency virus-infected pregnant women over an 18-month period. HPV was typed through L1 gene sequencing in cervical smears collected during gestation and at 12 months after delivery. Outcomes were defined as nonpersistence (clearance of the HPV in the 2nd sample), re-infection (detection of different types of HPV in the 2 samples), and type-specific HPV persistence (the same HPV type found in both samples). An unfavourable cytological outcome was considered when the second exam showed progression to squamous intraepithelial lesion or high squamous intraepithelial lesion. Ninety patients were studied. HPV DNA persistence occurred in 50% of the cases composed of type-specific persistence (30%) or re-infection (20%). A low CD4+T-cell count at entry was a risk factor for type-specific, re-infection, or HPV DNA persistence. The odds ratio (OR) was almost three times higher in the type-specific group when compared with the re-infection group (OR = 2.8; 95% confidence interval: 0.43-22.79). Our findings show that bonafide (type-specific) HPV persistence is a stronger predictor for the development of cytological abnormalities, highlighting the need for HPV typing as opposed to HPV DNA testing in the clinical setting. PMID:26872340

  2. Evaluation of adjunctive HPV testing by Hybrid Capture II® in women with minor cytological abnormalities for the diagnosis of CIN2/3 and cost comparison with colposcopy

    Kyi May S

    2003-09-01

    Full Text Available Abstract Background As a proportion of high grade cervical intraepithelial neoplasia (CIN2/3 are associated with equivocal cervical smears, which show borderline or mild dyskaryosis, follow up with repeat smears, colposcopy and biopsy is required. Since infection with oncogenic Human Papilloma Virus (HR HPV has been found to be associated with the development of cervical cancer, HRHPV testing appears to be an alternative. Objective The present study assesses if HRHPV testing can predict CIN2/3 in women referred for mild dyskaryosis and borderline cytological changes in an health authority with a referral policy to colposcopy after one single mild dyskaryotic Pap smear. Study design The HPV DNA Hybrid Capture II (Digene/Abbott, Maidenhead was evaluated on 110 consenting women with mild dyskaryosis and 23 women with persistent borderline changes, who were referred for colposcopy between May and November 2001. A cost comparison between two referral policies was performed. Results CIN2/3 was diagnosed histologically in 30 of 133 women (22% with minor cytological abnormalities. As the Receiver Operator Characteristics plot suggested a cut-off of 3 pg/ml the HRHPV HCII was evaluated at 3 RLU (relative light units and at the manufacturer's recommendation of 1 RLU. At both cut-offs sensitivity and negative predictive value were high at 97%. Specificity was low at 37% at a cut-off of 1 pg/ml and 46% at a cut-off of 3 RLU. To remain cost neutral in comparison to immediate colposcopy the costs for one HR HPV HC II must not exceed £34.37 per test at a cut off of 3 pg/ml. Conclusion The negative likelihood ratio (NLR was of good diagnostic value with 0.089 at 1 RLU and 0.072 at 3 RLU, which reduces the post-test probability for CIN2/3 to 2% in this population. Women with minor cytological disorders can be excluded from colposcopy on a negative HR HPV result. Specificity can be improved by restricting HR HPV testing to women with persistent borderline

  3. Early Lung Cancer Detection in Uranium Miners with Abnormal Sputum Cytology

    Saccomanno, G.

    2000-06-30

    ''Early Lung Cancer Detection in Uranium Miners with Abnormal Sputum Cytology'' was funded by the Department of Energy to monitor the health effects of radon exposure and/or cigarette smoke on uranium workers from the Colorado Plateau. The resulting Saccomanno Uranium Workers Archive and data base has been used as a source of information to prove eligibility for compensation under the Radiation Exposure Compensation Act and as the source of primary data tissue for a subcontract and other collaborations with outside investigators. The latter includes a study of radon exposure and lung cancer risk in a non-smoking cohort of uranium miners (subcontract); a study of genetic markers for lung cancer susceptibility; and a study of {sup 210}Pb accumulation in the skull as a biomarker of radon exposure.

  4. Cervical Abnormalities Are More Common among Indigenous than Other Australian Women: A Retrospective Record-Linkage Study, 2000–2011

    Whop, Lisa J.; Baade, Peter; Garvey, Gail; Cunningham, Joan; Brotherton, Julia M. L.; Lokuge, Kamalini; Valery, Patricia C.; O’Connell, Dianne L.; Canfell, Karen; Diaz, Abbey; Roder, David; Gertig, Dorota M.; Moore, Suzanne P.; Condon, John R.

    2016-01-01

    Indigenous Australian women have much higher incidence of cervical cancer compared to non-Indigenous women. Despite an organised cervical screening program introduced 25 years ago, a paucity of Indigenous-identified data in Pap Smear Registers remains. Prevalence of cervical abnormalities detected among the screened Indigenous population has not previously been reported. We conducted a retrospective cohort study of population-based linked health records for 1,334,795 female Queensland residents aged 20–69 years who had one or more Pap smears during 2000–2011; from linked hospital records 23,483 were identified as Indigenous. Prevalence was calculated separately for Indigenous and non-Indigenous women, for cytology-detected low-grade (cLGA) and high-grade abnormalities (cHGA), and histologically confirmed high-grade abnormalities (hHGA). Odds ratios (OR) were estimated from logistic regression analysis. In 2010–2011 the prevalence of hHGA among Indigenous women (16.6 per 1000 women screened, 95% confidence interval [CI] 14.6–18.9) was twice that of non-Indigenous women (7.5 per 1000 women screened, CI 7.3–7.7). Adjusted for age, area-level disadvantage and place of residence, Indigenous women had higher prevalence of cLGA (OR 1.4, CI 1.3–1.4), cHGA (OR 2.2, CI 2.1–2.3) and hHGA (OR 2.0, CI 1.9–2.1). Our findings show that Indigenous women recorded on the Pap Smear Register have much higher prevalence for cLGA, cHGA and hHGA compared to non-Indigenous women. The renewed cervical screening program, to be implemented in 2017, offers opportunities to reduce the burden of abnormalities and invasive cancer among Indigenous women and address long-standing data deficiencies. PMID:27064273

  5. Cervical Abnormalities Are More Common among Indigenous than Other Australian Women: A Retrospective Record-Linkage Study, 2000-2011.

    Whop, Lisa J; Baade, Peter; Garvey, Gail; Cunningham, Joan; Brotherton, Julia M L; Lokuge, Kamalini; Valery, Patricia C; O'Connell, Dianne L; Canfell, Karen; Diaz, Abbey; Roder, David; Gertig, Dorota M; Moore, Suzanne P; Condon, John R

    2016-01-01

    Indigenous Australian women have much higher incidence of cervical cancer compared to non-Indigenous women. Despite an organised cervical screening program introduced 25 years ago, a paucity of Indigenous-identified data in Pap Smear Registers remains. Prevalence of cervical abnormalities detected among the screened Indigenous population has not previously been reported. We conducted a retrospective cohort study of population-based linked health records for 1,334,795 female Queensland residents aged 20-69 years who had one or more Pap smears during 2000-2011; from linked hospital records 23,483 were identified as Indigenous. Prevalence was calculated separately for Indigenous and non-Indigenous women, for cytology-detected low-grade (cLGA) and high-grade abnormalities (cHGA), and histologically confirmed high-grade abnormalities (hHGA). Odds ratios (OR) were estimated from logistic regression analysis. In 2010-2011 the prevalence of hHGA among Indigenous women (16.6 per 1000 women screened, 95% confidence interval [CI] 14.6-18.9) was twice that of non-Indigenous women (7.5 per 1000 women screened, CI 7.3-7.7). Adjusted for age, area-level disadvantage and place of residence, Indigenous women had higher prevalence of cLGA (OR 1.4, CI 1.3-1.4), cHGA (OR 2.2, CI 2.1-2.3) and hHGA (OR 2.0, CI 1.9-2.1). Our findings show that Indigenous women recorded on the Pap Smear Register have much higher prevalence for cLGA, cHGA and hHGA compared to non-Indigenous women. The renewed cervical screening program, to be implemented in 2017, offers opportunities to reduce the burden of abnormalities and invasive cancer among Indigenous women and address long-standing data deficiencies. PMID:27064273

  6. Fine needle aspiration cytology: a tool to diagnose cervical and vaginal endometriosis in low-income places.

    Oliveira-Filho, Manoel; Rao, Vietla S; Eleutério, José; Medeiros, Francisco C

    2013-01-01

    Regarded as infrequent, vaginal and cervical endometriosis is probably more common than is generally realized. The apparent rarity of the lesion may be ascribed to the limited awareness of its clinical appearance, combined with technical difficulty in obtaining suitable biopsy material for confirmation. Thus, clinical recognition and tissue confirmation become essential. This paper focuses on vaginal and cervical endometriosis, documenting the clinical, macroscopic, cytological and colposcopic findings in 4 cases seen at a single physical vaginal examination. Diagnosis in these patients was facilitated and improved by fine needle aspiration cytology and confirmed by histology. This technique, which is not used for the diagnosis of endometriosis, could be an option in low-income areas. PMID:23406608

  7. Knowledge, attitudes and practices on cervical cytology-uterine in women from sincelejo and Cartagena, colombia

    Barrrios-Garcia Lia

    2011-12-01

    Full Text Available Although in Colombia screening programs of cervical cancer have achieved high levelsof coverage, cervical cancer has the first places in incidence and mortality. There isthe need to identify factors influencing it, among them is to investigate the level ofawareness of women about the screening test, their attitudes to screening and itspractices. For this we made a survey of 505 women 13 to 60 years who have had sexual life, living in the cities of Cartagena and Sincelejo (Colombia.The results showthat virtually all women have knowledge of cervical cytology, 94.5% of women havemade at least once. This percentage is higher in the range of 40 to 60 years where itreaches 99% in younger women this percentage decrease. In defining its usefulness,only 73.8% responded accurately. 50% reported unpleasant aspects related to themaking of the cytology, such as fear, and fear of a cancer diagnosis. A fail to rememberis the main factor for not claiming the results.These data show that the percentage ofwomen with sexual life that ignores the usefulness of cytology or never have practicedis minimal, which leads to the conclusion that ineffective screening programs to reducecervical cancer rates depends on other factors that should be investigated.RESUMEN:Aunque en Colombia los programas de prevención del cáncer de cérvix han alcanzadoaltos niveles de cobertura, todavía este ocupa los primeros lugares en incidencia ymortalidad. Existe la necesidad de identificar los factores que influyen en ello, por tantoes importante investigar el nivel de conocimiento de las mujeres sobre la prueba detamizaje, su actitud frente a la misma y sus prácticas relacionadas. Se realizó encuestaa 505 mujeres entre 13 y 60 años edad, que habían tenido vida sexual, residentes en lasciudades de Cartagena y Sincelejo (Colombia. Los resultados revelan que prácticamentetodas las mujeres tienen conocimientos sobre citología cérvico-uterina. El 94.5% delas mujeres se la han

  8. A method for quantitative analysis of clump thickness in cervical cytology slides.

    Fan, Yilun; Bradley, Andrew P

    2016-01-01

    Knowledge of the spatial distribution and thickness of cytology specimens is critical to the development of digital slide acquisition techniques that minimise both scan times and image file size. In this paper, we evaluate a novel method to achieve this goal utilising an exhaustive high-resolution scan, an over-complete wavelet transform across multi-focal planes and a clump segmentation of all cellular materials on the slide. The method is demonstrated with a quantitative analysis of ten normal, but difficult to scan Pap stained, Thin-prep, cervical cytology slides. We show that with this method the top and bottom of the specimen can be estimated to an accuracy of 1 μm in 88% and 97% of the fields of view respectively. Overall, cellular material can be over 30 μm thick and the distribution of cells is skewed towards the cover-slip (top of the slide). However, the median clump thickness is 10 μm and only 31% of clumps contain more than three nuclei. Therefore, by finding a focal map of the specimen the number of 1 μm spaced focal planes that are required to be scanned to acquire 95% of the in-focus material can be reduced from 25.4 to 21.4 on average. In addition, we show that by considering the thickness of the specimen, an improved focal map can be produced which further reduces the required number of 1 μm spaced focal planes to 18.6. This has the potential to reduce scan times and raw image data by over 25%. PMID:26477005

  9. A COMPARATIVE STUDY OF FINE NEEDLE ASPIRATION CYTOLOGY AND OPEN BIOPSY IN THE DIAGNOSIS OF CERVICAL LYMPHADENOPATHY IN RURAL TERTIARY CENTRE

    Karunamoorthy

    2016-04-01

    Full Text Available ABSTRACT Lymphadenopathy is a very common clinical manifestation of many diseases, defined as an abnormality in the size or character of lymph nodes, caused by the invasion or propagation of either inflammatory cells or neoplastic cells into the node. The clinical examination may be inaccurate in differentiating benign from neoplastic enlargement of the lymph node. Surgical excision of a palpable peripheral lymph node is relatively simple; it does require anaesthesia, strict sterility and theatre time and it leaves behind a scar. Fine needle aspiration cytology offers the advantages of an immediate with little cost and trauma. The present study is being undertaken to evaluate its accuracy in the diagnosis of tuberculosis and malignancy of the cervical lymph nodes. AIM AND OBJECTIVE To assess the usefulness of FNAC in the diagnosing cervical lymph node enlargement and cytological features of common pathological conditions affecting the lymph nodes and to evaluate the diagnostic accuracy of FNAC and open biopsy in cervical lymphadenopathy. MATERIALS AND METHODS A total of 100 patients were subjected for the study at CMCH and RC, Irungalur. FNAC was performed under aseptic precaution of the cervical lymph nodes using a 22G needle and HPE correlation was obtained for these patients remaining. These patients were subjected to surgical excision for radical dissection and the HPE correlation for specimen was obtained. RESULTS The result shows that the age wise distribution of patient with benign lesions were within 21-25 age groups and those with malignant lesion were in 31-50 age groups. Among the incidence of male-to-female ratio was 107:93. The duration of symptom was <6 months (<3 cm 50%/3-6 months 45%. The gross morphology shows that TB adenitis patient with positive matting nodes were 18 out of 25 patients were positive for matted nodes (94.47%. According to AJCC cancer staging the size of the nodes were assessed, which shows most of the nodes <3

  10. Comparison of conventional Papanicolaou smear and SurePath® liquid-based cytology in the Copenhagen population screening programme for cervical cancer

    Kirschner, Benny; Simonsen, Kåre; Junge, Jette

    2006-01-01

    OBJECTIVE: To compare diagnostic performance of conventional Papanicolaou smear with SurePath liquid-based cytology in a population screening programme. METHODS: A retrospective comparison was performed on data from two 18-month periods of the screening programme for cervical cancer...... in the municipality of Copenhagen with conventional Papanicolaou technique (n = 82,116) and liquid-based cytology (n = 84,414). RESULTS: After the conversion to liquid-based cytology the percentage of unsatisfactory samples decreased from 2.3% to 0.3% (P cervical samples lacking......-based technique. CONCLUSIONS: This study showed the number of unsatisfactory samples to be significantly reduced with the liquid-based technique. The data suggest that there is an increased detection rate of cervical precancerous lesions with liquid-based cytology, but the number of false positive tests is still...

  11. Cytological detection of cervical carcinoma with new cytochemical markers and flow microanalysis. [Mithramycin, chromomycin

    Jensen, R.H.; King, E.B.; Mayall, B.H.

    1976-04-21

    Human cervical cell samples have been stained with mithramycin or chromomycin A3 in an effort to analyze such preparations for premalignant abnormal cells by flow cytometry. Fluorescence from mithramycin or chromomycin A3-stained cells is similar to the fluorescence from DNA in solution when it is complexed with these same antibiotics. Mithramycin or chromomycin A3-stained cells exhibit nuclear specific fluorescence which, for exponentially grown tissue culture cells, reflects the cellular DNA content. All these facts indicate that DNA is the sole intracellular binding site for these antibiotics. Flow cytofluorometry on mithramycin or chromomycin A3-stained cervical cells using a single parameter, fluorescence intensity per cell, appears to be a poor diagnostic procedure. However, simultaneous analysis of cellular fluorescence and small angle light scatter permits a relatively detailed description of each cell sample and appears to be useful for automated sample diagnosis. Qualitative diagnostic analysis based on comparisons of two parameter histograms agrees moderately well with cytomorphological diagnosis on the same cell samples. A technique for quantitation in comparing two parameter histograms is presented and promises to be useful for further progress in flow analysis of human cervical cell samples.

  12. Cytomorphological evaluation of squamous cell abnormalities observed on cervical smears in government medical college, Jabalpur, India: a five year study

    Radhika Rajesh Nandwani

    2016-03-01

    Results: The overall frequency of normal, inadequate, inflammatory, and abnormal smears was 11.86%, 5.73%, 74.98% and 13.2% respectively. Atypical squamous cell carcinoma of undermined significance (ASCUS was seen in 3.61%, squamous intraepithelial lesion (SIL was seen in 5.36%, low grade squamous intraepithelial lesion (LSIL was seen in 2.59% while high grade squamous intraepithelial lesion (HSIL was seen in 2.77%. Invasive carcinoma was seen in 3.69%. The premalignant epithelial abnormalities like ASCUS, LSIL and HSIL were found to be highest in the age group of 31-50 years in our study, which correlated well with other similar studies. Conclusions: Hence we should advocate regular cervical cytology (PAP smear study, which can help to treat cervix lesions early before the progress into cervical cancer. Early detection is the only key to saving a woman's life as the later the abnormalities are discovered; mortality, morbidity and treatment cost all increase. [Int J Res Med Sci 2016; 4(3.000: 794-799

  13. Comparative analysis of cervical cytology and human papillomavirus genotyping by three different methods in a routine diagnostic setting.

    Padalko, Elizaveta; Ali-Risasi, Catherine; Mesmaekers, Stéphanie; Ryckaert, Inge; Van Renterghem, Lieve; Lambein, Kathleen; Bamelis, Mieke; De Mey, Anja; Sturtewagen, Yolande; Vastenavond, Hilde; Broeck, Davy Vanden; Weyers, Steven; Praet, Marleen

    2015-09-01

    Application of Bethesda guidelines on cervical cytology involves human papillomavirus (HPV) determinations on all ASC-US and ASC-H results. We compared HPV DNA results in view of the eventual development of a cervical intraepithelial neoplasia lesion determined either on cytology or histology. A total of 214 liquid-based cytology samples were analysed. Three different HPV DNA methods were applied: the Abbott RealTime High Risk HPV test, INNO-Lipa HPV Genotyping Extra and Full Spectrum PCR HPV Amplification and Detection/Genotyping System by Lab2Lab Diagnostic Service. A comparison of these three methods showed full concordance only for 49 samples (23%), and 27 (13%) of the samples were discordant in indicating the presence of the high-risk HPV type. Out of 214 patients, 88 were selected who presented with a cervical intraepithelial neoplasia or a VAIN lesion at follow-up cytology or histology. In this group, full concordance with HPV genotyping was present only in 19 (22%) follow-up samples. Nine (10%) follow-up samples showed discordant results for the presence of a high-risk genotype between the three genotyping methods tested either by negativity for high-risk HPV by one of the methods (n=6) or by failure to genotype HPV (n=2), or by a combination of both (n=1). Moreover, discordance for the detection of HPV16 or HPV18 was observed between the three HPV DNA genotyping methods used in 9 (10%) follow-up samples. In addition, the performance of genotyping methods on 20 external quality samples was assessed, showing discordant results for HPV16 and HPV18. Major differences were found in the genotyping results according to the HPV DNA method. Our findings highlight the importance of careful interpretation of data from studies using different HPV genotyping methods and underline the need for standardization by method validation in clinical laboratories, especially in the setting of primary HPV screening. PMID:25370681

  14. Clinical utility of Liqui-PREP™ cytology system for primary cervical cancer screening in a large urban hospital setting in China

    Deshou Hao

    2009-01-01

    Full Text Available Background: Liquid based cytology (LBC has been reported to increase the sensitivity of cervical cytology, in comparison with conventional cytology Pap smear (CPS. Most LBC systems though require expensive automated devices. Aims: To evaluate the efficiency of a new and inexpensive LBC system - LPT cytology system. Materials and Methods: Cervical screening was performed on 31500 patients utilizing the LPT cytology system test from January 2006 to May 2007. A similar number (n = 31500 of CPS were performed from January 2004 to July 2006. All cytology positive patients underwent colposcopy and cervical biopsy with histopathology examination. Fifty cases positive both on cytology and biopsy were submitted to the high-risk human papillomavirus (HPV L1 protein (HR-HPV L1 tests. Results: The LPT cytology system adequately preserved cellular structure for morphologic evaluation. There was a significant difference of the histology/cytology diagnosis concordant rate between that of the CPS and LPT systems [93.6 vs. 78.4%, p=0.001]. The significant higher concordant rate was also seen in the low grade intraepithelial lesion (LSIL (95.4 vs. 78.9%, p=0.001 and in high grade intraepithelial lesion (HSIL (90.2 vs. 76.1%, p=0.001 cytology diagnosis. There was no statistical difference in rate in atypical glandular cells (AGC (61.5 vs. 60% and glandular cell carcinoma (GCC (83.3 vs. 80%. LPT resulted in a marked increased global detection over the CPS. Nuclear expression of HPV L1 was seen in 34% (17/50 of cases. Conclusions: LPT showed an increase in detection rate compared to CPS (P = 0.001 and a significantly higher histological versus cytological concordant referral rate.

  15. Value of Cervical Smear Cytology for Cervical Cancer Screening%宫颈刮片脱落细胞学检查对宫颈癌筛选的价值

    黄瑞虹

    2013-01-01

    Objective:To explore the clinical value of cervical smear cytology for cervical cancer screening.Methods:5963 cases of gynecological examination of women underwent the cervical scraping levy cytology and TCT detection,the positive rate was compared.The TCT test result showed positive or suspected positive underwent colposcopy sampling biopsy,and was compared with the results of TCT test.Results:The positive rate of TCT detection of cervical lesions was significantly higher than that in the control group(P<0.01).There were a total of 538 cases of positive or suspected positive subjects by TCT detected, 449 cases of cervical precancerous lesions detected by biopsy,the detection rate was 83.46%.Conclusion:TCT detection of cervical precancerous lesions can help to improve clinical detection rate,the more significant of TCT diagnosis of abnormalities,the detection rate of biopsy is higher.%  目的:探讨宫颈刮片脱落细胞学检查对宫颈癌筛查的临床价值。方法:5963例妇科体检妇女均行宫颈刮片脱落细胞学检查及TCT检测,比较阳性率;TCT检测结果为阳性或疑似阳性受检者行阴道镜取样病理活检,并与TCT检测结果比较。结果:TCT检测宫颈病变的阳性率明显高于对照组(P<0.01);TCT检测共发现阳性或疑似阳性受检者538例,病理活检共检出宫颈癌前病变449例,检出率83.46%。结论:TCT检测有利于提高宫颈癌前病变的临床检出率,TCT诊断的异常性越显著,病理活检的检出率越高。

  16. Anal cytological abnormalities and anal HPV infection in men with Centers for Disease Control group IV HIV disease.

    Palefsky, J. M.; Holly, E. A.; Ralston, M L; Arthur, S.P.; Hogeboom, C J; Darragh, T M

    1997-01-01

    OBJECTIVE: To characterise risk factors for abnormal and cytology and anal human papilloma virus (HPV) infection in homosexual/bisexual men with advanced HIV related immunosuppression. DESIGN: Cross sectional study of men with Centers for Disease Control group IV HIV disease. SETTING: The University of California San Francisco, AIDS Clinic. PATIENTS: 129 homosexual or bisexual men with group IV HIV disease. METHODS: A questionnaire was administered detailing tobacco, alcohol and recreational ...

  17. EUROarray human papillomavirus (HPV) assay is highly concordant with other commercial assays for detection of high-risk HPV genotypes in women with high grade cervical abnormalities.

    Cornall, A M; Poljak, M; Garland, S M; Phillips, S; Machalek, D A; Tan, J H; Quinn, M A; Tabrizi, S N

    2016-06-01

    The purpose of this study was to evaluate the performance of the EUROIMMUN EUROArray HPV genotyping assay against the Roche Cobas 4800, Roche HPV Amplicor, Roche Linear Array and Qiagen Hybrid Capture 2 assays in the detection of high-risk HPV (HR-HPV) from liquid based cervical cytology samples collected from women undergoing follow-up for abnormal cervical cytology results. Cervical specimens from 404 women undergoing management of high-grade cytological abnormality were evaluated by EUROarray HPV for detection of HR-HPV genotypes and prediction of histologically-confirmed cervical intraepithelial neoplasia grade 2 or higher (≥CIN2). The results were compared to Hybrid Capture 2, Cobas 4800 HPV, Amplicor and Linear Array HPV. Positivity for 14 HR-HPV types was 80.0 % for EUROarray (95 % CI; 75.7-83.8 %). Agreement (κ, 95 % CI) between the EUROarray and other HPV tests for detection of HR-HPV was good to very good [Hybrid Capture κ = 0.62 (0.54-0.71); Cobas κ = 0.81 (0.74-0.88); Amplicor κ = 0.68 (0.60-0.77); Linear Array κ = 0.77 (0.70-0.85)]. For detection of HR-HPV, agreement with EUROarray was 87.90 % (Hybrid Capture), 93.58 % (Cobas), 92.84 % (Amplicor) and 92.59 % (Linear Array). Detection of HR-HPV was not significantly different between EUROarray and any other test (p < 0.001). EUROarray was concordant with other assays evaluated for detection of high-risk HPV and showed sensitivity and specificity for detection of ≥ CIN2 of 86 % and 71 %, respectively. PMID:27048314

  18. Anal cytological abnormalities and epidemiological correlates among men who have sex with men at risk for HIV-1 infection

    Donà Maria

    2012-10-01

    Full Text Available Abstract Background The incidence of anal cancer, a Human Papillomavirus (HPV-related neoplasia, has been increasing in recent decades, mainly in men who have sex with men (MSM. Cytological changes of the anal epithelium induced by HPV can be detected through an anal pap smear. This study aimed to evaluate the prevalence and epidemiological correlates of anal cytological abnormalities among relatively young MSM at risk for HIV-1 infection, to help clarify whether or not this population deserves further investigation to assess the presence of anal cancer precursor lesions. Methods MSM were recruited among attendees of a large STI clinic for a HIV-1 screening program. Anal samples, collected with a Dracon swab in PreservCyt, were used both for liquid-based cytology and HPV testing by the Linear Array HPV Genotyping Test. Data regarding socio-demographic characteristics and sexual behavior were collected in face-to-face interviews. Results A total of 346 MSM were recruited (median age 32 years. Overall, 72.5% of the individuals had an anal HPV infection, with 56.1% of them being infected by oncogenic HPV genotypes. Anal cytological abnormalities were found in 29.8% of the cases (16.7% ASC-US and 13.1% L-SIL. Presence of ASC-US+ was strongly associated with infection by any HPV type (OR=4.21, 95% CI: 1.97-9.23, and particularly by HPV 16 and/or 18 (OR=5.62, 95% CI: 2.33-13.81. A higher proportion of ASC-US+ was found in older MSM, in those with a higher number of lifetime partners and in those with a history of ano-genital warts. However, none of these variables or the others analyzed showed any significant association with abnormal cytological findings. Conclusions The presence of anal cytological abnormalities in about one third of the recruited MSM and their strong association with HPV infection, in particular that caused by HPV 16 and/or 18, might provide a further complement to the data that now support the introduction of HPV vaccination among

  19. Promoter Methylation of p16INK4A, hMLH1, and MGMT in Liquid-Based Cervical Cytology Samples Compared with Clinicopathological Findings and HPV Presence

    Aris Spathis

    2011-01-01

    Full Text Available Cervical cancer is a common cancer inflicting women worldwide. Even though, persistent infection with oncogenic Human Papillomavirus (HPV types is considered the most important risk factor for cervical cancer development, less than 5% of women with HPV will eventually develop cervical cancer supporting that other molecular events, like methylation-dependent inactivation of tumor suppressor genes, may cocontribute in cervical carcinogenesis. We analyzed promoter methylation of three candidate genes (p16, MGMT, and hMLH1 in 403 liquid-based cytology samples. Methylation was commonly identified in both benign and pathologic samples and correlated with higher lesion grade determined by cytological, colposcopical, or histological findings, with HPV DNA and mRNA positivity of specific HPV types and p16INK4A protein expression. Overall accuracy of methylation is much lower than traditional diagnostic tests ranking it as an ancillary technique with more data needed to identify the exact value of methylation status in cervical carcinogenesis.

  20. Comparative analysis of DNA quantitative cytology and TCT in cervical cancer screening%宫颈癌筛查中DNA定量分析与薄层液基细胞学检查对比分析

    钟萍萍; 顾依群; 王军; 周秋立; 王爱春

    2014-01-01

    Objective To compare the cytology diagnostic accuracy of DNA quantitative cytology and thinprep cytology test(TCT) in cervical cancer screening for exploring effective method in cervical cancer screening.Methods TCT and DNA quantitative cytology were carried out in 7 470 women.Women with positive results additionally underwent high risk human papillomavirus (HPV) detection.Positive cytologic diagnosis included atypical squamous cells(ASC) or above in TCT and DNA index 2.5 or above in DNA quantitative cytology.Results The positive rate was 13.0% in method of DNA quantitative cytology and 13.7% in method of TCT in 7 470 cases.Positive rate of the two methods had no significant difference in cervical cancer screening(x2 =1.813,P =0.178).There was significant difference in positive rate of TCT between cases with DNA index≥2.5,<4.5,heteroploid cells more than 3 or DNA index≥4.5 and cases with DNA index≥2.5,<4.5,heteroploid cells less than 3.Every grade of TCT abnormality had abnormal DNA index.Abnormality of DNA index had an increasing trend with the severity of TCT.Infection rate of high risk HPVs had significant difference in different grades of DNA index (x2 =62.648,P =0.000).Conclusion Combination of DNA quantitative cytology and TCT is an effective method in cervical cancer screening,which can reduce misdiagnosis,guide cervical biopsy and suggest infection of high risk of HPVs.%目的 比较DNA定量分析与薄层液基细胞学(TCT)检查在宫颈癌中的应用价值,以提高细胞学诊断的准确性.方法 对7 470例妇女行宫颈薄层液基细胞学(TCT)及DNA定量分析,结果异常者用二代基因杂交捕获法(HC2)检测高危型人乳头状瘤病毒(HPV),TCT在ASC及以上病变为阳性,DNA指数≥2.5为阳性.结果 7470例患者,用DNA定量分析法检测阳性率为13.0%,TCT检查阳性率为13.7%,两种检查方法差异无统计学意义(x2 =1.813,P=0.178);≥3个细胞2.5≤DNA指数<4.5者及DNA指数≥4.5

  1. Primary Screening for Cervical Cancer Based on High-Risk Human Papillomavirus (HPV) Detection and HPV 16 and HPV 18 Genotyping, in Comparison to Cytology

    Constantinidis, Theocharis; Constantinidis, Theodoros C.

    2015-01-01

    Objectives The objective of the present study is to assess the performance of a high-risk human papillomavirus (HR-HPV) DNA test with individual HPV-16/HPV-18 genotyping as a method for primary cervical cancer screening compared with liquid-based cytology (LBC) in a population of Greek women taking part in routine cervical cancer screening. Methods The study, conducted by the “HEllenic Real life Multicentric cErvical Screening” (HERMES) study group, involved the recruitment of 4,009 women, aged 25–55, who took part in routine cervical screening at nine Gynecology Departments in Greece. At first visit cervical specimens were collected for LBC and HPV testing using the Roche Cobas 4800 system. Women found positive for either cytology or HPV were referred for colposcopy, whereas women negative for both tests will be retested after three years. The study is ongoing and the results of the first screening round are reported herein. Results Valid results for cytology and HPV testing were obtained for 3,993 women. The overall prevalence of HR-HPV was 12.7%, of HPV-16 2.7% and of HPV-18 1.4%. Of those referred for colposcopy, cervical intraepithelial neoplasia grade 2 or worse (CIN2+) was detected in 41 women (1.07%). At the threshold of CIN2+, cytology [atypical squamous cells of undetermined significance (ASC-US) or worse] and HPV testing showed a sensitivity of 53.7% and 100% respectively, without change between age groups. Cytology and HPV testing showed specificity of 96.8% and 90.3% respectively, which was increased in older women (≥30) in comparison to younger ones (25–29). Genotyping for HPV16/18 had similar accuracy to cytology for the detection of CIN2+ (sensitivity: 58.5%; specificity 97.5%) as well as for triage to colposcopy (sensitivity: 58.5% vs 53.7% for cytology). Conclusion HPV testing has much better sensitivity than cytology to identify high-grade cervical lesions with slightly lower specificity. HPV testing with individual HPV-16/HPV-18

  2. Relation between psychiatric disorder and abnormal illness behaviour in patients undergoing operations for cervical discectomy

    Taylor, R.; Creed, F; Hughes, D.

    1997-01-01

    OBJECTIVE—To test the hypothesis that depression in patients being considered for cervical disc surgery is associated with severe organic pathology. Secondly, to test whether depression and abnormal illness attitudes recorded preoperatively would predict poorer recovery.
METHODS—Seventy four patients with pain and disability from cervical arthrosis were examined during investigations before potential cervical surgery. The prevalence of psychiatric disorder was assessed using...

  3. Genotype distribution of human papillomavirus (HPV) and co-infections in cervical cytologic specimens from two outpatient gynecological clinics in a region of southeast Spain

    Egea-Cortines Marcos; Pérez-Guillermo Miguel; Orantes-Casado Francisco; Doménech-Peris Asunción; Moya-Biosca Joaquín; Ortiz-Reina Sebastián; Conesa-Zamora Pablo

    2009-01-01

    Abstract Background Human Papillomavirus (HPV) genotype distribution and co-infection occurrence was studied in cervical cytologic specimens from Murcia Region, (southeast Spain), to obtain information regarding the possible effect of the ongoing vaccination campaign against HPV16 and HPV18. Methods A total of 458 cytologic specimens were obtained from two outpatient gynecological clinics. These included 288 normal benign (N/B) specimens, 56 atypical squamous cell of undetermined significance...

  4. A very rare case of HPV-53-related cervical cancer, in a 79-year-old woman with a previous history of negative Pap cytology

    Zappacosta R

    2014-04-01

    Full Text Available Roberta Zappacosta,1 Giuseppe Lattanzio,2 Patrizia Viola,2 Manuel Maria Ianieri,3 Daniela Maria Pia Gatta,1 Sandra Rosini11Cytopathology Unit, Experimental and Clinical Sciences Department, Gabriele d’Annunzio University of Chieti-Pescara, Chieti, Italy; 2Surgical Pathology Unit, 3Obstetrics and Gynecology Unit, SS Annunziata Hospital, Chieti, ItalyAbstract: The introduction of organized cervical cancer (CC screening programs has drastically reduced the prevalence of CC. However the incidence is still too high, especially among elderly women. All guidelines strongly recommend a regular Papanicolaou (Pap testing for young and middle-aged patients. On the other hand, many international professional societies no longer advise screening in women who have undergone hysterectomy, and in women aged 65 years and above, who have a previous history of regular Pap smears. Here we report the case of poorly differentiated CC, involving the pelvic lymph nodes and urinary bladder, occurring in a 79-year-old woman who regularly underwent Pap tests, with no reported cytological abnormalities. In this very rare case, the CC cells, as well as cells from metastatic lymph nodes and cells from urinary specimens, molecularly showed human papilloma virus (HPV-53. With the limitations of a single case, this report brings important information to prevent CC in elderly patients: the utility of molecular tests to increase sensitivity of Pap smears in postmenopausal women; the importance of HPV-53 as one of the four “emergent” genotypes having a possible role in oncogenesis; and the presence of HPV-53 in lymph node metastases from cervical carcinoma, which would support the role of this virus in the maintenance of malignant status.Keywords: old women, molecular tests, cervical cancer screening, HPV-DNA test, HPV genotyping

  5. TCT联合DNA定量细胞学检查对宫颈病变临床诊断价值研究%The study of TCT and DNA quantitive cytology in the diagnosis of cervical lesions.

    刘桂依; 黄艳美

    2011-01-01

    目的 评价宫颈细胞学配合DNA定量细胞学检查对子宫颈病变的诊断价值.方法 2006年2月至2007年12月间在我们中心对2 800例患者行液基薄层细胞学检查(TCT)及DNA定量细胞学检查.TCT或DNA定量细胞学检查异常者,3个月后复查.TCT未明确诊断意义的不典型鳞状上皮细胞(ASCUS)异常者行阴道镜下多点活组织病理检查.结果 TCT异常者302例,占10.79%(302/2 800).ASCUS 194例,占6.93%;低度鳞状上皮内病变(LSIL)34例,占1.21%;高度鳞状上皮(HSIL)内病变18例,占0.64%(18/2 800);鳞癌(SCC)3例,占0.10%.经阴道镜下多点活组织病理检查,诊断符合率较高.结论 采用TCT配合细胞DNA定量分析,因取材方便无创伤,是进行阴道镜下活检前筛查宫颈癌和癌前病变的好方法,可以帮助早发现宫颈癌和宫颈病变.%Objective To evaluate the diagnostic value of cervical cytology combined with DNA quantitive cytology for cervical lesions.Methods From February 2006 to December 2007, 2,800 patients were examined with liquid - based ThinPrep cytologic test ( TCT ) and DNA quantitative cytology. The patients with abnormal TCT or DNA quantitative cytology results were re - examined after three months. The patients with abnormal TCT results and atypical squamous cells of uncertain significance ( ASCUS ) were further examined by colposcopy and multi - site biopsy examinations. Results Abnormal TCT results were found in 302 patients ( 10.79% ), ASCUS, low - grade squamous intraepithelial lesions ( LSIL ), high - grade squamous intraepithelial lesion ( HSIL ) and squamous cell carcinoma ( SCC ) were found in 194 ( 6.93% ), 34 ( 1.21% ),18 ( 0.64% ) and 3 patients ( 0. 10% ), respectively. Pathological examination confirmed inflammation in 198 cases, accounting for 65.56%( 198/302 ) of abnormal TCT. The difference in TCT and human papillomavirus ( HPV ) infection diagnosis was significant ( P < 0.01 ). Conclusion The combined examinations of

  6. Abnormal radionuclide angiogram in cervical lymphadenitis: case report

    Increased activity over the neck was observed on radionuclide angiograms of two patients with cervical lymphadenitis. This incidental finding should not be confused with other causes of locally increased perfusion

  7. Liquid-based cervical cytology using ThinPrep technology: weighing the pros and cons in a cost-effectiveness analysis.

    Bekker-Grob, E.W. de; Kok, I.M. de; Bulten, J.; Rosmalen, J. van; Vedder, J.E.M.; Arbyn, M.; Klinkhamer, P.J.; Siebers, A.G.; Ballegooijen, M. van

    2012-01-01

    PURPOSE: Cervical cancer screening with liquid-based cytology (LBC) has been developed as an alternative to the conventional Papanicolaou (CP) smear. Cost-effectiveness is one of the issues when evaluating LBC. Based on the results of a Dutch randomised controlled trial, we conducted cost-effectiven

  8. 宫颈脱落细胞中的DNA甲基化研究%Study of DNA Methylation in Cervical Cytology

    仲肇基

    2012-01-01

    在宫颈病变发生、发展的过程中,DNA甲基化水平发生一系列改变.以往的研究多是基于宫颈组织的,而近来检测宫颈脱落细胞甲基化的研究越来越多.与宫颈组织相比,用宫颈脱落细胞作为研究对象进行检测安全无创,更方便临床应用,可能成为筛查、诊断宫颈病变和判断宫颈病变预后的有利工具.讨论研究较多的宫颈脱落细胞中基因的甲基化水平与宫颈病变等级的关系及其临床应用.%Aberrant promoter methylation has been detected in pathogenesis of many cancers,including cervical cancer. During cervical carcinogenesis,there is a series of alteration in the methylation status of host genes. Recently,the role of promoter hypermethylation as a diagnostic tool for cervical cancer screening has been examined in liquid-based cytology samples. Detection of DNA methylation in exfoliated cervical cytology samples is more convenient and minimally invasive than in biopsy tissues. In those samples .researchers are searching for DNA methylation markers selectively indicating high-grade precancerous lesions, in order to increase the accuracy of cervical cytological diagnosis. The methylation markers might be used as a potential biomarker for cancer screening,diagnosis and predicting clinical outcomes. Here,we discuss methylation status of host genes in foliated cervical cytology samples during cervical carcinogenesis and its clinical impact.

  9. Cytological diagnosis of tuberculous cervicitis: A case report with review of literature

    Kalyani, R; S R Sheela; M Rajini

    2012-01-01

    Tuberculosis of cervix is a rare disease. Tuberculosis usually affects women of childbearing age, indicating hormone dependence of infection. The patient presents with menstrual irregularities, infertility or vaginal discharge. Cervical lesions presents as papillary/vegetative growth or ulceration mimicking cervical cancer. Cervical Papanicolaou (Pap) smear plays an important role in diagnosing the disease by non-invasive technique in which the presence of epithelioid cells and Langhan′s type...

  10. Prevalence of anal human papillomavirus infection and cytologic abnormalities among HIV-infected and HIV-uninfected men who have sex with men

    Alessandra Latini; Maria Gabriella Dona; Livia Ronchetti; Amalia Giglio; Domenico Moretto; Manuela Colafigli; Valentina Laquintana; Mirko Frasca; Mauro Zaccarelli; Andrea Antinori; Antonio Cristaudo; Massimo Giuliani

    2014-01-01

    Introduction: Human papillomavirus (HPV) is responsible for 85% of anal cancers. Recently, anal cancer incidence has been increasing, particularly in men who have sex with men (MSM). Cytology may be a useful tool for the detection of anal precancerous lesions. We assessed the prevalence and determinants of anal HPV infection and cytologic abnormalities among HIV-infected and -uninfected MSM. Materials and Methods: MSM ≥18-year-old attending an STI clinic in Rome (Italy) were enrolled. Anal cy...

  11. Genotypic distribution of human papillomavirus (HPV) and cervical cytology findings in 5906 Thai women undergoing cervical cancer screening programs

    Kantathavorn, Nuttavut; Mahidol, Chulabhorn; Sritana, Narongrit; Sricharunrat, Thaniya; Phoolcharoen, Natacha; Auewarakul, Chirayu; Teerayathanakul, Narongchai; Taepisitpong, Chantanee; Saeloo, Siriporn; Sornsamdang, Gaidganok; Udomchaiprasertkul, Wandee; Krongthong, Waraphorn; Arnamwong, Arpaporn

    2015-01-01

    Background Cervical cancer is the major cause of morbidity and mortality in Thai women. Nevertheless, the preventive strategy such as HPV vaccination program has not been implemented at the national level. This study explored the HPV prevalence and genotypic distribution in a large cohort of Thai women. Methods A hospital-based cervical cancer screening program at Chulabhorn Hospital, Bangkok and a population-based screening program at a rural Pathum Thani Province were conducted using liquid...

  12. Clinical significance of Thinprep cytology test in screening of cervical lesions%液基薄层细胞学在筛查宫颈病变中的临床意义

    张江菊; 黄寅虎; 郭建新; 李力; 郑秀惠

    2013-01-01

    Objective:To explore the clinical significance of Thinprep cytology test (TCT) in screening of cervical lesions.Methods:TCT screening was conducted among 18 904 patients from outpatient department of Daping Hospital Affiliated to the Third Military Medical University from January to December in 2012,and 688 patients were found with cytological abnormalities (diagnosis of TBS system ≥ ASC-US),then 416 patients underwent colposcopy and biopsy ; the clinical significance of TCT in screening of cervical lesions was evaluated with pathological examination as gold standard.Results:A total of 416 patients were found with cytological abnormalities,including 195 patients with ASC,65 patients with LSIL,138 patients with HSIL,and 52 patients with cervical cancer; 128 patients with cervicitis,106 patients with cervical intraepithelial neoplasia (CIN) Ⅰ,78 patients with CIN Ⅱ,52 patients with CIN Ⅲ,and 52 patients with cervical invasive carcinoma (including one patient with cervical adenocarcinoma) were found by pathological examination; the coincidence rates of diagnosis between pathological examination and TCT were 48.21% (ASC),81.54% (LSIL),89.13% (HSIL),and 100.00% (cervical cancer),respectively; the sensitivity and specificity of TCT for cervical lesions (≥ CIN Ⅱ) were 90.66% and 76.07%,respectively.Conclusion:TCT can improve the detection rate of cervical lesions and it has a high concordance with the histopathological results with high sensitivity,TCT is an effective method for screening cervical lesions and missed diagnosis can be reduced.%目的:探讨液基薄层细胞学在筛查子宫颈病变中的临床意义.方法:对2012年1月~12月第三军医大学大坪医院18 904例门诊患者进行TCT筛查,发现细胞学异常(TBS系统诊断≥ASC-US)的患者688例,其中416例进行了阴道镜检查并取活检,以病理学为标准,评价TCT筛查子宫颈病变的临床意义.结果:细胞学异常的416例患者中,ASC 195例,LSIL65

  13. 18356例宫颈液基细胞学与活检组织病理学结果分析%Analysis the Results of 18 356 Cases of Liquid-based Cervical Cytology and the Histopathology of Colposcopic Biopsy in Cervical Screening/

    江淑萍; 孔友明; 陈冰

    2013-01-01

      目的:探讨宫颈液基细胞学与活检组织病理学在宫颈病变筛查中的价值.方法:对18356例经宫颈液基细胞学检查发现异常者在阴道镜下活检的患者临床及病理资料进行回顾性分析.结果:LCT 显示:18356例中,ASCUS 以上的有1256例,阳性率为6.8%,其中 ASCUS 占51.8%,LSIL占29.5%,HSIL 占10.6%.宫颈活检:慢性炎症占39.7%,CIN Ⅰ占37.3%,CIN Ⅱ占13.6%,CIN Ⅲ占8.9%,宫颈癌占0.4%.结论:LCT 液基细胞学检测系统是一种有效的宫颈癌前病变筛查方法.对 LCT 阳性病例行阴道镜下活检,能大大提高宫颈癌前病变及宫颈癌早期检出率,减少漏诊的发生.%Objective:To evaluate the value of liquid-based cytology (LCT) and histopathology of colposcopic biopsy in cervical screening.Methods:The cervical LCT results of 18 356 cases were analyzed,follow up diagnoses of colposcopic biopsy were available for those cytological abnormalities,then we performed a retrospective analysis of those clinical and pathological data.Results:Among 18 356 patients receiving LCT,1256 patients were diagnosed as Above-ASCUS pathological changes,the positive detection rate was 6.8%.Among these,ASCUS,LSIL and HSIL were 51.8%,29.5% and 10.6%,respectively. Among 1256 patients receiving colposcopic biopsy,39.7% were diagnosed as chronic inflammation,and cervical intraepithelial neoplasiaⅠ(CINⅠ) were 37.3%, CIN Ⅱ were 13.6%,CIN Ⅲ were 8.9% and cervical cancer were 0.4%.Conclusion:LCT liquid-based cytology technology is an effective method in screening of cervical precancerous disease.Combining with colposcopic biopsy among patients with abnormal LCT results,can not only improve the detection rate of cervical precancerous lesions and early stage of cervical cancer,but also reduce the incidence of missed diagnosis,significantly.

  14. Prevalence of human papillomavirus in abnormal cervical smears in Malaysian patients.

    Sharifah, Noor Akmal; Seeni, A; Nurismah, M I; Clarence-Ko, C H; Hatta, A Z; Ho, Ng-Paul; Rafaee, T; Adeeb, N; Jamal, R

    2009-01-01

    Cervical cancer is the second most common female malignancy in Malaysia. Despite advances in treatment, the overall survival for this disease has not changed in the last decade. Infection by certain types of HPV is recognized as a causal and necessary factor for its development. This study was carried out to determine the prevalence of HPV infection in abnormal cervical smears in Malaysian patients using archival cervical smears retrieved from the Cytopathology Unit, Universiti Kebangsaan Malaysia Medical Centre (UKMMC) between the years 1992-1995. DNA was extracted from 38 abnormal smears comprising 25 intraepithelial lesions and 13 cervical carcinomas and 10 normal smears. Amplification of HPV genes was carried out using the polymerase chain reaction (PCR) technique. HPV genotypes were determined using direct sequencing and the results were compared to the database from Genebank. DNA was successfully extracted from all 48 cervical smears. High-risk HPV (HR-HPV) genotypes were detected in 95% of the abnormal smears. Eight high-risk oncogenic types were identified: 16, 18, 31, 51, 52, 56, 58 and 66. All (100%) cervical cancer smears showed presence of HR-HPV compared to 92% of the cervical intraepithelial lesions. Among the eight HR-HPV genotypes identified, HPV 16 and 52 were the commonest (23.7% each) HPV genotypes encountered and among the CIN lesions, HPV 16 (28%) was the most frequent. We conclude that HPV 16 is the most prevalent HPV genotype present in abnormal cervical smears in Malaysian patients, and that the use of archival material to assess the presence of HPV is potentially worthwhile, and can be utilized for longitudinal studies of HPV presence and persistence. PMID:19537900

  15. Prevalence of High-Risk Human Papillomavirus (HR-HPV) Genotypes and Multiple Infections in Cervical Abnormalities from Northern Xinjiang, China

    Du, Jingyun; Jiang, Jianjun; Jia, Xuesong; Chen, Chuangfu; Wang, Yuanzhi

    2016-01-01

    Multiple human papillomavirus (HPV) genotypes often coexist within the cervical epithelia and are frequently detected together in various grades of the cervical neoplasia. To date, only a few reports exist on multiple HPV infections of HPV in Xinjiang Uygur Autonomous Region (XUAR). In the present study, we investigated the prevalence of High-Risk HPV (HR-HPV) genotypes and multiple infections. Cervical cytology samples were collected from 428 women who presented cervical abnormalities. Genotyping of HPV was performed by polymerase chain reaction–sequencing based typing (PCR-SBT) using consensus primers and specific primers. Of them, 166 samples were positive for HPV according to PCR results using the consensus primers. These samples contained cervical abnormalities enriched with inflammation (n = 107), cervical intraepithelial neoplasia (CIN) I (n = 19), CINII-III (n = 9) and cervical cancer (n = 31). Of the 166 HPV positive samples as determined by PCR analysis, 151 were further typed by PCR-SBT using 19 pairs of genotype-specific primers. Using this method, 17 different HR-HPV genotypes were identified. The most frequently observed HPV genotypes were HPV16 (44.0%, 73/166), 53 (28.9%, 48/166), 52 (25.3%, 42/166), 58 (22.3%, 37/166) and 35 (17.5%, 29/166). The proportions of single and multiple infections in the HPV-positive specimens were 34.9% and 65.1%, respectively. Multiple HPV types were most prevalent in the inflammatory state (63.0%), followed by cervical cancer (24.1%), CINI (11.1%), and CINII-III (1.9%). The results of our data analyses suggested that i) multiple HPV infection is not necessarily correlated with the severity of cervical abnormalities; and ii) among the multiple HPV infections, double infections combined with HPV16 is the most common. In addition, L1 full-length sequences of the top five high-risk HPV genotypes were amplified and sequenced. According to the L1 sequence of the epidemic genotypes that were amplified, we found that these

  16. TCT联合HPV检测在宫颈病变筛查中的意义%Cervical Liquid-Based Cytology Combined Human Papillomavirus Testing in Cervical Lesion

    戴一菲; 田荣华

    2012-01-01

    Objective To study the significance of combination of cervical liquid-based cytology and human papillomavirus detection in cervical lesion screening. Methods From March 2010 to December 2011,3,028 patients were detected with nipple shaped tumor virus ( HPV) and cervical liquid base cytology (TCT) ,TCT was used by 2001 International Cancer Association TBS diagnosis system report way,to the patients with positive results of TCT check for ASCIIS and the above lesions and (or) HPV detection, cervical organization biopsy under electronic vaginal mirror were performed. Results The sensitivity of TCT check was 56.72% ,with the specificity of 28. 19% ;the sensitivity of HPV check was 86.03% ,with specific for 46.38% ;among 408 cases of CIN and cervical cancer pathology ,28 cases were single TCT positive (6. 86% ) ;with TCT and HPV positive 203 ca-ses(49. 75% ) ,there was significant difference in diagnosis of cervical squamous intraepithelial neoplasm ( CIN) and cervical cancer(x2 = 184.926,P=0.000) between single TCT check and combination of TCT and HPV examination. Conclusion TCT combined with HPV check can improve the detection rate of cervical cancer and precancerous lesions, improve the sensitivity and specificity of screening,effectively reduce the TCT in detection of false-negative rates,and avoid excessive colposcopy and biopsy in low-risk populations and over-treatment.%目的 探讨宫颈液基细胞学检查与人乳头状瘤病毒检测联合应用在宫颈病变筛查中的意义.方法 选取2010年3月-2011年12月孝感市中心医院病理科同时进行了宫颈液基细胞学(TCT)检查及人乳头状瘤病毒(HPV)检测的患者3028人,TCT采用2001年国际癌症协会TBS诊断系统报告方式,对TCT检查结果为ASCUS及以上病变和(或)HPV检测结果为阳性的患者在电子阴道镜下取宫颈组织活检.结果 TCT检查敏感度为56.72%,特异度为28.19%;HPV检查敏感度为86.03%,特异度为46.38%;病

  17. 宫颈刮片脱落细胞学检查在筛选宫颈癌中的应用分析%Application Analysis the Cervical Scraping Cytology in Screening of Cervical Cancer

    张鸥

    2016-01-01

    目的:对宫颈刮片脱落细胞学检查在筛选宫颈癌中的应用进行观察分析。方法选取我院2014年1月~2015年12月收治的214例进行宫颈癌筛查患者作为研究对象,进行宫颈刮片脱落细胞学检查,将宫颈刮片脱落细胞学检查结果同宫颈活组织病理检查相比较,观察分析宫颈刮片脱落细胞学检查在诊断宫颈癌、癌前病变的敏感度、特异度、阴性预测值和阳性预测值等。结果宫颈刮片脱落细胞学检查诊断宫颈癌、癌前病变敏感度为90.43%,特异度为89.17%,阳性预测值为86.73%,阴性预测值为92.24%,诊断准确率为89.72%。结论宫颈刮片脱落细胞学检查在筛查宫颈癌方面具有较高的敏感度。%Objective To observe and analyze the application of cervical scraping cytology in screening of cervical cancer.Methods Selected 214 cases of patients with cervical cancer screening from January 2014 to December 2015 in our hospital, for example, cervical scraping cytology, cervical scraping cytology results with cervical biopsy compared toobserve and analyze the cervical scraping off cytology in the diagnosis of cervical cancer and precancerous lesions of sensitivity, speciifcity, negative predictive and positive predictive value.Results The sensitivity of cervical cancer and precancerous lesion was 90.43%, the speciifcity was 89.17%, the positive predictive value was 86.73%, the negative predictive value was 92.24%, the diagnostic accuracy rate was 89.72%.Conclusion Cervical scraping cytology test in the screening of cervical cancer has a high sensitivity.

  18. Long-term risk of cervical intraepithelial neoplasia grade 3 or worse according to high-risk human papillomavirus genotype and semi-quantitative viral load among 33,288 women with normal cervical cytology

    Thomsen, Louise T; Frederiksen, Kirsten; Munk, Christian;

    2015-01-01

    In this prospective cohort study, we estimated the long-term risk of cervical intraepithelial neoplasia grade 3 or cancer (CIN3+) by high-risk human papillomavirus (hrHPV) genotype and semi-quantitative viral load at baseline among 33,288 women aged 14-90 years with normal baseline cytology. Duri...

  19. Integrated cervical smear screening using liquid based cytology and bioimpedance analysis

    Lopamudra Das

    2014-01-01

    Conclusion: The integration of bioimpedance observation along with the proposed low-cost monolayer technology could increase the efficiency of the cervical screening to a greater extent thereby reducing the rates of faulty diagnosis.

  20. Effect of intrauterine copper device on cervical cytology and its comparison with other contraceptive methods

    Sipra Bagchi

    2016-08-01

    Conclusions: There was no significant risk of cervical dysplasia or invasive carcinoma in IUCD users up to 2 years of use while other contraceptives (except barrier one showed increased incidence of mild dysplasia (LSIL after 1 year of use. Though risk of cervical malignancy is less with intrauterine copper devices, regular follow up should be done in long term users. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2795-2798

  1. 宫颈细胞DNA倍体定量分析联合液基细胞学在宫颈癌早期筛查中的应用价值%Value of quantitative analysis is of DNA ploidy and cervical liquid-based cytology in the screening of ;cervical cancer and cervical intraepithelial neoplasm

    宋志琴; 王蔼明

    2014-01-01

    Objective To evaluate the application of DNA ploidy detection and cervical liquid-based cytology in the screen methods of cervical cancer and cervical precancerous lesion. Methods 12 630 women were detected by DNA ploidy and cervical liquid-based cytology, and in which of 1 146 cases with DNA aneuploidy and (or) abnormal cervical liquid-based cytology were given cervical biopsy. Pathological diagnosis was taken as gold standard. The clinical significance of two methods in the screen of cervical lesion was analyzed. Results The positive rates of DNA ploidy was significantly higher than cervical liquid-based cytology. Cases which were observed that LSIL and all above decided by cervical liquid-based cytology, and cases with DNA heteroploid cell more than 3 were sent to fixed point biopsy, the sensitivity of 73.28%and the specificity of 76.50%were cervical liquid-based cytology, while the sensitivity of 89.14%and the specificity of 75.80%by quantitative DNA. Conclusion DNA imaging cytometry is better for screening cervical dysplasia and carcinoma of the uterine cervix than conventional cytology.%目的:探讨宫颈细胞DNA倍体检测联合液基细胞学在宫颈癌早期筛查中的应用价值。方法对12630例患者采用宫颈细胞DNA倍体定量检测与液基细胞学联合进行宫颈病变的早期筛查,对其中1146例宫颈细胞DNA倍体定量检测阳性和(或)宫颈液基细胞学阳性者行阴道镜检查并取活检,以病理诊断为金标准,评价两种方法在宫颈癌早期筛查中的作用与意义。结果(1)宫颈DNA异倍体细胞的检出率和宫颈液基细胞学的阳性率分别为13.68%和8.97%,有统计学差异(P<0.01);(2)随着DNA异倍体细胞数量的增加,液基细胞学的阳性率也相应增加,且宫颈病变的严重程度也增加,两种方法检测结果均阳性者与活检病理诊断有较高的符合率;(3)以1~2个倍体异常细胞为宫颈活检标准,发现

  2. Cytological diagnosis of tuberculous cervicitis: A case report with review of literature

    R Kalyani

    2012-01-01

    Full Text Available Tuberculosis of cervix is a rare disease. Tuberculosis usually affects women of childbearing age, indicating hormone dependence of infection. The patient presents with menstrual irregularities, infertility or vaginal discharge. Cervical lesions presents as papillary/vegetative growth or ulceration mimicking cervical cancer. Cervical Papanicolaou (Pap smear plays an important role in diagnosing the disease by non-invasive technique in which the presence of epithelioid cells and Langhan′s type of giant cells is diagnostic. However, other causes of granulomatous cervicitis should be considered and ruled out. Ziehl-Neelsen (ZN stain for acid fast bacilli, fluorescent technique, biopsy and culture help in confirming the disease. We present the case of a 45-year-old female, who presented with vaginal discharge, dysfunctional uterine bleeding, first degree uterine descent with grade II cystocele and rectocele and cervical ulcer. Pap smear revealed epithelioid cells and Langhan′s type of giant cells, confirmed by ZN stain of cervical smear, fluorescent technique and culture.

  3. Histological and cytological studies on radiosensitivity of cervical carcinoma according to histological types

    Morphological investigation were made on the radiosensitivity, according to the histological types; 1 keratinizing(K), 2 large cell nonkeratinizing(LNK), and 3 small cell nonkeratinizing(S) type. The result obtained are as follows. 1) Histological and cytological estimation of irradiated effects were examined at the 7th day after 10 Gray test-irradiation: (i) Histological studies were done with the biopsy specimens (76 cases): There were significance differences among 3 histological types (LNK>K>S, PS, K>S, P<0.05). (iii) There was a correlation between the histological and cytological irradiation effects. 2) DNA histogram patterns were also examined spectrophotometrically. It seemed that the patterns after test-irradiation were broad and these peaks were situated rather to high ploidy in histologically and cytologically highly effective cases. 3) Early ultrastructural findings after test-irradiation were as follows: (i) appearance of intra-nuclear ''pseudoinclusion'', (ii) swelling of mitochondria, endoplasmic reticulum, and so on. Although these characteristics presented the same sequence of events without regard to their histological types, they were not synchronized. It seemed that they appeared earlier after test-irradiation in histologically high-sensitivity cases than in low-sensitivity cases. (author)

  4. Human Papillomavirus Research on the Prevention, Diagnosis, and Prognosis of Cervical Cancer in Taiwan

    Chyong-Huey Lai; Angel Chao; Huei-Jean Huang

    2012-01-01

    Cervical cancer is third in incidence and fourth in mortality among cancers of women worldwide. Epidemiological studies have shown that human papillomavirus (HPV) is necessary, if not sufficient, to cause nearly 100% of cervical cancers. HPV testing is useful in primary screening for cervical neoplasms. The value of HPV detection or genotyping is potentially useful in triage of borderline or low-grade abnormal cervical cytology, follow-up after treatment of cervical intraepithelial neoplasia,...

  5. 宫颈薄层液基细胞学检查联合高危型HPV检测在宫颈病变筛查中的临床应用%CLINICAL APPLICATION OF CERVICAL THIN PREP CYTOLOGIC-TEST AND HIGH-RISK HPV TYPE TESTING IN SCREENING OF CERVICAL LESIONS

    朱华洁

    2012-01-01

    目的 研究宫颈薄层液基细胞学检查(thin prep cytologic test,TCT)联合高危型人乳头瘤病毒(human papilloma virus,HPV)检测在子宫颈病变筛查中的诊断价值.方法对2010年1-12月行宫颈病变筛查的患者680例,进行TCT和高危型HPV检测,同时行阴道镜下组织活检.结果 680例患者中宫颈TCT检查结果异常180例,对宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)诊断的敏感性为85.57%,特异性为97.12%,漏诊率为4.12%.TCT与HPV联合检查,诊断敏感性为89.69%,特异性为85.80%,漏诊率1.62%.HPV感染率为26.91%,随着细胞学和组织学诊断级别的升高,HPV感染率不断上升.结论 TCT与高危型HPV联合检测是筛查宫颈癌及癌前病变的有效方法,可防止漏诊,有利于提高宫颈上皮内瘤变的诊断率.%Objective To explore the diagnostic value of cervical thin prep cytologic test ( TCT ) combined with high - risk human papilloma virus ( HPV ) detection in the screening of cervical lesions. Methods A total of 680 patients for cervical lesions screeing underwent TCT and high - risk HPV type detection in gynecology outpatient from January 2010 to December 2010, meanwhile, biopsy was performed under colposcopy. Results Among 680 cases,the result of cervical TCT was abnormal in 180 cases. The sensitivity, specificity and the rate of missed diagnosis of TCT for the diagnosis of cervical intraepithelial neoplasia ( CIN ) was 85.57% , 97. 12% and 4. 12% , respectively, while thoses of combination of TCT and HPV was 89. 69% ,85. 80% and 1. 62%. The infection rate of HPV was 26. 91%. With the increase of cytological and histological grading, the infection rate of HPV increased. Conclusion TCT combined with high risk HPV detection is an effective method in screening cervical cancer and precancerous lesions. It helps to prevent missed diagnosis and improve the diagnosis rate of CIN.

  6. Evaluation of fine needle aspiration cytology of cervical lymphadenopathy in Bir Hospital

    Subash Khadka

    2015-09-01

    Full Text Available Background & Objectives: To correlate FNAC of cervical lymphadenopathy with the histopathology.Materials and Methods: Prospective study on 67 patients with cervical lymphadenopathy at the ENT Department, Bir Hospital, from January 2013 to July 2014. Patients were subjected to both FNAC and histopathology.Results: Thirty cases (44.8% were females and 37 cases (55.2% were males. Tuberculosis was most common disease in 30(44.80% patients. Sensitivity, specificity, and diagnostic accuracy of FNAC to diagnose tubercular lymphadenopathies were 83.0%, 100.0%, and 92.54% respectively. Overall correlation of FNAC to histopathology was 86.57%.Conclusion: FNAC is very simple and accurate technique for diagnosis of cervical lymphadenopathy.JCMS Nepal. 2015;11(1: 22-25

  7. The preparation of cervical scrape material for automated cytology using gallocyanin chrome-alum stain.

    Eason, P J; Tucker, J H

    1979-01-01

    A method is described for preparing cervical scrape specimens for automated analysis on the Cerviscan prescreening system. In order to reduce the cellular clumping found in cervical scrape material, cells are collected in suspension, syringed to disaggregate the cell clumps, and then pipetted onto a glass to give a monolayer of cells. The cells are then stained with gallocyanin chrome-alum to give the required quantitation of nucleic acid content, using a rapid staining procedure. Experimental results are given which show that specimens prepared by this method are more suitable for automated analysis than the conventional Papanicolaou stained preparation. PMID:86562

  8. Diagnostic value of cervical cytological examination, HPV-DNA test combined with colposcopy examination in cervical lesions diagnosis%宫颈细胞学检查、HPV-DNA检测配合阴道镜检查对子宫颈病变的诊断价值

    李玉欢

    2013-01-01

    目的 分析与探讨宫颈细胞学检查、HPV-DNA(人乳头瘤病毒基因检测)检测配合阴道镜检查对于子宫颈病变的诊断价值.方法 选取本院2010年8月至2012年8月期间收治的接受子宫颈病变筛查的妇女共1020例,对其实施宫颈细胞学检查和HPV-DNA配合阴道镜检查,检查结果与组织学金标准进行比对,以对比两种方法的准确性与诊断价值.结果 采取HPV-DNA配合阴道镜检查为异常结果的检出率较宫颈细胞学检查更高,差异具有统计学意义(P<0.05),前者检出异常共64例,后者检出异常共34例.结论 宫颈细胞学检查、HPV-DNA检测以及阴道镜检查对于子宫颈病变均有一定的诊断价值,而采用HPV-DNA检测配合阴道镜检查能够帮助医生较早地发现患者的宫颈癌前病变,为患者的治疗方案的选择提供科学依据.%Objective To analyze and discuss the diagnostic value of cervical cytological examination,HPV-DNA test combined with colposcopy examination in diagnosis of cervical lesions.Methods From August 2010 to August 2012 in our hospital a total of 1020 cases of women who underwent cervical diseases screening,were implemented with cervical cytological examination and HPV-DNA combined with colposcopy examination,the correlated pathological results were compared with the gold standard in accuracy and diagnostic value of two methods.Results The HPV-DNA abnormal results detection rate was higher than that of cervical cytological examination combined with colposcopy examination,with statistically significant difference,former found 64 abnormal cases,the latter examination found 34 cases of abnormal.Conclusion Cervical cytological examination,HPV-DNA testing combined with colposcopy examination for cervical lesions has certain diagnostic value,and the combined use of HPV-DNA testing and colposcopy examination could help doctors find early precancerous lesion of cervical cancer,and provide scientific basis for the

  9. Tele-cytology: An innovative approach for cervical cancer screening in resource-poor settings.

    Singh, Sandeep; Badaya, Sorabh

    2016-01-01

    Carcinoma cervix remains a leading cause of cancer mortality among women in countries lacking any screening program. The existing screening policy and approach via conventional cytology centered mainly in Tertiary Care Center, is totally unaffordable to Indian women, especially in the remote areas. This suggests the need of depolarizing the resources via generating the near real time modalities which could be used at the door step of the needy ones. For any screening modality to be effective it should be adequately sensitive, specific, reproducible, cheap, simple, affordable, and the most important is should be real time to ensure wide coverage and curtail loss to follow-up. Incorporating telecytology as a screening tool could make the dream come true. Telecytology is the interpretation of cytology material at a distance using digital images. Use of mobile telecytology unit housed in a van carrying satellite equipment and the automated image capturing systems is the central theme behind this idea. The imaging equipment would be carrying out the imaging of Papanicolaou smears prepared at the screening site and sending the images to the central laboratories situated at some tertiary care level. This concept could overcome the hindrance of trained cytology infrastructure in the resource poor settings and could provide an efficient and economical way of screening patients. There is possibility that the designed approach may not detect the entire women positive for the disease but if the desired objective was to diagnose as many cases as possible in resource poor setting, then this process offers an advantage over no screening at all. PMID:27461597

  10. Tele-cytology: An innovative approach for cervical cancer screening in resource-poor settings

    Sandeep Singh

    2016-01-01

    Full Text Available Carcinoma cervix remains a leading cause of cancer mortality among women in countries lacking any screening program. The existing screening policy and approach via conventional cytology centered mainly in Tertiary Care Center, is totally unaffordable to Indian women, especially in the remote areas. This suggests the need of depolarizing the resources via generating the near real time modalities which could be used at the door step of the needy ones. For any screening modality to be effective it should be adequately sensitive, specific, reproducible, cheap, simple, affordable, and the most important is should be real time to ensure wide coverage and curtail loss to follow-up. Incorporating telecytology as a screening tool could make the dream come true. Telecytology is the interpretation of cytology material at a distance using digital images. Use of mobile telecytology unit housed in a van carrying satellite equipment and the automated image capturing systems is the central theme behind this idea. The imaging equipment would be carrying out the imaging of Papanicolaou smears prepared at the screening site and sending the images to the central laboratories situated at some tertiary care level. This concept could overcome the hindrance of trained cytology infrastructure in the resource poor settings and could provide an efficient and economical way of screening patients. There is possibility that the designed approach may not detect the entire women positive for the disease but if the desired objective was to diagnose as many cases as possible in resource poor setting, then this process offers an advantage over no screening at all.

  11. FTIR Microspectroscopy Coupled with Two-Class Discrimination Segregates Markers Responsible for Inter- and Intra-Category Variance in Exfoliative Cervical Cytology

    Mark A. Pitt

    2008-01-01

    Full Text Available Infrared (IR absorbance of cellular biomolecules generates a vibrational spectrum, which can be exploited as a “biochemical fingerprint” of a particular cell type. Biomolecules absorb in the mid-IR (2–20 μm and Fourier-transform infrared (FTIR microspectroscopy applied to discriminate different cell types (exfoliative cervical cytology collected into buffered fixative solution was evaluated. This consisted of cervical cytology free of atypia (i.e. normal; n = 60, specimens categorised as containing low-grade changes (i.e. CIN1 or LSIL; n = 60 and a further cohort designated as high-grade (CIN2/3 or HSIL; n = 60. IR spectral analysis was coupled with principal component analysis (PCA, with or without subsequent linear discriminant analysis (LDA, to determine if normal versus low-grade versus high-grade exfoliative cytology could be segregated. With increasing severity of atypia, decreases in absorbance intensity were observable throughout the 1,500 cm−1 to 1,100 cm−1 spectral region; this included proteins (1,460 cm−1, glycoproteins (1,380 cm−1, amide III (1,260 cm−1, asymmetric (νas PO2 − (1,225 cm−1 and carbohydrates (1,155 cm−1. In contrast, symmetric (νs PO2 − (1,080 cm−1 appeared to have an elevated intensity in high-grade cytology. Inter-category variance was associated with protein and DNA conformational changes whereas glycogen status strongly influenced intra-category. Multivariate data reduction of IR spectra using PCA with LDA maximises inter-category variance whilst reducing the influence of intra-class variation towards an objective approach to class cervical cytology based on a biochemical profile.

  12. Prevalence of HPV Infection and Its Association with Cytological Abnormalities of Pap Smears in Tehran

    M Jamali Zavarei Jamali Zavarei

    2008-09-01

    Full Text Available Background: Human papillomavirus infection is one of the most common genital infections. More than 100 types of this virus have been identified, and most of them are capable of infecting the genital mucosa. Human papillomavirus is in association with cancerous and precancerous lesions of the cervix; some types like HPV 16 and 18 are highly carcinogenic, some types like HPV 31 and 33 are moderately and some types like HPV 6 and 11 are mildly carcinogenic. In this research, the relationship between cytological changes of the squamous epithelial cells and the presence of HPV infections in our cases has been assessed."nMethods: In this prospective study, we collected 681 samples from women admitted to different hospitals and private gynecological clinics in Tehran, during the years 2003-2005. Two specimens were collected from each patient; one for a Pap smear study and the other for PCR assay in order to detect HPV."nResults: Out of our 681 samples, 600 specimens were suitable for PCR assay, and 34 cases were HPV positive in PCR assay. This means that 5.7 percent of our patients were infected with HPV."nConclusion: HPV infection is common in Iran and is nearly identical to European countries such as Germany, and Spain. Also, we found that using PCR assay in order to detect the presence of HPV viruses in vaginal discharges can be very helpful.

  13. Cervical Cytology Smear Combined Colposcopy in the Diagnosis of Cervical Lesions in Clinical Observa-tion%宫颈细胞学涂片联合阴道镜诊断宫颈病变的临床观察

    许盛芳

    2015-01-01

    Objective To explore the cervical cytological smear the clinical effect of combined colposcopy in the di-agnosis of cervical lesions.Methods Between January 2013 and December 2013 in our hospital to accept the cervical cytological smear combined colposcope examination of 880 cases of married women as the research object, on the cervical lesions of inspection, analysis of the clinical condition.Results Of cervical smear cytologic examination and vaginoscope diagnosis coincidence rate in RCI score photogenic compared with significant difference ( P<0.05) , after statistics treat-ment, under colposcopy in the diagnosis of CIN sensitivity was 94.84%, specificity is 88.81%, both the positive pre-dictive value was 72.31% and negative predictive value was 95.63%.Conclusions Cervical cytological smear com-bined colposcope examination before screening of cervical lesions can ensure cerical cancer lesions and early diagnosis of cervical cancer, can also become local screening test for cervical cancer lesion before effective policies.%目的:探讨宫颈细胞学涂片联合阴道镜诊断宫颈病变的临床效果。方法选取2013年1月~2013年12月在我院接受宫颈细胞学涂片联合阴道镜检查的880例已婚妇女作为研究对象,对其进行宫颈病变的检查,分析其临床情况。结果宫颈涂片细胞学检查与阴道镜下RCI评分诊断在符合率上相比较差异具有显著性( P<0.05),经统计学处理后,阴道镜下诊断CIN的敏感性是94.84%,特异性是88.81%,两者联合的阳性预测值是72.31%,阴性预测值是95.63%。结论宫颈细胞学涂片联合阴道镜检查筛选子宫颈病变可以保证宫颈癌前病变和前期宫颈癌的确诊,还可以成为当地筛选检查宫颈癌前病变的有效政策。

  14. Risk assessment on liquid based cytology test and human papilloma virus L1 Nuclecapsid protein detection in the diagnosis of cervical lesions and its progress

    Ling-Zhi Chen

    2016-01-01

    Objective: To discuss the clinical value of liquid based cytology test in the diagnosis of cervical lesions and to evaluate the expression difference and significance of human papilloma virus L1(HPV L1) protein in exfoliative cells of different cervical lesions. Methods: A total of 1 400 cases of patients in gynaecological clinics of our hospital from January 2009 to August 2013 were selected and were given liquid based cytology test(LCT) examination and HPV L1 protein expression detection in exfoliative cells. Meanwhile, cervical biopsy pathology results were taken as baseline for make a comparison. Results: (1) In such1400 cases of women: LCT(+)-30 cases, accounting for 2.1%, HPV L1 protein detection(+)-18 cases, accounting for 1.29%; LCT and HPV L1 protein detection(+)-8 cases, LCT and HPV L1 protein detection(-)- 1360 cases. (2)Pathological tissue biopsy was performed on 30 cases of patients with LCT(+), results showed that(+)were 23 cases; pathological tissue biopsy was performed on 18 cases of patients with HPV L1 protein(+),results showed that (+)were 14 cases. Among 1 360 cases with LCT and HPV L1 protein detection(-), 497 cases were willing to accept the pathological biopsy, and the results showed that 1 case presented(+), accounting for 0.2%. Total 545 cases were willing to accept the pathological biopsy, among whom, 38 cases presented(+), accounting for 6.97%;(3)Sensitivity and specificity of LCT combined with HPV L1 protein detection were higher than single-method detection, and difference had statistical significance. Conclusion: liquid based cytology test combined with HPV L1 protein detection could improve the diagnostic rate of cervical lesions, and were expected as the effective method in the early clinical screening of cervical neoplasia lesions.

  15. Prevalence of anal human papillomavirus infection and cytologic abnormalities among HIV-infected and HIV-uninfected men who have sex with men

    Alessandra Latini

    2014-11-01

    Full Text Available Introduction: Human papillomavirus (HPV is responsible for 85% of anal cancers. Recently, anal cancer incidence has been increasing, particularly in men who have sex with men (MSM. Cytology may be a useful tool for the detection of anal precancerous lesions. We assessed the prevalence and determinants of anal HPV infection and cytologic abnormalities among HIV-infected and -uninfected MSM. Materials and Methods: MSM ≥18-year-old attending an STI clinic in Rome (Italy were enrolled. Anal cytologic samples were collected in PreservCyt (Hologic using a Dacron swab. The Linear Array HPV Genotyping Test (Roche Diagnostics was used for the detection and genotyping of 37 mucosal HPV types. Liquid-based cytological slides were obtained using a ThinPrep2000 processor (Hologic. The morphology of the anal pap-test was classified following the Bethesda 2001 guidelines. Results: We enrolled 180 HIV-infected (median age 41 years, IQR 33–47 and 438 HIV-uninfected MSM (median age 32 years, IQR: 27–39. Most of the individuals were Caucasian (92.2% and 97.0%, respectively. HPV prevalence, both overall (93.3% vs 72.4%, p<.001 and by high-risk (HR HPV types (80.5% vs 56.0%, p<.001, was significantly higher among HIV-infected than HIV-uninfected individuals. HPV-multiple infections were evidenced in 48.2% of the HIV-uninfected and 76.1% of the HIV-infected MSM (p<.001. HPV16 was the most prevalent genotype in both groups (23.3% in HIV-positive and 17.6% in HIV-negative MSM. HPV6 and 84 were the most frequent low-risk types in both cohorts. Anal cytologic abnormalities were found in a significantly higher proportion of HIV-infected MSM (46.1% vs 27.9%, p<.001. H-SILs (high-grade squamous intraepithelial lesions were exclusively observed among the HIV-infected individuals, although at a low prevalence (1.2%. Conclusions: A high prevalence of anal HPV infection and cytologic abnormalities was evidenced in both populations. Nonetheless, HIV-infected MSM showed a

  16. Follow-up of abnormal or inadequate test results in the Danish Cervical Cancer Screening Program

    Kristiansen, Bettina Kjær

    2014-01-01

    -up recommendation. However problems with delayed follow-up may threaten the effectiveness of the Danish Cervical Cancer Screening Program, as 20% of women are delayed and dysplasia potentially can progress into cancer. Delayed follow-up is found in situations where women either consciously or unconsciously postpone......Denmark has a higher incidence of cervical cancer than other Nordic countries, although all Danish women (aged 23–65) are screened regularly to identify possible cervical dysplasia or asymptomatic invasive cancer. Annually 40 000 women receives an abnormal or inadequate test result and a follow...... follow-up, or because of organizational aspects of the screening program, where communication regarding test results can fail either in content or with delay.This study will evaluate two interventions designed to increase follow-up: 1) A letter with the test result and potential recommendation for follow...

  17. Striatal morphology correlates with sensory abnormalities in unaffected relatives of cervical dystonia patients.

    Walsh, Richard A

    2012-02-01

    Structural grey matter abnormalities have been described in adult-onset primary torsion dystonia (AOPTD). Altered spatial discrimination thresholds are found in familial and sporadic AOPTD and in some unaffected relatives who may be non-manifesting gene carriers. Our hypothesis was that a subset of unaffected relatives with abnormal spatial acuity would have associated structural abnormalities. Twenty-eight unaffected relatives of patients with familial cervical dystonia, 24 relatives of patients with sporadic cervical dystonia and 27 control subjects were recruited. Spatial discrimination thresholds (SDTs) were determined using a grating orientation task. High-resolution magnetic resonance imaging (MRI) images (1.5 T) were analysed using voxel-based morphometry. Unaffected familial relatives with abnormal SDTs had reduced caudate grey matter volume (GMV) bilaterally relative to those with normal SDTs (right Z = 3.45, left Z = 3.81), where there was a negative correlation between SDTs and GMV (r = -0.76, r(2) = 0.58, p < 0.0001). Familial relatives also had bilateral sensory cortical expansion relative to unrelated controls (right Z = 4.02, left Z = 3.79). Unaffected relatives of patients with sporadic cervical dystonia who had abnormal SDTs had reduced putaminal GMV bilaterally compared with those with normal SDTs (right Z = 3.96, left Z = 3.45). Sensory abnormalities in some unaffected relatives correlate with a striatal substrate and may be a marker of genetic susceptibility in these individuals. Further investigation of grey matter changes as a candidate endophenotype may assist future genetic studies of dystonia.

  18. Psychosocial outcomes of three triage methods for the management of borderline abnormal cervical smears: an open randomised trial

    McCaffery, Kirsten J.; Irwig, Les; Turner, Robin; Chan, Siew Foong; Macaskill, Petra; Lewicka, Mary; Clarke, Judith; Weisberg, Edith; Barratt, Alex

    2010-01-01

    Objective To assess which of three triage strategies for women with borderline abnormal cervical smear results in the best psychosocial outcomes. Design Pragmatic, non-blinded, multicentre, randomised controlled trial. Setting 18 family planning clinics across Australia, covering both urban and rural areas, between January 2004 and October 2006. Participants Women aged 16-70 years (n=314) who attended routine cervical screening and received a borderline cervical smear. Interventions Patients ...

  19. Comparison of conventional Papanicolaou smear and SurePath® liquid-based cytology in the Copenhagen population screening programme for cervical cancer

    Kirschner, Benny; Simonsen, Kåre; Junge, Jette

    2006-01-01

    municipality of Copenhagen with conventional Papanicolaou technique (n = 82,116) and liquid-based cytology (n = 84,414). RESULTS: After the conversion to liquid-based cytology the percentage of unsatisfactory samples decreased from 2.3% to 0.3% (P < 0.001), whereas the number of normal cervical samples lacking...... liquid-based technique. CONCLUSIONS: This study showed the number of unsatisfactory samples to be significantly reduced with the liquid-based technique. The data suggest that there is an increased detection rate of cervical precancerous lesions with liquid-based cytology, but the number of false positive...... an endocervical component increased from 8.5% to 8.9% (P < 0.005). The percentage of samples with atypical cells and cells suspicious for malignancy increased from 3% to 4.2% (P < 0.001) and from 1.9% to 2.4% (P < 0.001), respectively. The subsequent histological follow-up showed normal findings...

  20. Mathematical Description with Fractals Dimensions of Normal Cells and Cytological Abnormality's of Uterine Neck

    Javier Rodríguez

    2006-12-01

    Full Text Available Introduction. The fractal geometry has shownto be adapted in the mathematical description ofirregular objects; this measurement has denominatedfractal dimension. The application of thefractal analysis to measure the contours of thenormal cells as well as those that present sometype of abnormality, has shown the possibility of mathematical characterization of itsirregularity. Objectives. To measure, from thefractal geometry cells of the squamous epitheliumof uterine neck classified like normal,atypical squamous cells of undetermined significance(ASC-US and Low Grade IntraepitelialLesion (L-SIL, diagnosed by means of microscopicobservation, in search of mathematicalmeasurements that distinguish them. Methodology.This is an exploratory descriptive studyin which the fractal dimensions were calculated,with the simplified and the conventional boxcounting method, of the cellular and nuclearcontours of 13 normal and with abnormalitiescells of the scaly epithelium of uterine neck likeASC-US and L-SIL, from digital photographiesof 7 normal cells, 2 ASC-US and 4 L-SIL diagnosedwith cytomorphologic criteria by meansof microscopic conventional observation. Results.There developed a quantitative, objective and reproduciblemeasurement of the degree of irregularityin the cells of the scaly epithelium of uterineneck identified microscopically like normal, ASCUSy LEI BG. Conclusions an fractal organizationwas demonstrated in the cellular normal architecture,as well as in cells ASC-US and the injuriesintraepiteliales of low degree L-SIL. They did notfind differences between the cellular studied types.

  1. Screening results on cervical lesions with DNA quantitative cytology and liquid-based cytology%DNA定量细胞学配合液基细胞学对宫颈病变筛查的价值

    曹红英; 武卫华; 许振; 许艳梅

    2011-01-01

    OBJECTIVE: To evaluate the value of the DNA quantitative cytology with liquid-based cytology in cervical cancer prevention and treatment. METHODS: 4 352 cases of patients in our hospital outpatient gynecologic from 01-01-2009 to 10-31-2010 were involved in this study. All the 504 cases which were recommended biopsy were conducted colposcopy and biopsy. The pathological changes were observed after the routine HE staining. Then the positive coincidence rate of the liquid-based cytology was calculated with routine HE staining and DNA Feulgen staining with routine HE staining respectively. RESULTS: The positive rate was 52. 18% (263/504) with the diagnosis of the TBS biopsy criteria. The positive rate was 66.67%(336/504) with the diagnosis of the DNA Feulgen staining biopsy criteria, While the positive rate was 81.75 % (412/504) with the diagnosis of the two combined cytological method biopsy criteria. There was significant difference among the three methods (P<0. 05). CONCLUSIONS: DNA Feulgen staining compared with the single liquid-based cytology, the rate of early detection of cervical lesions is improved significantly. The false negative rate of thc liquid-based cytology can be reduced by the combination of the two, but also the detection rate of cervical lesions of early can be improved. It plays a posive role in order to prevent further development of lesions of early cervical cancer.%目的:评价DNA定量细胞学配合液基细胞学检查在宫颈癌防治中的价值.方法:收集2009-01-01-2010-10-31在我院妇科门诊行液基细胞学及DNA定量检查的患者4 352例,对检查结果建议为活检的病例504例行阴道镜检查及活体组织检查,常规HE染色后观察病变程度,分别计算其与液基细胞学和DNA Feulgen染色后的阳性率.结果:以TBS活检标准行活检病例的阳性检出率为52.18%(263/504),以DNA定量分析结果活检标准行活检的病例阳性检出率为66.67%(336/504),经2种细胞学方法联

  2. HPV-Based Screening, Triage, Treatment, and Followup Strategies in the Management of Cervical Intraepithelial Neoplasia

    Oscar Peralta-Zaragoza; Jessica Deas; Claudia Gómez-Cerón; Wendy Argelia García-Suastegui; Geny del Socorro Fierros-Zárate; Nadia Judith Jacobo-Herrera

    2013-01-01

    Cervical cancer is the second most common cause of death from cancer in women worldwide, and the development of new diagnostic, prognostic, and treatment strategies merits special attention. Many efforts have been made to design new drugs and develop immunotherapy and gene therapy strategies to treat cervical cancer. HPV genotyping has potentially valuable applications in triage of low-grade abnormal cervical cytology, assessment of prognosis and followup of cervical intraepithelial neoplasia...

  3. Cervical histology after routine ThinPrep or SurePath liquid-based cytology and computer-assisted reading in Denmark

    Rebolj, Matejka; Rask, Johanne; van Ballegooijen, Marjolein;

    2015-01-01

    nationwide registers, technological phases were identified by slide preparation, reading technique, and triage of borderline cytology. Trends in the detection of cervical intraepithelial neoplasia (CIN) were an indicator of the technology's relative sensitivity, and trends in false-positive tests an...... 58%; the 16% increase with ThinPrep was not significant. At 45-59 years, both technologies led to nonsignificant decreases in the detection. SurePath/FocalPoint doubled the frequency of false-positive tests at any age. With ThinPrep, these proportions remained the same at 23-29 years, but decreased...... by two-thirds at 45-59 years. In a fourth laboratory with continuous use of manually read conventional cytology, no such trends were seen. CONCLUSIONS: The sensitivity and specificity of modern LBC and computer-assisted reading technologies may be brand- and age-dependent....

  4. Abnormal surround inhibition does not affect asymptomatic limbs in people with cervical dystonia.

    McDougall, Laura; Kiernan, Dovin; Kiss, Zelma H T; Suchowersky, Oksana; Welsh, Timothy N

    2015-09-14

    Surround inhibition is a neural mechanism hypothesized to facilitate goal-directed action by disinhibiting agonist muscle activity while simultaneously inhibiting antagonist and other uninvolved muscle activity. The present study was designed to investigate if abnormalities in surround inhibition are found in asymptomatic body parts (the hand) of people with focal cervical dystonia (neck). Participants with (n=7) and without (n=17) cervical dystonia completed a protocol in which they abducted their index finger while EMG was recorded from the first dorsal interosseous (agonist) and abductor digiti minimi (uninvolved) muscles. Transcranial magnetic stimulation was delivered over the primary motor cortex at intervals ranging from 0 to 950+ms after the onset of agonist muscle activity. Motor-evoked potential (MEP) amplitudes from both muscles were compared. In control participants, MEPs from the uninvolved muscle were significantly lower than agonist MEPs at intervals from 0 to 480ms. Similarly, in the hands of participants with cervical dystonia - the asymptomatic body part - MEPs from the uninvolved muscle were significantly lower than agonist MEPs from 0 to 175ms. These findings suggest that surround inhibition in people with focal dystonia may be intact in asymptomatic hands. In other words, abnormalities in surround inhibition may be restricted to the dystonic limb. PMID:26219986

  5. Genotype distribution of human papillomavirus (HPV and co-infections in cervical cytologic specimens from two outpatient gynecological clinics in a region of southeast Spain

    Egea-Cortines Marcos

    2009-08-01

    Full Text Available Abstract Background Human Papillomavirus (HPV genotype distribution and co-infection occurrence was studied in cervical cytologic specimens from Murcia Region, (southeast Spain, to obtain information regarding the possible effect of the ongoing vaccination campaign against HPV16 and HPV18. Methods A total of 458 cytologic specimens were obtained from two outpatient gynecological clinics. These included 288 normal benign (N/B specimens, 56 atypical squamous cell of undetermined significance (ASC-US, 75 low-grade squamous intraepithelial lesions (LSIL and 39 high-grade squamous intraepithelial lesions (HSIL. HPV genotyping was performed using PCR and tube array hybridization. Results The most frequent genotype found was HPV16 (14.9% in N/B; 17.9% in ASC-US; 29.3% in LSIL and 33.3% HSIL. Distribution of other genotypes was heavily dependent on the cytologic diagnoses. Co-infections were found in 15.3% of N/B, 10.7% of ASC-US, 48% of LSIL and 25.6% of HSIL cases (significantly different at p Conclusion HPV vaccination might prevent 34.6% and 35.8% of LSIL and HSIL, respectively. Co-infection rate is dependent on both cytologic diagnosis and HPV genotype. Moreover, genotypes belonging to A5, A7 and A9 species are more often found as co-infections than genotype pertaining to A6 species. This suggests that phylogenetically related genotypes might have in common similar grades of dependency for cervical epithelium colonization.

  6. DIAGNOSTIC AND THERAPEUTIC POSSIBILITIES IN THE PROPHYLAXIS OF CERVICAL CANCER

    Marzena Wrześniewska

    2013-11-01

    Full Text Available Poland is one of the countries with high cervical cancer morbidity and mortality. The main means to change this situation is to manage an active and modern programme of cervical cancer prophylaxis and diagnostics. To a large extent, the effectiveness of a cervical cancer prophylaxis programme is decided by the availability of modern diagnostic research. The conventional Papanicolaou test and modern LBC cytology techniques were discussed in the article, taking into consideration HPV diagnostics in the procedures for carefully selected cytological diagnosis, in the so called in-depth stage of preventive screening tests and the role of the p16 biomarker in predicting the development of a higher degree of epithelial-cell pathologies of the cervix. Colposcopy as a diagnostic method for the verification of cytological and virological abnormalities. The modern LEEP/LLETZ procedure used in diagnosis and treatment of cervical changes is used to realise the in-depth stage of cervical cancer prophylaxis programmes.

  7. Research of cervical cytology screening in diagnosis of 370,000 cases with cervical lesion in Guangdong%广东地区37万例妇女子宫颈细胞学筛查子宫颈病变的研究

    Baowen Zheng; Congde Chen; Anxiang Wei; Han Ran; Dong Liu; Wenling Yue; Huirong Zhou; Qingyi Zhu; Juming Su

    2009-01-01

    Objective:Analysis of the results of 37 million cases by using cervical liquid-based cytology screening.discussion the situation of cervical cancer and precancerous lesions in Guangdong province.Methods:From 2002 to 2006.using liquid-based thin-layer cytology (TCT)method screening cervical lesions within 371.929 women in Guangdong.Cytological diagnosis adopt TBS(the Bethesda system)Standard(TBS improved 2001 version of the diagnostic criteria),staastic positive rate by age and region respectively.Results:371,929 cases of gynecology cervical samples in Guangdong.331,251 cases were negative,accounted for 91.23%:cytology positive cases:32,548 cases were squamous intreepithelial lesions(8.96%),486 cases were glandular epithelial lesions(0.13%):grouped according to age:30 to 40-year-old positive rate was 9.13%,40 to 50-year-old positive rate was 9.60%.the latter had higher cytology positive rate;grouped according to region:the total samples in PRD areas were 304.951 cases,accounted for 81.99%,in which 24301 cases were positive(8.14%),in 66978 cases(18.01%)of NON-PRD regions,7645 cases were positive(11.87%),there were 1858 cases had biopsy/follow-up results from 2004t02005.and the rate was 2.88%.Conclusion:The cytological positive rate of cervical cancer and its pre-cancerous lesions was 9.09%in Guangdong(of which the rate of cytological diagnosis as precancerous lesions was 3.40%),30 to 50 age group had the high incidence of cervical cancer and its precursor lesions.and also the main stage of prevention for cervical cancer.Cytology positive rate was 11.87% in economic underdevelopment Non-Pead River Delta regions.much higher than the Pearl River Delta region.

  8. Chlamydia trachomatis detection in cervical PreservCyt specimens from an Irish urban female population.

    Keegan, H

    2012-02-01

    OBJECTIVE: The aim of this study was to determine the prevalence of cervical Chlamydia trachomatis infection by polymerase chain reaction (PCR) in urban women undergoing routine cervical cytological screening and to investigate the relationship with age, cytology, smoking status and concurrent human papillomavirus (HPV) infection. METHODS: A total of 996 women (age range 16-69 years) attending general practitioners for routine liquid-based cervical smear screening in the Dublin area were recruited in the study of prevalence of C. trachomatis. Informed consent was obtained and liquid-based cytology (LBC) specimens were sent for cytological screening. DNA was extracted from residual LBC and tested for C. trachomatis by PCR using the highly sensitive C. trachomatis plasmid (CTP) primers and for HPV infection using the MY09\\/11 primers directed to the HPV L1 gene in a multiplex format. RESULTS: The overall prevalence of C. trachomatis was 5.4%. Prevalence was highest in the <25 years age group (10%). Coinfection with HPV and C. trachomatis occurred in 1% of the screening population. A higher rate of smoking was observed in women positive for C. trachomatis, HPV infections or those with abnormal cervical cytology. Chlamydia trachomatis infection was not associated with abnormal cytology. CONCLUSIONS: Women (5.4%) presenting for routine cervical screening are infected with C. trachomatis. Opportunistic screening for C. trachomatis from PreservCyt sample taken at the time of cervical cytological screening may be a possible strategy to screen for C. trachomatis in the Irish female population.

  9. Fine-needle aspiration cytology in nonpalpable mammographic abnormalities in breast cancer screening: results from the breast cancer screening programme in Oslo 1996-2001.

    Sauer, Torin; Myrvold, Kristina; Lømo, Jon; Anderssen, Karin Yvonne; Skaane, Per

    2003-10-01

    Fine-needle aspiration cytology (FNAC) of nonpalpable mammographic lesions has been under attack from two sides for some years. There has been much discussion and controversy as to the ability to differentiate between in situ and invasive carcinomas in cytological material. A further issue is that of optimal sampling to obtain adequate cell material in sufficient quantity. We present the results of FNAC from 832 nonpalpable mammographic abnormalities detected in the course of the breast cancer screening programme in Oslo during 1996-2001. In 11.6% of cases the smears were inadequate, and there were 7% false negatives (FN) and 1.3% false positives. Of the FN, 64% represented microcalcifications and 86% were due to sampling errors. Absolute sensitivity was 74%, complete sensitivity 88% and specificity 88%. In 255 carcinomas a cytological diagnosis of them as in situ or invasive was made. In 93% of the invasive cases (190/205) these had been correctly identified as invasive on FNAC. In 78% of cases proper follow-up could be resolved by cytology/radiology alone. Suboptimal sampling and localization remains the main cause of FN FNAC results. Problems in differentiating between in situ and invasive breast carcinomas can be significantly reduced by applying strict criteria for in situ lesions. PMID:14659146

  10. The Application Value of Colposcopy Combined with Cervical Cytology in Cervical Lesions%阴道镜检查结合宫颈细胞学在宫颈病变中的应用价值

    王少华

    2014-01-01

    目的:探讨阴道镜检查结合宫颈细胞学在宫颈病变诊治中的临床应用价值。方法随机选在该院接收的656例行阴道镜检查结合宫颈细胞学的妇女作为研究对象,对所有对象的资料进行回顾性分析,总结患者的治疗效果。结果单纯行阴道镜检查筛查3例,无漏诊,癌前期可疑1例。单纯行新柏氏液基细胞学检测检查筛选宫颈癌4例,漏诊1例。行阴道镜检查结合新柏氏液基细胞学检测符合宫颈癌病例5例,无漏诊。结论单纯性阴道镜检查或者新柏氏液基细胞学检测宫颈癌存在漏诊情况,而结合两种方法进行检查后无漏诊现象,即结合两种方法诊断早期宫颈癌有助于提高疾病检出率,值得在临床上推广和使用。%Objective To investigate the clinical application value of colposcopy combined with cervical cytology in the diagnosis and treatment of cervical lesions. Methods 656 cases of women underwent colposcopy combined with cervical cytology in our hos-pital from March, 2012 to March, 2013 were randomly selected as the subjects, and the data of them were analyzed retrospectively, the treatment effect was summarized. Results A simple colposcopy screening 3 cases, no missed diagnosis, pre-cancerous suspi-cious 1 case. Simple ThinPrep liquid-based cervical cytology screening examination in 4 cases, missed 1 case. Colposcopy com-bined with ThinPrep liquid-based cervical cytology in line 5 cases, no missed case. Conclusion Missed diagnosis exists in simple colposcopy or ThinPrep liquid-based cervical cytology for detecting cervical cancer, but that does not exist if combining the two methods for detecting cervical cancer, and the diagnosis of early cervical cancer by combining the two methods is conducive to im-proving the detection rate of the disease, which is worthy of clinical popularization and application.

  11. Multichannel somato sensory evoked potential study demonstrated abnormalities in cervical cord function in brachial monomelic amyotrophy

    Nalini A

    2008-01-01

    Full Text Available Background: Brachial monomelic amyotrophy (BMMA is known to affect the central cervical cord gray matter resulting in single upper limb atrophy and weakness. Settings and Design: Case series of BMMA patients who underwent somatosensory evoked potentials (SEP studies at a tertiary referral center. Aims: We proposed to record Multichannel Somatosensory Evoked Potentials (MCSSEP from median and ulnar nerves with neck in neutral and neck fully flexed position in 17 patients with classical BMMA seen over three years. Materials and Methods: Recordings were done from both median (MN and ulnar nerves (UN. N9, P9, N13, N20 potentials were recorded and amplitudes measured. SSEPs were performed in 22 age-matched healthy men. Amplitudes of cervical response were calculated by N13/P9 ratio and compared in both positions. Results: Among the controls N13 amplitude was always normal {MN: mean N13/P9 - 0.96 in neutral; 0.95 in flexed}{UN: mean N13/P9 - 0.82 in neutral; 0.83 in flexed}, and mean amplitudes did not reveal any difference in both conditions ( P >0.05. Among 17 patients N9, P9 and N20 responses were normal in neutral position. Flexion showed no change in latency or amplitude of N9 and N20 responses ( P -0.63 whereas the N13 response was abnormal in at least one tested nerve in the affected limb (MN: P < 0.01; UN: P < 0.01. During flexion, N13 response was abnormal in 14 (82% patients after MN stimulation and in all 17(100% after UN stimulation {MN: mean N13/P9 - 0.62 in neutral; 0.38 in flexed}{UN: mean N13/P9 - 0.55 in neutral; 0.31 in flexed}. Conclusion: MCSSEP in BMMA with neck flexion caused a significant reduction of the cervical N13 response indicating segmental cervical cord dysfunction.

  12. 6000例宫颈液基细胞学检查的病理分析%Pathological Analysis on 6000 Cases of Cervical Thinprep Cytological Test

    郝彤; 李晓敏; 马潇潇; 刘学伟; 何金萍; 刘晓燕

    2013-01-01

    Objective:Compare detection rate of cervical cancer lession precancerous 、degree of satisfaction of the examples and coincidence of biopsy masccline by liquid-based cytology test and traditional Bethesda smeara.To explore apply value of liquid-based cytology test in the screening of cervical cancer .Methods:Analyse resultes of liquid-based cytology test of six thousands married women in Ren Qiu area.Review resultes of traditional Bethesda smeara of five thousands women from 2008-2010.Compare the two.And compare cervical biopsy of masccline cases.Results:TCT cervical biopsy CINI 69 cases、CINII 16 cases、CINIII 42 cases. detection rate of cervical cancer lession precancerous 、degree of satisfaction of examples and the coincidence of biopsy masccline are 96.02%、2.11%、62.56%.Control group cervical biopsy CINI 23 cases、CINII 5 cases、CINIII 9 cases. detection rate of cervical cancer lession precancerous 、degree of satisfaction of the examples and coincidence of biopsy masccline are 62.7%、0.62%、38.54%.Conclusion:liquid-based cytology test is bet er than traditional Bethesda smeara in the above three indexes. It can improve diagnosis rate of prophase cervix lesion、reduce incidence rate of cervical cancer and promote woman reproductive health.%目的:通过将液基细胞学(TCT)检查与传统巴氏涂片检查对妇科宫颈癌癌前病变的检出率、标本满意度及活检阳性符合率进行对比,探讨TCT在妇科宫颈病变筛查中的应用价值。方法:对任丘地区6000例已婚妇女应用液基细胞学检查结果进行分析,并回顾2008-2010年5000例应用传统巴氏涂片的妇科检查结果,二者对比,并对细胞学检查阳性病例行宫颈活检对照。结果:TCT组宫颈活检CINI 69例,CINII 16例,CINIII 42例,标本满意度和宫颈癌癌前病变的检出率分别是96.02%和2.11%,活检阳性符合率为62.56%;对照组宫颈活检CINI 23例,CINII 5例,CINIII 9例,标本满

  13. Analysis on liquid-based cytology test in the screening of cervical cancer%宫颈癌筛查中液基细胞学研究

    王赫

    2009-01-01

    目的:评价液基细胞学(LPT)薄片制片对宫颈癌筛查的准确性.方法:对3 600例和2 200例受检者分别进行LPT制片和传统宫颈细胞涂片法进行宫颈癌筛查.细胞诊断采用TBS分级系统,阳性诊断包括意义不明的不典型鳞状上皮(ASCUS)以上病变.所有ASCUS以上病变的受检者全部在阴道镜下活检.结果:LPT薄片法和传统涂片法对ASCUS以上病变检出阳性率分别为10.5%和5.2%,两种检测方法的阳性率差异有统计学意义(P<0.01);两种制片方法的阳性结果与病理检查符合率比较:LPT薄片法检出SCC、HSIL、LSIL与阴道镜活检阳性符合率分别为100%、91%、82%,传统宫颈巴氏涂片法检出SCC、HSIL、LSIL与阴道镜活检阳性符合率分别为100%、60%、53%,两种方法比较差异有统计学意义(P<0.05).结论:LPT液基细胞学检查敏感性明显高于传统宫颈细胞涂片法,能大大提高检出率,尤其是对宫颈癌前筛查的患者.%Objective: To evaluate the accuracy of liquid-based cytology test in the screening of cervical cancer. Methods: 3 600 and 2 200 subjects were screened for cervical cancer by liquid-based cytology test and traditional cervical cells smears, respectively. Cell diagnosis adopted TBS-group system, positive diagnosis included above-ASCUS pathological changes. All the subjects of above-ASCUS pathological changes were examined under colposcopo. Results: The detection rates of above-ASCUS pathological changes identified by liq-uid-based cytology test and traditional smears were 10. 5% and 5.2 %, respectively (P < 0. 01) . The coincidence rates of SCC, HSIL and LSIL detected by liquid-based cytology test and biopsy under eolposcepe were 100%, 91% and 82%, respectively, while the coinci-dence rates detected by traditional cervical cells smears and biopsy under colposcope were 100%, 60% and 53%, respectively (P <0. 05)Conclusion: The sensitivity and detection rate of liquid-based cytology test are higher than those

  14. Cervical cancer screening in the Faroe Islands

    Hammer, Turið; Lynge, Elsebeth; Djurhuus, Gisela W;

    2015-01-01

    BACKGROUND: The Faroe Islands have had nationally organised cervical cancer screening since 1995. Women aged 25-60 years are invited every third year. Participation is free of charge. Although several European overviews on cervical screening are available, none have included the Faroe Islands. Our...... aim was to provide the first description of cervical cancer screening, and to determine the screening history of women diagnosed with cervical cancer in the Faroe Islands. MATERIAL AND METHODS: Screening data from 1996 to 2012 were obtained from the Diagnostic Centre at the National Hospital...... 1999. At present, 7.0% of samples have abnormal cytology. Of all ASCUS samples, 76-95% were tested for HPV. A total of 58% of women diagnosed with cervical cancer did not participate in screening prior to their diagnosis, and 32% had normal cytology in the previous four years. CONCLUSION: Despite...

  15. Cellphone based mobile colposcope for the evaluation of women with abnormal cervical cancer screening

    Kahn, Bruce S.; Kass, Alex J.; Waalen, Jill; Levitz, David

    2015-03-01

    Objective: Compare an inexpensive cell-phone based Mobile Colposcope, with a standard colposcope in the evaluation of women with abnormal Pap smear screening. Methodology: The study was a prospective, parallel noninferiority trial. Thirty women underwent colposcopy for the evaluation of an abnormal Pap smear. After application of acetic acid, images of the cervix were obtained with both a standard colposcope and the Mobile Colposcope. An additional set of images using both devices were obtained using the red-free (green filter) mode. Eight experienced gynecologists then evaluated 100 paired images (plain and green filter) from two different sites in random order using a web based assessment program. After reviewing each set of paired images, the expert would make an assessment of: 1) normal (no biopsy/ random biopsy), or 2) abnormal. For abnormal images, the expert then electronically marked the site(s) on the image where a biopsy was recommended. In image analysis, the cervical image was divided into 12 radial sectors and the marked sites for biopsy on the matched pairs were compared. Matched pairs that were considered normal, or those where biopsy site recommendations were within +/- 30° were considered equivalent; unmatched biopsy sites were considered non-equivalent. Results were compared using Wilcoxon Matched Pairs Signed Ranks Test. Expert assessment of Mobile Colposcope images compared with assessment by standard colposcope is currently onging. Conclusions: if the Mobile Colposcope demonstrates non-inferiority to imaging obtained with a standard colposcope and due to its low cost, it has the potential help improve cervical cancer screening in low resource settings.

  16. Age-specific prevalence of HPV genotypes in cervical cytology samples with equivocal or low-grade lesions

    Brismar-Wendel, S; Froberg, M; Hjerpe, A; Andersson, S; Johansson, B

    2009-01-01

    Background: To define the spectrum of human papillomavirus (HPV) types and establish an age limit for triage HPV testing in atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LSIL). Materials and methods: 343 liquid-based cytological samples from the population-based screening programme with minor abnormalities were subjected to HPV genotyping (Linear Array, Roche, Basel, Switzerland). Results: High-risk human papillomavirus (HR-HPV) was found in 71% of LSIL and 49% of ASCUS cases (P<0.001). High-risk human papillomavirus prevalence was age-dependent in LSIL (P=0.01), with decreasing prevalence until the age of 50 years, followed by a slight increase. Human papillomavirus type 16 was the most common HR-HPV, found in 23% of HPV-positive women. Human papillomavirus type 18 was the sixth most common, found in 9.9% (P<0.001). An age-dependent quadratic trend was observed for multiple infections (P=0.01) with a trough at about 42 years. The most common HR-HPV types to show a coinfection with HPV16 (clade 9) were HPV39 (28%), 45 (38%), and 59 (46%), belonging to HPV18 clade 7. The frequency of low-risk (LR) vs probable HR and HR-HPV also followed an age-dependent quadratic trend. Conclusions: After the age of 25 years, HR-HPV prevalence is similar in LSIL and ASCUS cases, motivating a low age limit for triage HPV testing. Multiple infections and LR/HR-HPV dominance are age-dependent. Genotyping in longitudinal design is needed to elucidate the importance of multiple infections in cancer progression and in cross-protection from vaccination. PMID:19623178

  17. CO2 laser vaporization in the treatment of cervical human papillomavirus infection in women with abnormal Papanicolaou smears

    Ruge, S; Felding, C; Skouby, S O; Lundvall, F; Hørding, U; Norrild, B

    1992-01-01

    In a randomized study, we have evaluated the treatment of cervical human papillomavirus (HPV) lesions by CO2 laser vaporization. Fifty patients with abnormal Papanicolaou smears and histological evidence of cervical HPV infection associated or not with cervical intraepithelial neoplasia (CIN) grade...... I were randomized to either a treatment or a control group. The cervical swabs were obtained every 3 months in both groups and examined for HPV type 16 DNA by the polymerase chain reaction. After a follow-up period of 12 months no significant differences were found between the laser treatment and...... the control groups in relation to the disappearance of the abnormal Papanicolaou smear. Two patients in the treatment group and 3 in the control group had a conization because of development of CIN I or aggravation of the concomitant CIN found at the initial visit. The percentage of women who...

  18. Absent cervical spine pedicle and associated congenital spinal abnormalities - a diagnostic trap in a setting of acute trauma: case report

    Congenital spinal abnormalities can easily be misdiagnosed on plain radiographs. Additional imaging is warranted in doubtful cases, especially in a setting of acute trauma. This patient presented at the emergency unit of our university hospital after a motor vehicle accident and was sent to our radiology department for imaging of the cervical spine. Initial clinical examination and plain radiographs of the cervical spine were performed but not conclusive. Additional CT of the neck helped establish the right diagnosis. CT as a three-dimensional imaging modality with the possibility of multiplanar reconstructions allows for the exact diagnosis and exclusion of acute traumatic lesions of the cervical spine, especially in cases of doubtful plain radiographs and when congenital spinal abnormalities like absent cervical spine pedicle with associated spina bifida may insinuate severe trauma

  19. Reproducibilidad en la lectura de un set de placas de citología cérvico-uterinas en cuatro centros especializados de Medellín, Antioquia / Reproducibility of reading a set of cervical cytology smears in four specialized centers in Medellin, Antioquia

    Edwin Guevara

    2014-05-01

    Full Text Available Objetivo: evaluar el grado de reproducibilidad en la lectura de placas de citología cérvico-uterina entre cuatro centros de lectura especializados de la ciudad de Medellín, Colombia. Metodología: 181 placas de citología cérvico-uterina provenientes de un estudio de prevalencia de anormalidades citológicas en Pueblorrico, Antioquia, se sometieron a lectura en cuatro centros especializados de Medellín. Se le pidió a cada centro que realizara una lectura rutinaria manteniendo el estudio en ciego por medio de recodificación de las placas, evitando que se filtrara información entre centros. Se calculó la concordancia general y el índice kappa de Fleiss. Resultados: de las 181 placas, sólo en 55 placas los 4 centros concordaron en el resultado, obteniéndose un porcentaje de concordancia global del 30% y un índice kappa global de 0,31. Según la escala de Fleiss, se observó una baja reproducibilidad en la lectura de las placas citológicas entre los cuatro centros involucrados en el estudio. La concordancia por pares de centros presentó índices de kappa entre 0,3 a 0,7. Discusión: existe una alta variabilidad en la interpretación de los resultados citológicos entre los centros estudiados. Es necesario implementar procesos de entrenamiento y unificación de criterios de lecturas de la citología cervical en nuestro medio Objective: to assess the degree of reproducibility in the reading of cervical cytology smears among four specialized reading centers at Medellin, Colombia. Methodology: 181 cervical cytology smears from a study on the prevalence of cytological abnormalities in Pueblorrico, a town located in the southwestern region of the state of Antioquia in Colombia, were re-read by four specialized centers in Medellin. Each center was asked to conduct a blind routine reading of the smears to avoid disclosure of information between centers. The reproducibility was measured by percentage agreement and kappa. Results: of 181 smears

  20. Cost-effectiveness of conventional cytology and HPV DNA testing for cervical cancer screening in Colombia Costo-efectividad de la citología y la tamización con pruebas de ADN-VPH para cáncer de cuello uterino en Colombia

    Oscar Andrés-Gamboa; Liliana Chicaíza; Mario García-Molina; Jorge Díaz; Mauricio González; Raúl Murillo; Mónica Ballesteros; Ricardo Sánchez

    2008-01-01

    OBJECTIVE: To assess cost-effectiveness of conventional cytology and HPV DNA testing for cervical-cancer screening in Colombia. MATERIAL AND METHODS: The National Cancer Institute of Colombia (NCIC) in 2007 developed a Markov model on the natural history of cervical cancer; no screening, conventional cytology, and HPV DNA testing were compared. Only direct costs were used. Outcomes comprise cervical cancer mortality, years of life saved, and lifetime costs. Discounted incremental cost-effecti...

  1. Effects of streamlining cervical cancer screening the Dutch way: consequences of changes in the Dutch KOPAC-based follow-up protocol and consensus-based limitation of equivocal cytology

    Briët, Martijn C; Berger, Thomas H D; van Ballegooijen, Marjolein;

    2010-01-01

    To analyze the impact of the 1995 revision of the Dutch cervical screening program guidelines (e.g., the introduction of more stringent criteria for cytologic diagnosis of atypical squamous cells of undetermined significance [ASCUS]) on the negative side effects of screening in Region West....

  2. Evaluation of Brain and Cervical MRI Abnormality Rates in Patients With Systemic Lupus Erythematosus With or Without Neurological Manifestations

    Central nervous system (CNS) involvement has been observed in 14-80% of patients with systemic lupus erythematosus (SLE). Magnetic resonance imaging (MRI) is an appropriate method for evaluating CNS involvement in these patients. Clinical manifestations and MRI findings of CNS lupus should be differentiated from other mimicking diseases such as multiple sclerosis (MS). The aim of this study was to evaluate the prevalence and extent of brain and cervical cord MRI lesions of lupus patients. The relationship between neurological signs and symptoms and MRI findings were evaluated as well. Fifty SLE patients who had been referred to the rheumatology clinic of our hospital within 2009 were included in a cross sectional study. All patients fulfilled the revised 1981 American College of Rheumatology (ACR) criteria for SLE. We evaluated the neurological signs and symptoms and brain and cervical MRI findings in these patients. Forty-one patients (82%) were female and nine (18%) were male. The mean age was 30.1 ± 9.3 years. Twenty eight (56%) patients had an abnormal brain MRI. No one showed any abnormality in the cervical MRI. The lesions in 20 patients were similar to demyelinative plaques. Seventeen patients with abnormal brain MRI were neurologically asymptomatic. There was only a significant relationship between neurological motor manifestations and brain MRI abnormal findings. Unlike the brain, cervical MRI abnormality and especially asymptomatic cord involvement in MRI is quite rare in SLE patients. This finding may be helpful to differentiate SLE from other CNS disorders such as MS

  3. Frequency and patterns of abnormal Pap smears in Sudanese women with infertility: What are the perspectives?

    Ahmed O Almobarak

    2013-01-01

    Conclusions: Epithelial cell abnormalities are significantly higher in women with infertility as compared with fertile women. Importantly, inflammatory smears were reported two times more than in the controls. We recommend pap smear as a routine practice for all women assessed for infertility problems. Further studies are necessary to evaluate the incidence of human papilloma virus infections in infertile women with abnormal cervical cytology.

  4. 薄层液基细胞学在宫颈癌及其癌前病变筛查中的价值%The value of Thin prep cytology test in cervical precancerous lesions and cervical cancer screening

    雷静; 万霖; 李惠新; 蒋瑛; 李瑞萍

    2011-01-01

    Objective: To evaluate the detecting technology of thin layers of liquid base cytology (TCT) on the diagnosis of precancerous lesions of uterine cervix and the clinical value, accuracy of the cervical cancer screening. Methods: To collect and analysis 7340 patients who were did examine of TCT in gynecological clinic line of our hospital from May, 2009 ~ November, 2010. Take cytology diagnosed ASC - US and higher as positive results, and the positive results do pathohistological. Take histological diagnosis as gold standard. Results: Thin prep cytology test specimens of SCC, and satisfaction LSIL accuracy HSIL, respectively, 76.8% 97.3%, 100%. Conclusion: TCT combination diagnostic systems of TBS are ideal method of current diagnosis precancerous lesions of uterine cervix (CIN) and cervical cancer screening. Also it can be used as an indicator for cervical cancer detecting. There is some risk of precancerous lesions of young In ASC-US patients.%目的:评价薄层液基细胞学(Thin prep cytology test,TCT)检测技术对宫颈癌前病变的诊断和宫颈癌筛查的准确性及临床价值.方法:收集分析2009年5月~2010年11月在我院妇科门诊行TCT检查的受检者7340例,以细胞学诊断为未明确意义的不典型鳞状上皮细胞(ASC-US)及以上者为阳性结果,并对阳性结果行病理组织学诊断,以组织学诊断作为金标准.结果:液基细胞学标本满意度高,对SCC、HSIL、LSIL的准确率分别为76.8%、97.3%、100%.结论:TCT结合TBS诊断系统是目前诊断宫颈癌前病变和筛查宫颈癌的理想方法 [1],同时也可以作为一项宫颈癌术后随访的检测指标 [2].ASC-US患者中存在部分年轻的高危癌前病变者.

  5. The effectiveness of acetic acid wash protocol and the interpretation patterns of blood contaminated cervical cytology ThinPrep® specimens

    Nora K Frisch

    2015-01-01

    Full Text Available Background: ThinPrep® (TP cervical cytology, as a liquid-based method, has many benefits but also a relatively high unsatisfactory rate due to debris/lubricant contamination and the presence of blood. These contaminants clog the TP filter and prevent the deposition of adequate diagnostic cells on the slide. An acetic acid wash (AAW protocol is often used to lyse red blood cells, before preparing the TP slides. Design: From 23,291 TP cervical cytology specimens over a 4-month period, 2739 underwent AAW protocol due to initial unsatisfactory smear (UNS with scant cellularity due to blood or being grossly bloody. Randomly selected 2739 cervical cytology specimens which did not undergo AAW from the same time period formed the control (non-AAW group. Cytopathologic interpretations of AAW and non-AAW groups were compared using the Chi-square test. Results: About 94.2% of the 2739 cases which underwent AAW were subsequently satisfactory for evaluation with interpretations of atypical squamous cells of undetermined significance (ASCUS 4.9% (135, low-grade squamous intraepithelial lesions (LSIL 3.7% (102, and high-grade squamous intraepithelial lesions (HSIL 1% (28. From the 2739 control cases, 96.3% were satisfactory with ASCUS 5.5% (151, LSIL 5.1% (139, and HSIL 0.7% (19. The prevalence of ASCUS interpretations was similar (P = 0.33. Although there were 32% more HSIL interpretations in the AAW group (28 in AAW vs. 19 in non-AAW, the difference was statistically insignificant (P = 0.18. AAW category; however, had significantly fewer LSIL interpretations (P = 0.02. The percentage of UNS cases remained higher in the AAW group with statistical significance (P < 0.01. Conclusions: While AAW had a significantly higher percent of UNS interpretations, the protocol was effective in rescuing 94.2% of specimens which otherwise may have been reported unsatisfactory. This improved patient care by avoiding a repeat test. The prevalence of ASCUS and HSIL

  6. Carcinogenic HPV prevalence and age-specific type distribution in 40,382 women with normal cervical cytology, ASCUS/LSIL, HSIL, or cervical cancer

    Kjær, Susanne K; Munk, Christian; Junge, Jette;

    2014-01-01

    BACKGROUND: Assessment of the prevaccination type-specific prevalence of human papillomavirus (HPV) in the general population is important for the prediction of the impact of HPV vaccination. METHODS: We collected consecutively residual specimens from liquid-based cytology samples from 40,382 women...... from the general population in Copenhagen, Denmark, during 2002-2005. All samples were tested for high-risk HPV using the Hybrid Capture 2 technique, and genotyping was done using LiPa (Innogenetics). Through linkage with the Pathology Data Bank, we obtained information on the cytology result......, and histology if any, on all women. RESULTS: The participants were 14-95 years of age (median age 37 years) at enrollment. The overall prevalence of HR HPV was 20.6 % ranging from 46.0 % in 20-23-year-old women to 5.7 % in women 65 years or older. Independently of cytology/histology, HPV16 was the most...

  7. The relationship between cerebral infarctive CT findings and cervical carotid arterial abnormalities

    The relationship between cervical carotid arterial changes and cerebral occlusive or ischemic disease was discussed in 120 consecutive cases (60 abnormal and 60 normal CT findings) which had been examined by means both of angiography and of brain CT. Even the low-grade stenosis of the carotid artery (less than 50%) had influence on the infarctive changes in CT; in these low-grade stenotic cases, clinico-pathological study sometimes revealed intimal damage, calcification, and clot formation on the damaged inner wall. Angiographically, the focal accumulation of contrast media in the carotid pathological region is a radiological expression of focal circulatory disturbance, a transient staying of the carotid blood flow, of clot-formation. More dynamic circulatory findings were revealed by Cine-Angiography. In cases of positive brain CT findings, cortical and multiple lesions more frequently had carotid changes and the accumulation of contrast media than did the basal ganglia and subcortical lesions. Even in the cases of negative brain CT findings, carotid changes were observed in about 20% of the cases. Angiographical study has the limitation that it cannot reveal the abnormality of the carotid arterial wall itself. On the other hand, carotid angio-CT was able to reveal carotid wall changes - for instance, calcification at a high density and atheromatous change at a low density: it can also investigate the range and degree. It is also useful in the follow-up study of pre-operative and post-operative changes, or anti-platelet therapy. (author)

  8. Rescreening in cervical cytology for quality control. When bad data is worse than no data or what works, what doesn't, and why.

    Renshaw, Andrew A

    2003-09-01

    The currently mandated methods to measure the sensitivity of Papanicolaou smear interpretation (including the 5-year look back and review of 10% of negative smears) are misleading. They do not allow one to measure the true sensitivity of the test and allow only a small fraction of errors to be detected and corrected. Rapid prescreening and automated screening are the only methods that seem practically feasible, and will allow the sensitivity of the method to be measured on a routine basis, and, thereby allow a reduction in overall errors. Although emerging technologies, such as HPV testing, may allow alternative methods of measuring sensitivity, the most appropriate way to use and interpret these data in this context are not yet fully developed. Unfortunately, at present there seems to be little desire to change the way things are done, and, therefore, to accurately measure sensitivity in cervical cytology. The first task that needs to be undertaken in fixing a problem is to admit that one exists. At present, most laboratory directors believe that their own laboratory is performing satisfactorily. They may well be, although the laboratories lack an analytic method to demonstrate this, and, therefore, the need for better QA methods does not seem to be acute. There is some educational value to the currently practiced and mandated performance measures, the 5-year look back and review of 10% of negative smears. Most laboratory directors seem to be happy with their QA methods and are not concerned that the data that are derived from the 10% review of negative slides does not reflect their actual sensitivity of screening in any meaningful way. Unfortunately, the forces that are currently in place in the United States ensure that accurate measures of the sensitivity of cervical cytology interpretation are unlikely to be implemented beyond the level of individual experimentation. As long as the expectation of cytologists is that the error rates are significantly less than

  9. Association of Human Papillomavirus Infection and Abnormal Anal Cytology among HIV-Infected MSM in Beijing, China

    Yang, Yu; Li, Xiangwei; Zhang, Zhihui; Qian, Han-Zhu; Ruan, Yuhua; Zhou, Feng; Gao, Cong; Li, Mufei; Jin, Qi; Gao, Lei

    2012-01-01

    Background In the recent years, dramatic increases in HIV transmission among men who have sex with men (MSM) have been observed in China. Human papillomavirus (HPV) infection related anal cancer is more common among HIV-infected MSM as compared to the general population. However, HPV infection and anal cytology has been rarely studied in HIV-infected MSM in China. Methods HIV-infected MSM in Beijing, China were invited to participate in this study between January and April 2011. Anal swabs we...

  10. Inter-Rater Agreement of Anal Cytology

    Darragh, Teresa M.; Tokugawa, Diane; Castle, Philip E.; Follansbee, Stephen; Borgonovo, Sylvia; LaMere, Brandon J.; Schwartz, Lauren; Gage, Julia C.; Fetterman, Barbara; Lorey, Thomas; Wentzensen, Nicolas

    2012-01-01

    Most anal cancers are caused by persistent infections with carcinogenic human papillomaviruses (HPV). Similar to cervical carcinogenesis, the progression from HPV infection to anal cancer goes through precancerous lesions that can be treated to prevent invasion. In analogy to cervical cytology, anal cytology has been proposed as a screening tool for anal cancer precursors in high-risk populations. We analyzed the inter-observer reproducibility of anal cytology in a population of 363 HIV-infec...

  11. Intra- and inter-observer reliability of MRI examination of intervertebral disc abnormalities in patients with cervical myelopathy

    Braga-Baiak, Andresa [Center for Excellence in Surgical Outcomes, Duke University Medical Center, Durham, NC (United States); Post-graduation Program, Department of Radiology, University of Sao Paulo (Brazil); Shah, Anand [Center for Excellence in Surgical Outcomes, Duke University Medical Center, Durham, NC (United States); Pietrobon, Ricardo [Center for Excellence in Surgical Outcomes, Duke University Medical Center, Durham, NC (United States); Department of Surgery, Duke University Medical Center, Durham, NC (United States); Braga, Larissa [Center for Excellence in Surgical Outcomes, Duke University Medical Center, Durham, NC (United States); University of Nebraska Medical Center, Lincoln NE (United States); Neto, Arnolfo Carvalho [Clinica DAPI, Curitiba (Brazil); Section of Diagnostic Radiology, Department of Internal Medicine, Universidade Federal do Parana (Brazil); Cook, Chad [Center for Excellence in Surgical Outcomes, Duke University Medical Center, Durham, NC (United States); Division of Physical Therapy, Duke University Medical Center, Durham, NC (United States)], E-mail: chad.cook@duke.edu

    2008-01-15

    Purpose: Intervertebral cervical disc herniation (CDH) is a relatively common disorder that can coexist with degenerative changes to worsen cervicogenic myelopathy. Despite the frequent disc abnormalities found in asymptomatic populations, magnetic resonance imaging (MRI) is considered excellent at detecting cervical spine myelopathy (CSM) associated with disc abnormality. The objective of this study was to investigate the intra- and inter-observer reliability of MRI detection of CSM in subjects who also had co-existing intervertebral disc abnormalities. Materials and methods: Seven experienced radiologists reviewed twice the MRI of 10 patients with clinically and/or imaging determined myelopathy. MRI assessment was performed individually, with and without operational guidelines. A Fleiss Kappa statistic was used to evaluate the intra- and inter-observer agreement. Results: The study found high intra-observer percent agreement but relatively low Kappa values on selected variables. Inter-observer reliability was also low and neither observation was improved with operational guidelines. We believe that those low values may be associated with the base rate problem of Kappa. Conclusion: In conclusion, this study demonstrated high intra-observer percent agreement in MR examination for intervertebral disc abnormalities in patients with underlying cervical myelopathy, but differing levels of intra- and inter-observer Kappa agreement among seven radiologists.

  12. Restriction of human papillomavirus DNA testing in primary cervical screening to women above age 30

    Rebolj, Matejka; Njor, Sisse H; Lynge, Elsebeth

    2012-01-01

    Cervical screening with human papillomavirus (HPV) testing is less specific for high-grade cervical intraepithelial neoplasia (=CIN3) than cytology. The aim of this systematic review was to determine whether a restriction of HPV testing to women aged at least 30 years would eliminate the problem....... On the basis of the data from randomized controlled trials, we calculated the relative detection of CIN1 and CIN2, and the relative risks of false-positive tests (positive tests without subsequent =CIN3) per age group and trial for HPV testing versus cytology. For women aged at least 30 years in...... trials with a low cytology abnormality rate, detection of CIN1 increased significantly by 50-90% in the two trials with reported data; detection of CIN2 was doubled in three trials; the risks of false-positive HPV tests were also doubled. In trials with a high cytology abnormality rate, these risks were...

  13. Cervical lymph node metastases from thyroid cancer: does thyroglobulin and calcitonin measurement in fine needle aspirates improve the diagnostic value of cytology?

    Baldini Enke

    2013-02-01

    Full Text Available Abstract Background Measurement of thyroglobulin (Tg protein in the washout of the needle used for fine needle aspiration biopsy cytology (FNAB-C has been shown to increase the sensitivity of FNAB-C in identifying cervical lymph node (CLN metastasis from well-differentiated thyroid cancer (TC. In this study, we evaluated whether routine measurement of Tg protein (FNAB-Tgp, Tg mRNA (FNAB-Tgm and calcitonin (CT mRNA (FNAB-CTm in the FNAB washout of CLN increases the accuracy of FNAB-C in the diagnosis of suspicious metastatic CLN. Methods In this prospective study 35 CLN from 28 patients were examined. Histology showed metastatic papillary TC (PTC in 26 CLN, metastatic medullary TC (MTC in 3 CLN, metastatic anaplastic TC (ATC in 3 CLN and 3 metastatic CLN from extra-thyroidal cancers. Results The overall accuracy of FNAB-C was 84.4%, reaching 95.7% when the analysis was restricted to PTC. Both FNAB-Tgp and FNAB-Tgm compared favorably with FNAB-C and shown diagnostic performances not statistically different from that of FNAB-C. However, FNAB-Tgp and FNAB-Tgm/FNAB-CTm were found useful in cases in which cytology results were inadequate or provided diagnosis inconsistent with patient's clinical parameters. Conclusions We demonstrated that FNAB-C, Tg/CT mRNA and Tg protein determination in the fine-needle washout showed similar accuracy in the diagnosis of metastatic CLN from TC. The results of this study suggest that samples for Tg protein and Tg/CT mRNA measurements from CLN suspicious for metastatic TC should be collected, but their measurements should be restricted to cases in which FNAB-C provides uninformative or inconsistent diagnosis with respect to patient's clinical parameters.

  14. Desempenho do exame colpocitológico com revisão por diferentes observadores e da captura híbrida II no diagnóstico da neoplasia intra-epitelial cervical graus 2 e 3 Performance of cervical cytology with review by different observers and hybrid capture II in the diagnosis of cervical intraepithelial neoplasia grades 2 and 3

    André Luís Ferreira Santos

    2003-08-01

    Full Text Available Para avaliar o desempenho da colpocitologia (CO de encaminhamento e daquela coletada no serviço de referência, com revisão por diferentes técnicas e observadores, e da captura híbrida II (CH II no diagnóstico da neoplasia intra-epitelial cervical (NIC de alto grau, foram incluídas 105 mulheres atendidas entre agosto de 2000 e junho de 2001 por atipias pré-neoplásicas na CO. Todas foram submetidas à coleta de nova CO e CH II para detecção do DNA-HPV. Foi realizada biópsia cervical em 91, sendo o diagnóstico histológico considerado padrão ouro. Foram descritas a sensibilidade, especificidade e razão de verossimilhança positiva (RVP dos métodos propedêuticos com intervalo de confiança de 95% (IC95%. A sensibilidade e especificidade da CO de encaminhamento foi de 57% e 82% para o diagnóstico de NIC 2 e 3, e a RVP de 3,2 (IC95%: 1,5-6,8. A CO do serviço mostrou uma sensibilidade e especificidade 79% e 84%, respectivamente e RVP de 5,0 (IC95%: 2,5-10,0. A sensibilidade (86%, especificidade (80% e RVP (4,3 foram semelhantes com a revisão lenta realizada pelo segundo observador, havendo uma queda significativa da sensibilidade (64% à revisão rápida pelo terceiro observador. A CH II mostrou alta sensibilidade (100%, baixa especificidade (43% e baixa RVP (1,7, IC95%: 1,4-2,2.To evaluate the performance of initial cervical cytology and that collected at the reference service with a review conducted by different observers and techniques, as well as hybrid capture II, in the diagnosis of high-grade cervical intraepithelial neoplasia (CIN, 105 women attended from August 2000 to June 2001 for preneoplastic atypia upon cervical cytology were included. A new cervical cytology and hybrid capture II for DNA-HPV were conducted in all the patients. Cervical biopsies were taken in 91 women. Performance of the investigative procedures was described by estimating the sensitivity, specificity, and positive likelihood ratio (PLR, with a 95

  15. Cervical Liquid-based Cytology in Cervical Lesions the Pathological Diagnosis of Significance%宫颈液基薄层细胞学在宫颈病变病理诊断中的意义

    郑国文

    2013-01-01

      Objective To investigate the liquid-based cytology (TCT) value in pathological diagnosis of cervical lesions. Methods Retrospective analysis of 2009 January to 2012 June, 5795 patients with TCT cervical cytology, colposcopy biopsy positive cases, compared the two results. Results In 5499 cases of TCT were negative, 296 cases were positive, the positive rate was 5.11%, false negative in 15 cases, no false positive cases. 17 cases of biopsy tissue inflammation, 224 cases of CIN Ⅰ, 20 cases of CINⅡ, 30 cases of CINⅢ, CA 5 cases, LSIL and CIN Ⅰcoincidence rate was 80% (36/45), HSIL and CINⅡ/Ⅲcoincidence rate was 88.9% (24/27). Conclusion TCT examination has a little injury, high positive rate, strong repeatability, for married women can be used as the main method of screening for cervical cancer and precancerous lesions.%  目的探讨液基薄层细胞学(TCT)检查在宫颈病变病理诊断中的意义。方法回顾分析我院2009年1月至2012年6月5795例患者运用 TCT 进行宫颈脱落细胞学检查,阳性病例在阴道镜下活检,二者结果相比较分析。结果 TCT 检查阴性5499例,阳性296例,阳性率5.11%,假阴性15例,无假阳性病例。组织活检炎症17例,CIN Ⅰ224例,CIN Ⅱ20例,CIN Ⅲ30例,CA 5例,LSIL 与 CIN Ⅰ符合率80.0%(36/45),HSIL 与 CIN Ⅱ/Ⅲ符合率88.9%(24/27)。结论 TCT 检查具有损伤小,阳性检出率高,重复性强,对已婚妇女可作为宫颈癌及癌前病变筛查的主要方法。

  16. The possible role of cranio-cervical trauma and abnormal CSF hydrodynamics in the genesis of multiple sclerosis.

    Damadian, Raymond V; Chu, David

    2011-01-01

    UPRIGHT Multi-Position MR scanning has uncovered a key set of new observations regarding Multiple Sclerosis (MS), which observations are likely to provide a new understanding of the origin of MS. The new findings may also lead to new forms of treatment for MS. The UPRIGHT MRI has demonstrated pronounced anatomic pathology of the cervical spine in five of the MS patients studied and definitive cervical pathology in the other three. The pathology was the result of prior head and neck trauma. All eight MS patients entered the study on a first come first serve basis without priority, and all but one were found to have a history of serious prior cervical trauma which resulted in significant cervical pathology. The cervical pathology was visualized by UPRIGHT MRI. Upright cerebrospinal fluid (CSF) cinematography and quantitative measurements of CSF velocity, CSF flow and CSF pressure gradients in the upright patient revealed that significant obstructions to CSF flow were present in all MS patients. The obstructions are believed to be responsible for CSF "leakages" of CSF from the ventricles into the surrounding brain parenchyma which "leakages" can be the source of the MS lesions in the brain that give rise to MS symptomatology. The CSF flow obstructions are believed to result in increases in intracranial pressure (ICP) that generate "leakages" of the CSF into the surrounding brain parenchyma. In all but one MS patient, anatomic pathologies were found to be more severe in the upright position than in the recumbent position. Similarly, CSF flow abnormalities were found to be more severe in the upright position than in the recumbent position in all but one MS patient. Images of the MS patient anatomic pathologies and CSF flow abnormalities are provided with comparison images from normal examinees in Figures 1-15. PMID:21970155

  17. Comprehensive evaluation of early screening of cervical cancer cytological examination%宫颈癌早期筛查细胞学检查方法综合评价

    刘玉瑰

    2015-01-01

    Objective To appraise the comprehensive evaluation of early screening of cervical cancer cytological examination.Methods From October 2012 to October 2014, 1000 cases of gynecology clinic admissions were selected, and they were randomly divided into group A and group B, with 500 cases in each group, group A was given Pap cytology, while B group was given ThinPrep cytology (TCT), comparative analysis of test results, while the colposcopic biopsy histology results were analyzed.Results CIN and cervical cancer diagnostic sensitivity and specificity was significantly higher in group B than those in group A (P < 0.05).Conclusions Early cervical cancer screening to take ThinPrep cytology diagnosis can be achieved relatively good sensitivity and specificity, it is worth learning from.%目的 综合评价宫颈癌早期筛查细胞学检查方法.方法 抽取2012年10月至2014年10月妇科门诊接诊的患者1000例,随机分为A组与B组,每组500例,其中A组采取巴氏细胞学检查,而B组采取液基薄层细胞学检查(TCT),对比分析检查结果,同时与阴道镜组织学活检结果进行对比分析.结果 B组诊断CIN及宫颈癌的敏感性与特异性皆高于A组(P<0.05).结论 宫颈癌早期筛查采取液基薄层细胞学检查诊断可取得比较好的敏感性与特异性,值得借鉴.

  18. Expression of cellular bromodomain protein 4 and human papillomavirus-16 E2 protein in cervical cytological specimens%Brd4与HPV-16病毒E2在宫颈脱落细胞中的表达及意义

    黄卓敏; 江曼茹; 王楚莹; 姚吉龙; 谢建生

    2012-01-01

    Objective To investigate the expression of cellular bromodomain protein (Brd4) and human papillomavirus-16 (HPV-16) E2 protein in cervical cytological specimens as well as their potential roles in cervical carcinogenesis and their potential clinical significances. Methods The expression of Brd4 and E2 protein in 150 cases of cervical cytological specimens with HPV-16 infection was detected by Western-blot assay. According to cytological diagnosis, the samples were classified into five groups, including 30 cases of normal control, 46 cases of ASCUS, 23 cases of LSIL, 31 cases of HSIL and 20 cases of cervical cancer. Then, 120 cases with abnormal cytology were divided into four groups by histopathological identification, including 21 cases of cervicitis, 25 cases of CIN I , 45 cases of CIN Ⅱ/Ⅲ and 29 cases of invasive cervical carcinoma as well. Results Brd4 and E2 protein expression significantly decreased in groups of ASCUS, LSIL, HSIL and cervical carcinoma compared with that in normal cervical exfoliated cells. Meanwhile, Brd4 and E2 protein expression in groups of HSIL and cervical carcinoma was significantly lower than that of LSIL and HSIL. No significant difference of Brd4 and E2 protein expression was found in both groups of cervicitis and CIN I (P > 0.05). However, Brd4 and E2 protein expression was decreased dramatically corresponding with pathological upgrading from CIN group to invasive cervical carcinoma group(P < 0.05). The sensitivity, specificity, positive predictive value and negative predictive value of Brd4 and E2 protein for screening potential cervical lesions in ASCUS was 0.93, 0.94, 0.88, 0.98 and 0.80, 0.95, 0.86, 0.93, respectively. Conclusions Deletion of HPV-16 E2 protein induced by degradation of Brd4-E2 complex has been proved to be a key step in the malignant transformation of HPV-induced cervical cells, which may play an important role in cervical carcinogenesis. Therefore, Brd4 and E2 protein expression may be used for

  19. Impression Cytology

    Sevda Söker

    2007-01-01

    Full Text Available Impression cytology is fast, easy to perform, economical and non-invasive technique for the diagnosis of conjunctival eye diseases. Conjunctival impression cytology using cellulose acetate filter paper of the ocular surface epithelium with no side effects or contraindication. In this article, technique of conjunctival impression cytology is reviewed.

  20. Discussion of Results Inconsistent between the Cervical Biopsy and Cytological Smear%宫颈活检病理诊断与细胞学涂片结果不符的探讨

    贠世娟; 赵素香; 徐辉

    2014-01-01

    Objective:To improve the cytological diagnosis level of cervical lesions and investigate the situation adapt to cervical biopsy.Method:31 pathological sections and cytological smears which results inconsistent between the cervical biopsy and cytological smear in our hospital from 2008 to 2012 were reexamined.Result:Biopsy pathological diagnosis:1 case of AIS;3 cases of CIN1;1 case of CIN hard classification;6 cases of AIM;2 cases of HPV infection;6 cases of ISM;2 cases of atrophy;10 cases of chronic cervicitis.Conclusion:The inspection results of cervical lesions are directly related to the accuracy of cytologic diagnosis which depends on diagnostician's cognitive level.If the cytologic interpretation results are cancer or HSIL,the direct cervical biopsy should be done.If the cytologic interpretation results are LSIL,ASC-H,ASCUS, the vaginoscopy should be done first,then determine whether it’s worth doing cervical biopsy,AGC,cervical canal biopsy or endometrium biopsy related to tumor.%目的:提高对宫颈病变的细胞学诊断水平及探讨适应宫颈活检的情况。方法:复查本院2008-2012年宫颈活检病理诊断与细胞学涂片结果不符31例病理切片及细胞学涂片。结果:活检病理诊断:原位腺癌1例;CIN1(上皮内肿瘤1级)3例;CIN难分级1例;AIM(不典型不成熟鳞状细胞化生)6例;HPV(人乳头状瘤病毒)感染2例;ISM(不成熟鳞状细胞化生)6例;萎缩2例;慢性宫颈炎10例。结论:细胞学诊断的准确性直接关系到宫颈病变的检出,而其依赖于诊断医生的认识水平;细胞学判读结果为癌或HSIL(高级别鳞状上皮内病变)时直接做宫颈活检,为LSIL(低级别鳞状上皮内病变)、ASC-H(非典型性鳞状细胞、不除外HSIL)、ASC-US(意义不明确的非典型性鳞状细胞)时至少要做阴道镜检查后,再决定是否做宫颈活检,AGC(非典型性腺细胞)倾向于肿瘤的

  1. The effects of cervical joint manipulation, based on passive motion analysis, on cervical lordosis, forward head posture, and cervical ROM in university students with abnormal posture of the cervical spine

    Gong, Wontae

    2015-01-01

    [Purpose] The aim of this study was to determine the effect of cervical posture manipulation, based on passive motion analysis (MBPMA) and general mobilization, on cervical lordosis, forward head posture (FHP), and cervical ROM in university students with problems in cervical posture and range of motion (ROM). [Subjects] The Subjects were 40 university students in their 20s who displayed problems in cervical posture and ROM; they were divided into an MBPMA group (n=20) and a mobilization grou...

  2. 液基细胞学和巴氏涂片在宫颈癌筛查中的对比研究%Comparative study of liquid-based cytology and Pap smear in the screening of cervical cancer

    赵章树

    2013-01-01

    Objective: To explore the value of liquid-based cytology and Pap smear in cervical cancer screening of the general population. Methods: Retrospective analysis on 9562 cases of liquid-based cytology specimens were collected by our hospital from 2010-2011, cytology diagnosis using TBS (2001) classification reporting system; and 30 370 cases of Pap smears, cytology diagnosis using Palestine's five classification report; for the part of positive cytology cases, they were all under colposcopy with cervical biopsy and were sent for pathological diagnosis. Results: Among 9 562 cases of liquid-based, the positive were 403 cases, the detection rate was 4.21%, the pathological diagnosis of biopsy-positive rate is 90.3%; Among 30 370 cases of Pap smear, the positive were 187 cases, the detection rate was 0.62%, the pathological diagnosis of biopsy-positive rate is 88.2%. Conclusion: The positive detection rate of liquid-based cytology is much higher than that of Pap smear, but there is no obvious difference in pathological diagnosis of biopsy-positive rate between liquid-based cytology and Pap smear.%目的:探讨液基细胞学(TCT)和巴氏涂片检查在普通人群宫颈癌筛查中的价值.方法:回顾性分析2010-2011年本院收集的TCT标本9 562例,细胞学诊断以TBS (2001)分级系统报告;巴氏涂片标本30 370例,细胞学诊断以巴氏五级分类法报告;对细胞学阳性者,在阴道镜下行宫颈活检,送病理诊断.结果:9 562例TCT标本中阳性者403例,检出率为4.21%,和组织病理学诊断阳性符合率为90.3%;30 370例巴氏涂片标本中阳性者187例,检出率为0.62%,和组织病理学诊断阳性符合率为88.2%.结论:TCT阳性检出率明显高于巴氏涂片组,和组织病理学诊断阳性符合率两者无明显差异.

  3. 高危型 HPV 结合液基细胞学技术在宫颈癌前病变诊断中的应用%Application of High-risk HPV Combined with Liquid-based Cytology Technology in the Diagnosis of Cervical Lesions

    颜萍; 龚旭华

    2014-01-01

    Objective To investigate the application of high-risk HPV genotyping assay combined with liquid-based cy-tology for cervical lesions .Methods Liquid-based cytology samples of 204 cases of cervical cancer were detected by high-risk HPV genotyping assay ,and were compared with cervical biopsy results .Results 138 patients were TCT-positive combined with HPV infection,LSIL showed that HPV-positive was 40 cases (29.0%),HSIL showed that HPV-positive was 10 cases (7.2%), ASCUS showed that HPV-positive was 80 cases(58.0%),SCC showed that HPV-positive was 8 cases (5.8%).High-risk HPV was 42 cases,and positive rate was 30.4%.Samples of different types of high-risk HPV infection had significant difference ( P<0.05).When TCT and HPV were both ( -),there had no high grade lesion .When HPV-positive and TCT abnormal both oc-curred,detection rate of ≥CINⅠwas 34.8%.When TCT was abnormal HPV (-),the detection rate was 47.8%.Conclusion High-risk HPV genotyping assay combined with liquid-based cervical cytology is a valuable method for early screening of cervical cancer,the result is more reliable than single inspection .%目的:探讨高危型HPV基因分型检测结合液基细胞学检查在宫颈癌前病变诊断中的应用。方法纳入204例宫颈癌患者,采集液基细胞标本后,进行高危型HPV基因分型检测,并与宫颈活检结果进行比较分析。结果138例患者显示TCT阳性合并HPV感染,其中LSIL显示HPV阳性40例(29.0%),HSIL显示HPV阳性10例(7.2%),AS-CUS显示HPV阳性80例(58.0%),SCC显示HPV阳性8例(5.8%)。42例HPV高危型,阳性率为30.4%。不同类型标本HPV高危型感染率具有显著性差异( P<0.05)。 TCT和HPV均为(-)时,则未发生高度病变。 HPV阳性和TCT异常同时存在时,≥CINⅠ的检出率为34.8%。仅TCT异常而HPV(-)时,检出率为47.8%。结论高危型HPV基因分型检测结合液基细胞学检查是极具价

  4. Clinical Application of Colposcopy Cervical Biopsy and Liquid-based Cytology Test in the Screening of Cervical Lesions%阴道镜宫颈活检与 TCT 联合检测在宫颈病变中的应用

    冷海娜; 孙名芳

    2013-01-01

    Objective To explore the clinical application value of colposcopy cervical biopsy and liquid -based cytology test in the screening of cervical lesions .Methods Four hundred and eighty-three patients who udergone the TCT examination from January to December in gynecological clinic were chosen for pathological colposcopy cervical biopsy To select 483 gynecological clinic patients who had the TCT examination and were inspected to be abnormal in Care Hospital from January to December ,2012 ,have pathological colposcopy cervical biopsy for them and retrospective a-nalysis fwas carried out .or their entire clinical datum .Among which the TBS diagnostic system wasis used in the TCT in-spection report ,which contributed to the diagnosis ,as well as combined with the pathological examination report to make the diagnosis.Results Among the patients with the TCT result being ASC-US351,CINⅠ~CINⅢ223 patients(63. 53%) were detected with the pathological colposcopy cervical biopsy;CINⅠ~CINⅢ75 patients(91.46%) were de-tected with the pathological colposcopy cervical biopsy;CINⅠ~CIMⅢ41 patients were detected with the pathological colposcopy cervical biopsy and among the 6 SCC patients ,SCC 6 patients were detected with the colposcopy cervical bi-opsy .Conclusion The diagnose accordance rate of TCT examination and cervical biopsy diagnosis is high ;the diagnose accordance rate of cervical cancer with CIN of higher level is high .Precancerous lesions of uterine cervix can be found at an earlier age with the adoption of colposcopic cervical biopsy combined with TCT examination and stopped or slowed down ,which is the safe ,reliable and accurate examination method for the screening of cervical cancer .%目的:探讨阴道镜宫颈活检与宫颈薄层液基细胞学( TCT )在宫颈病变筛查中的临床应用价值。方法选取2012年1月~12月在妇科门诊行宫颈薄层液基细胞学( TCT)检查异常的483例患者,并同时行阴道镜宫颈活检

  5. Spinal cord swelling with abnormal gadolinium-enhancement mimicking intramedullary tumors in cervical spondylosis patients: Three case reports and review of the literature

    Sasamori, Toru; Hida, Kazutoshi; Yano, Shunsuke; Takeshi, Aoyama; Iwasaki, Yoshinobu

    2010-01-01

    Objective: Spinal cord swelling with abnormal gadolinium (Gd) enhancement is a rare preoperative radiological finding in patients with cervical spondylosis. In the presence of progressive myelopathy, timely surgical decompression can be curative. Case presentation: We report 3 patients with cervical spondylotic myelopathy. Preoperative magnetic resonance imaging (MRI) revealed spondylotic changes and intramedullary lesions in the cervical spine. We noted cervical cord swelling with high intensity on T2-weighted MRI and abnormal Gd-DTPA enhancement. Laminoplasty resulted in marked improvement of their neurological condition and postoperative MRI revealed gradual regression of the intramedullary lesions during the first year. Conclusion: We posit that the intramedullary lesions in our patients were reflective of spinal cord edema with blood-brain-barrier disturbance in the cervical cord, possibly due to minor recurrent spinal cord injury and disturbed venous circulation. Spinal cord edema is a rare condition in patients with cervical spondylosis and an accurate diagnosis and timely surgery are necessary for cure. Therefore, this unusual condition must be considered in spondylosis patients manifesting as intramedullary lesions on MRI of the cervical spinal cord. Careful evaluation of the postoperative course can be used to confirm the diagnosis and help in selecting a subsequent therapeutic strategy. PMID:22028753

  6. 颈淋巴结穿刺细胞学检查对颈淋巴结转移的诊断价值%Clinical value of aspiration cytology of cervical lymph node in the diagnosis of cervical lymph node metastasis

    刘新梅

    2016-01-01

    Objective To investigate the clinical value of aspiration cytology of cervical lymph node in the diagnosis of cervical lymph node metastasis.Methods 80 cases of thyroid cancer with cervical lymph node metastasis admitted in our hospital from January 2003 to February 2015 were randomly selected.All patients were treated with fine needle aspiration cytology of cervical lymph node;the results were observed and recorded, and then compared with the routine postoperative pathological diagnosis results for analysis.Results After 80 patients received fine needle aspiration cytology of cervical lymph node, 74 cases were diagnosed as metastasis of cervical lymph node of thyroid cancer, with the positive rate of 92.50%;and the sensitivity of aspiration cytology of cervical lymph node was higher than that of slide cytological examination (85.19% vs.33.33%), with statistically significant difference (P<0.05).Conclusion Aspiration cytology of cervical lymph node can provide accurate preoperative diagnosis for thyroid cancer patients with cervical lymph node metastasis, which is helpful for the decision of the surgical plan and the successful development of the treatment.%目的 探讨采用颈淋巴结穿刺细胞学检查进行颈淋巴结转移诊断的临床价值.方法 随机选取本院2003年1月至2015年2月收治的甲状腺癌颈淋巴结转移患者80例,所有患者均接受颈淋巴结细针穿刺细胞学检查,对患者的细胞学检查结果进行观察记录,并同术后常规病理诊断结果进行对比分析.结果 80例患者经颈淋巴结穿刺细胞学检查,其中74例患者诊断为存在甲状腺癌颈淋巴结转移,阳性率为92.50%;颈淋巴结穿刺细胞学检查的灵敏度(85.19%)明显高于甲状腺切片细胞学检查结果(33.33%),差异有统计学意义(P<0.05).结论 颈淋巴结穿刺细胞学检查可对甲状腺癌合并颈淋巴结转移患者进行准确的术前诊断,有助于手术方案的制定和治疗的

  7. Genomic amplification patterns of human telomerase RNA gene and C-MYC in liquid-based cytological specimens used for the detection of high-grade cervical intraepithelial neoplasia

    Chen Shaomin

    2012-04-01

    Full Text Available Abstract Background The amplification of oncogenes initiated by high-risk human papillomavirus (HPV infection is an early event in cervical carcinogenesis and can be used for cervical lesion diagnosis. We measured the genomic amplification rates and the patterns of human telomerase RNA gene (TERC and C-MYC in the liquid-based cytological specimens to evaluate the diagnostic characteristics for the detection of high-grade cervical lesions. Methods Two hundred and forty-three residual cytological specimens were obtained from outpatients aged 25 to 64 years at Qilu Hospital, Shandong University. The specimens were evaluated by fluorescence in situ hybridization (FISH using chromosome probes to TERC (3q26 and C-MYC (8q24. All of the patients underwent colposcopic examination and histological evaluation. A Chi-square test was used for categorical data analysis. Results In the normal, cervical intraepithelial neoplasia grade 1 (CIN1, grade 2 (CIN2, grade 3 (CIN3 and squamous cervical cancer (SCC cases, the TERC positive rates were 9.2%, 17.2%, 76.2%, 100.0% and 100.0%, respectively; the C-MYC positive rates were 20.7%, 31.0%, 71.4%, 81.8% and 100.0%, respectively. The TERC and C-MYC positive rates were higher in the CIN2+ (CIN2, CIN3 and SCC cases than in the normal and CIN1 cases (p p p > 0.05. Conclusions The TERC test is highly sensitive and is therefore suitable for cervical cancer screening. The C-MYC test is not suitable for cancer screening because of its lower sensitivity. The amplification patterns of TERC become more diverse and complex as the severity of cervical diseases increases, whereas for C-MYC, the amplification patterns are similar between the normal/CIN1 and CIN2+ groups. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1308004512669913.

  8. BACTERIAL VAGINOSIS IS NOT IMPORTANT IN THE ETIOLOGY OF CERVICAL NEOPLASIA - A SURVEY ON WOMEN WITH DYSKARYOTIC SMEARS

    VANLEEUWEN, AM; PIETERS, WJLM; HOLLEMA, H; QUINT, WGV; BURGER, MPM

    1995-01-01

    Background and Objectives: It has been suggested that bacterial vaginosis may play a role in the etiology of cervical neoplasia. The authors analyzed the prevalence, risk factors, and impact on histologic changes of bacterial vaginosis in women with cytological abnormalities of the uterine cervix. M

  9. Multichannel somato sensory evoked potential study demonstrated abnormalities in cervical cord function in brachial monomelic amyotrophy

    Nalini A; Praveen-Kumar S; Ebenezer Beulah; Ravishankar S; Subbakrishna D

    2008-01-01

    Background: Brachial monomelic amyotrophy (BMMA) is known to affect the central cervical cord gray matter resulting in single upper limb atrophy and weakness. Settings and Design: Case series of BMMA patients who underwent somatosensory evoked potentials (SEP) studies at a tertiary referral center. Aims: We proposed to record Multichannel Somatosensory Evoked Potentials (MCSSEP) from median and ulnar nerves with neck in neutral and neck fully flexed position in 17 patients with classical...

  10. The value of liquid-based cytology combined with colposcopy in cervical cancer screening%液基细胞学联合阴道镜筛查在宫颈癌防治中的应用价值

    刘晓艳

    2013-01-01

    Objective To investigate the value of liquid-based cytology combined with colposcopy in cervical cancer screening. Methods 400 cases were randomly divided into two groups, each 200 cases, the observation group used liquid-based cytology combined with colposcopy, the control group simply used liquid-based cytology, then pathological findings diagnostic results and analyzed the false positive rate and false negative rate were compared in the two groups. Results The observation group with cervical cancer diagnosed was 95.4%, and then were significantly higher than 63.1% in control group (P < 0.05), the observation group with false negative rates of false-positive rate was significantly lower than control group (P < 0.05). Conclusion The liquid-based cytology combination with colposcopy can improve cervical cancer screening rates and reduce the misdiagnosis and missed diagnosis rate, so it is worthy of promotion.%目的:探讨液基细胞学联合阴道镜筛查在宫颈癌防治中的应用价值。方法选择400例患者,随机分为两组,各200例,观察组使用液基细胞学联合阴道镜检术,对照组则单纯使用液基细胞学检查,比较两组患者诊断结果与病理检查结果,并分析假阳性率和假阴性率。结果观察组宫颈癌确诊率为95.4%,显著高于对照组的63.1%(P<0.05),观察组假阳性率和假阴性率均显著低于对照组(P<0.05)。结论液基细胞学检查联合阴道镜检能有效提高宫颈癌筛查率,减少误诊和漏诊率,值得临床推广。

  11. Application of thinprep cytology test and cervical smear combined with colposcope in screening of cervical lesions%液基细胞学、宫颈刮片联合阴道镜在宫颈病变筛查中的应用

    江明珠

    2015-01-01

    目的 探讨液基细胞学(TCT)、宫颈刮片联合阴道镜在宫颈病变筛查中的应用价值. 方法 选取2014年1月~2015年4月来我所妇科门诊行TCT筛查的1726例妇女(门诊组)和在乡镇行宫颈刮片细胞学筛查的26 021例妇女(乡镇组)作为研究对象,两组均行TBS分级诊断,将细胞学阳性者进一步行阴道镜及镜下活组织病理学检查,分析两组不同取材方法的细胞学筛查结果,并观察细胞学阳性者的阴道镜和病理组织学检查结果. 结果 两组细胞学检出阳性率差异有统计学意义(X2=86.56,P0.05). 以病理组织学诊断为金标准,宫颈癌前病变和宫颈癌(CIN+SCC)两者合计,阴道镜诊断符合率为90.14%(128/142), 细胞学诊断符合率为70.73%(87/123). 结论 TCT筛查法优于传统刮片细胞学筛查法,联合应用阴道镜及镜下活检组织病理学检查,可明显提高宫颈癌前病变及宫颈癌的检出.%Objective To discuss the application value of thinprep cytology test(TCT) and cervical smear combined with colposcope in screening of cervical lesions. Methods 1726 cases of female patients (outpatient group) visited outpatient clinic in our hospital from January 2014 to April 2015 and 26 021 cases of rural women (rural group) receiving cervical cancer screening were selected as research object.Two groups were diagnosed by TBS classification,and those with pos-itive cytologic results were further examined by colposcope and histopathological examination.The cytologic screening results in two groups were analyzed by different methods, the colposcope and histopathologic results of patients with positive cytologic results were observed. Results There was significant difference in positive rate of cytologic results be-tween two groups (X2=86.56,P0.05).The gold standard was diagnosed by histopathology.The total of cervical precancerous lesions and cervical cancer (CIN+SCC),colposcope diagnosis coincidence rate was 90.14%(128/142),and cytology

  12. ROLE OF COLPOSCOPY USING MODIFIED REID’S INDEX IN SCREENING OF CERVICAL CANCER IN WOMEN WITH ABNORMAL CERVIX ON NAKED EYE EXAMINATION

    Deshpande; Yelikar; Andurkar; Dahitankar

    2014-01-01

    OBJECTIVE: To assess the validity of Colposcopy using Modified Reid's Index as a screening tool in cervical cancer in women with abnormal cervix on naked eye examination . METHODS: This observational study was carried out in Government medical college, Aurangabad from June 2011 to May 2013 . Total 392 women with abnormal cervix on naked eye examination of underwent colposcopy and diagnosis was made on the basis of Modified R eid’s Index. Colposcope directed biops...

  13. Human papillomavirus research on the prevention, diagnosis, and prognosis of cervical cancer in Taiwan.

    Chao, Angel; Huang, Huei-Jean; Lai, Chyong-Huey

    2012-01-01

    Cervical cancer is third in incidence and fourth in mortality among cancers of women worldwide. Epidemiological studies have shown that human papillomavirus (HPV) is necessary, if not sufficient, to cause nearly 100% of cervical cancers. HPV testing is useful in primary screening for cervical neoplasms. The value of HPV detection or genotyping is potentially useful in triage of borderline or low-grade abnormal cervical cytology, follow-up after treatment of cervical intraepithelial neoplasia, assessment of prognosis and treatment planning for invasive cervical cancer. Studies from Chang Gung Memorial Hospital have defined the genotype distribution of cervical cancer in Taiwan and confirmed the independent prognostic value of the HPV genotype in cervical cancer. The cost-effectiveness of using HPV testing in prevention and management of cervical neoplasms depends on the medical and public health infrastructure of the individual country. The population-based HPV prevalence and genotype distribution as well as longitudinal follow-up studies have established strong support for incorporating HPV testing with cervical cytology and for future comparisons of HPV epidemiology before and after implementation of HPV prophylactic vaccines in Taiwan. Future directions in HPV research are discussed. PMID:22913856

  14. Computer-assisted myelography in degenerative abnormalities of the cervical vertebral column.

    van der Tas, C

    1979-01-01

    In 19 patients with symptoms suggestive of a cervicobrachial syndrome due to degernative lesions of the cervical spine, a CT scan was made after intrathecal administration of metrizamide. The images thus obtained supply adequate information on the extent of bone apposition, if any, on the degree of displacement and compression of the spinal cord, and on the condition of the intervertebral foramina. A CT scan is indicated in the case of discrepancy between myelographic findings and clinical diagnosis. In the case of recurrent postoperative symptoms, too, CT scans have proved to supply valuable information. PMID:535511

  15. Concurrent evaluation of visual, cytological and HPV testing as screening methods for the early detection of cervical neoplasia in Mumbai, India.

    Shastri, Surendra S.; Ketayun Dinshaw; Geetanjali Amin; Smriti Goswami; Sharmila Patil; Roshini Chinoy; Kane, S.; Rohini Kelkar; Richard Muwonge; Cédric Mahé; Dulhan Ajit; Sankaranarayanan, R.

    2005-01-01

    OBJECTIVE: Naked eye visual inspection with acetic acid (VIA), magnified VIA (VIAM), visual inspection with Lugol's iodine (VILI), cytology and human papillomavirus (HPV) testing were evaluated as screening methods for the detection of high-grade squamous intraepithelial lesions (HSIL) of the uterine cervix in a cross-sectional study in Mumbai, India. METHODS: Cytology, HPV testing, VIA, VIAM and VILI were carried out concurrently for 4039 women aged 30-65 years. All women were investigated w...

  16. Telomerase activity as a biomarker for (pre)neoplastic cervical disease in scrapings and frozen sections from patients with abnormal cervical smear

    Wisman, GBA; Hollema, H; de Jong, S; ter Schegget, J; Tjong-A-Hung, SP; Ruiters, MHJ; Krans, M; de Vries, EGE; van der Zee, AGJ

    1998-01-01

    Purpose: To evaluate the diagnostic value of semiquantitative telomerase activity assessment in cervical scrapings together with human papillomavirus (HPV) typing for detection of (pre)neoplastic cervical lesions and to compare telomerase activity in cervical scrapings and frozen specimens from the

  17. Detection of gene amplification in MYCN, C-MYC, MYCL1, ERBB2, EGFR, AKT2, and human papilloma virus in samples from cervical smear normal cytology, intraepithelial cervical neoplasia (CIN I, II, III, and cervical cancer

    Dabeiba Adriana García

    2011-06-01

    Full Text Available Introducción: El cáncer cervical es el segundo cáncer más importante en mujeres a nivel mundial y es la segunda causa de muerte por cáncer en mujeres. Se ha demostrado que el proceso de carcinogénesis cervical presenta componentes tanto genéticos como epigenéticos y medio ambientales. En la actualidad, hay gran interés en la búsqueda de marcadores moleculares asociados con la progresión de esta enfermedad, uno de los posibles mecanismos y que además está poco estudiado en cáncer cervical es la amplificación génica de algunos oncogenes como la familia MYC, EGFR y AKT entre otros. Objetivos: Detectar la amplificación génica de MYCN, C-MYC, MYCL1, ERBB2, EGFR y AKT2 además de la presencia del virus de papiloma humano en cepillados cervicales en mujeres con citología normal o con neoplasia intraepitelial cervical (NIC I, II y III o con cáncer cervical. Métodos: Se genotipificó mediante reverse line blot (RLB el virus de papiloma humano (VPH y se determinó el estado de amplificación génica de los genes mencionados mediante PCR en tiempo real utilizando sondas taqman. Resultados: El VPH se encontró presente en 4% de las pacientes con citología normal, en 48% en NIC I, 63.6% en NIC II, 64% en NIC III y 70.8% en cáncer cervical. Los genes MYCN, MYCL1 y ERBB2 mostraron mayor amplificación en lesiones de alto grado y cáncer con diferencias estadísticamente significativas  a las lesiones de bajo grado y citología normal, en 39.1%, 34.7% y 30.4% respectivamente. Además, se encontraron amplificados los genes C-MYC, EGFR y AKT2, en muestras de pacientes con cáncer cervical, en 12%, 18% y 13% respectivamente. Sin embargo, no se observaron diferencias estadísticamente significativas con respecto a las lesiones de alto y bajo grado y citología normal. Conclusión: En las lesiones de alto grado como en cáncer cervical, se encuentra mayor prevalencia del virus al igual que se detectan mayor cantidad de alteraciones gen

  18. 不同细胞学检查方法在宫颈癌筛查中的应用%Applications of different methods for cytological examination in cervical cancer screening

    张敏; 张丽华; 胡争光; 徐爱娣

    2012-01-01

    Objective; To evaluate the effects of different methods for cytological examination in cervical cancer screening, explore the appropriate techniques for screening of cervical cancer, in order to conduct early diagnosis and early treatment, improve the detection rate of precancgrous lesions of uterine cervix. Methods: Liquid - based cytological test and traditional Papanicolaou smear were used for cervical cancer screening among 1 091 cases and 4 784 cases respectively from October 2005 to June 2007, then the cases with positive results of cytological examination underwent biopsy under colposcope and pathological examination. Results: The sensitivity, specificity, negative predictive value, positive predictive value, and coincidence rate of traditional Papanicolaou smear were 44. 44% , 83. 33% , 30. 0% , 83. 33% , and 77. 95 % , respectively; the sensitivity, specificity, negative predictive value, positive predictive value, and coincidence rate of traditional Papanicolaou smear were 92. 11% , 88. 37% , 77. 78, 88. 37% , and 89. 52% , respectively. The detection rate of precancerous lesions of uterine cervix by liquid - based cytological test was 91. 67% , which was significantly higher than that by traditional Papanicolaou smear (40. 00% ) ( P < 0. 05) . Conclusion: The sensitivity of liquid - based cytological test is significantly higher than that of traditional Papanicolaou smear, liquid - based cytological test can improve the detection rate obviously, especially for the cases with low - grade squa-mous intraepithelial lesion (LSIL) and high -grade squamous intraepithelial lesion (HSIL) .%目的:评价不同细胞学检查方法在宫颈癌筛查中的作用,探讨宫颈癌筛查的适宜技术,以便做到早诊、早治,有效提高宫颈癌前病变的检出率.方法:采用液基薄层细胞学检测技术(LCT)及传统宫颈细胞涂片(巴氏涂片)法,分别对2005年10月~ 2007年6月1 091名及4 784名受检者进行宫颈癌筛查,根据细胞学

  19. Validade da citologia e da biópsia orientada pela colposcopia no diagnóstico do carcinoma cervical pré-clínico Validity of cytology and colposcopy - guided biopsy for the diagnosis of preclinical cervical carcinoma

    Aldo Franklin Ferreira Reis

    1999-05-01

    ,5 para displasia acentuada e carcinoma in situ, zero para displasia leve e moderada, zero para negativo e inflamatório e 0,4 para o conjunto de resultados negativos para invasão.Purpose: to evaluate the efficacy of cytology and colposcopy-directed biopsy to distinguish preclinical invasive cervical carcinoma from intraepithelial lesions. Patients and Methods: 441 patients submitted to conization, hysterectomy and Wertheim-Meigs operation from 1978 to 1995 in the University Hospital "Clementino Fraga Filho", Federal University of Rio de Janeiro, Cervical Pathology Outpatient Clinic. We estimated sensitivity, specificity, predictive values, likelihood ratio and confidence intervals of each study, which were divided into four classes: 1 normal and inflammatory; 2 mild and moderate dysplasias; 3 severe dysplasia and carcinoma in situ; 4 microcarcinoma and invasive carcinoma. Biopsies were analyzed as a whole and separated in accordance with the type of the colposcopic result (satisfactory and unsatisfactory. Results: cytology has shown sensitivity of 50%, specificity of 89%, positive predictive value of 63% and negative predictive value of 82%. The likelihood ratios were 4.4 for stromal invasion diagnosis, 0.7 for severe dysplasia and carcinoma in situ, 0.1 for mild and moderate dysplasia, 2.2 for normal and inflammatory report and 0.6 for the negative results for invasion as a whole. Satisfactory colposcopic guided biopsy white a visible lesion showed sensitivity of 59%, specificity of 100% positive predictive value of 100% and negative predictive value of 83%. Likelyohood ratios were: tending to infinity for invasion, 0.5 for severe dysplasia and carcinoma in situ, zero for mild and moderate dysplasia, zero for negative and inflammatory and 0.4 for all negative results for invasion.

  20. The PapilloCheck Assay for Detection of High-Grade Cervical Intraepithelial Neoplasia.

    Crosbie, Emma J; Bailey, Andrew; Sargent, Alex; Gilham, Clare; Peto, Julian; Kitchener, Henry C

    2015-11-01

    Human papillomavirus (HPV) testing is used in primary cervical screening, as an adjunct to cervical cytology for the management of low grade abnormal cytology, and in a test of cure. PapilloCheck (Greiner Bio-One) is a PCR-based DNA microarray system that can individually identify 24 HPV types, including the 13 high-risk (HR) types identified by Hybrid Capture 2 (HC2). Here, we compare PapilloCheck with HC2 for the detection of high-grade cervical intraepithelial neoplasia (CIN2+) in a total of 8,610 cervical cytology samples from the ARTISTIC population-based cervical screening study. We performed a retrospective analysis of 3,518 cytology samples from round 1 ARTISTIC enriched for underlying CIN2+ (n = 723) and a prospective analysis of 5,092 samples from round 3 ARTISTIC. Discrepant results were tested using the Roche reverse line blot (RLB) or Linear Array (LA) assay. The relative sensitivity and specificity of HR PapilloCheck compared with that of HC2 for the detection of CIN2+ in women aged over 30 years were 0.94 (95% confidence interval [CI], 0.91, 0.97) and 1.05 (95% CI, 1.04, 1.05), respectively. HC2 missed 44/672 (7%) CIN2+ lesions, while HR PapilloCheck missed 74/672 (11%) CIN2+ lesions. Thirty-six percent of HC2-positive normal cytology samples were HR HPV negative by both PapilloCheck and RLB/LA, indicating that the use of HR PapilloCheck rather than HC2 in population-based primary screening would reduce the number of additional tests required (e.g., reflex cytology) in women where underlying CIN2+ is extremely unlikely. HR PapilloCheck could be a suitable HPV detection assay for use in the cervical screening setting. PMID:26338859

  1. A evaluation on cervical intraepithelial lesion and cervical cancer screening by DNA quantitative analysis and liquid-based monolayer cytology%液基薄层细胞学联合DNA定量方法对宫颈病变诊断试验的评价

    侯安丽; 张玉娟; 李秀芬; 邵雪斋; 王杏茶

    2012-01-01

    目的 评价采用液基薄层细胞学联合DNA定量分析方法进行宫颈癌普查的工作效率.方法 对参与宫颈癌普查的2 599名妇女用宫颈刷取材,进行液基薄层制片,分别进行巴氏染色和Feulgen染色,由细胞学医师对巴氏染色片做细胞学诊断,应用全自动DNA定量分析对Feulgen染色片进行自动扫描诊断.其中156例进一步做了宫颈组织病理诊断.结果 DNA定量分析方法的敏感度、特异度、准确度、阳性预测值、阴性预测值、阳性似然比均高于液基薄层细胞学方法,而误诊率、漏诊率及阴性似然比均低于液基薄层细胞学方法.液基薄层细胞学和DNA定量分析方法的平行诊断试验的联合敏感度和联合特异度分别是99.56%、44.52%,两种方法的系列诊断试验的联合敏感度和联合特异度分别是83.78%、89.61%.平行诊断试验的敏感度最高,系列诊断试验的特异度最高.结论 DNA定量分析方法与液基薄层细胞学联合筛查,可提高宫颈癌前病变及宫颈癌筛查的敏感度和特异度.%Objective To evaluate the working efficiency of cervical cancer screening by combining DNA quantitative analysis with liquid-based monoiaycr cytology. Methods A total of 2599 women were involved in this study and cervical samples were taken by a cervical brush. Monolaycr of cells were deposited onto microscopic slides by liquid-based sampling preparation. Two slides were prepared from each case: one slide was stained by Papanicolaou stain for conventional cytology examination, while the other slide was stained by Fculgcn method for determination of amount of DNA using an automated DNA imaging cytomctry. 156 women of the total were followed by pathological examination of cervical tissue. Results The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and positive likelihood ratio of DNA quantitative analysis arc higher than liquid-based monolaycr cytology,however the

  2. 液基细胞学检查与HPV定量分析在宫颈癌普查中的应用%Application of Thinprip Cytologic Test Combined with Cervical HPV Quantitative Analysis in the General Survey of Cervical Cancer

    黎骋

    2015-01-01

    目的::探讨宫颈液基细胞学检查与宫颈HPV定量分析联合应用于宫颈癌普查中的临床病理意义。方法:回顾性分析2010年3月至2014年3月的1000例妇产科患者的临床资料,包括患者的门诊资料和住院病历数据,记录、比较液基细胞检查、HPV定量分析及联合诊断的准确率,总结相关数据的临床意义。结果:HPV感染率与各级宫颈病变和年龄段之间存在统计学差异( P<0.05)。液基细胞学检查准确率(79.60%)低于宫颈HPV定量分析准确率(81.00%)和联合检查准确率(98.50%),宫颈液基细胞学检查联合宫颈HPV定量分析的临床准确率显著高于宫颈液基细胞学检查、宫颈HPV定量分析的单独准确率(P<0.05)。结论:较之单独的宫颈液基细胞学检查和宫颈HPV定量分析,二者联合具有极高的诊断准确率,为子宫颈癌普查中的有效方法,可在临床筛查中进一步推广应用。%Objective:To discuss the clinicopathological significance of applying thinprip cytologic test (TCT) combined with cervical HPV quantitative analysis in the general survey of cervical cancer. Methods:Retrospectively analyzed the clinical datas of 1 000 patients in obstetrics and gynecology department from Mar 2010 to Mar 2014;the outpatient datas, hospital cases, TCT, HPV quantitative analysis and diagnosis were recorded and compared to; and summarized the clinical significance of the related datas. Results:There were differences in HPV infection rate,all level cervical lesions and age groups (P<0. 05). The accuracy of TCT (79. 60%) was lower than cervical HPV quantitative analysis (81. 09%) and combined diagnosis (98. 51%). Clinical accuracy of liquid-based cervical cytology combined with quantitative analysis of cervical HPV was significantly greater than that of liquid-based cervical cytology or cervical HPV quantitative analysis alone (P<0. 05). Conclusion:TCT combined with cervical HPV quantitative

  3. 探讨宫颈液基细胞学与HPV检测在宫颈癌筛查中的联合作用%The Discussion about the Combined Effect of Cervical Liquid Based Cytology and HPV Test in Screening for Cervical Cancer

    李琴艳; 付雯; 刘蔚; 陈加来

    2014-01-01

    Objective:To discuss the application value of Thin prep cytologic test and high-risk human papilloma virus HPV-DNA test in the diagnosis of cervical lesions. Method:1194 patients in our hospital department of gynaecology clinic were selected as the research object,who should do cervical liquid based cytology and HPV test routinely. Cytology positive or HPV-DNA positive did pathology biopsy test under colposcope and regarded the pathology diagnosis as the gold standard. Result:The sensitivity,specificity,accuracy,and Youden index of each diagnostic test was listed respectively as follows:89.66%,90.49%,90.45%,0.801 for liquid-based cytology,79.31%,91.90%,91.29%,0.712 for HPV DNA test,94.83%,89.70%,89.95%,0.845 for combine liquid-based cytology and HPV DNA test in parallel,87.93%, 95.16%,94.81%,0.831 for combine liquid-based cytology and HPV DNA test in series. The diagnosis value of combine liquid-based cytology and HPV DNA test in series and in parallel was higher than the others through the analysis of the area under ROC curve. Conclusion:LPT combined with HPV-DNA testing for cervical cancer screening can improve not only the sensitivity and specificity of cervical cancer and precancerous lesions,but also detection rate.%目的:探讨液基细胞学检查(LPT)与高危型人乳头状瘤病毒HPV-DNA检测在子宫颈病变诊断中的应用价值。方法:选取1194例在本院妇科门诊就诊的妇女作为研究对象,常规行宫颈液基细胞学及HPV-DNA检查,以活检的病理诊断为金标准。结果:以组织病理学结果作为标准,液基细胞学检查方法的敏感性、特异性、准确性及约登指数分别为89.66%、90.49%、90.45%、0.801,HPV-DNA检测方法的敏感性、特异性、准确性及约登指数分别为79.31%、91.90%、91.29%、0.712,并联液基细胞学检查和HPV DNA检测方法的敏感性、特异性、准确性及约登指数分别为94.83%、89.70%、89.95%、0.845,串

  4. [P16NIK4a expression in premalignant cervical lesions].

    Bolanca, Ines Krivak; Simon, Suzana Katalenić; Sentija, Karmela; Duić, Zeljko; Kukura, Vlastimir; Zovko, Gojko; Valetić, Josip; Vranes, Jasmina

    2011-09-01

    Increased expression of viral E6 and E7 oncoproteins within the host cells results in an increase in cellular protein p16INK4a expression. That increase may serve as a marker for dysplastic and neoplastic cells of the uterine cervical epithelium. The aim of this study is to assess the p16INK4a protein expression in different stages of cytological abnormality in correlation with the proven high oncogenic risk human papillomavirus infection in order to demonstrate its value as the diagnostic marker. The study included cervical smear samples of 371 patient in whom the viral typization was done. In 171 patient, during their regular gynaecological examination, along with conventional Pap smear sampling an additional smear was taken. Two hundred cervix brush (Rovers Medical DevicesOss, the Netherlands) samples were obtained and analyzed by the LBC method and the ThinPrep2000 machine. All samples were analyzed cytologically, classified according to the Bethesda system, and immunostained with the p16INK4a-specific monoclonal antibody E6H4 (MTM Laboratories, Heidelberg, Germany). A significant difference is seen in p16 positivity between the cytological diagnosis of a high grade cervical squamous intraepithelial lesion and the group with mild dysplasia (chi2=146,48; D.F.=4; ptechnique renders it suitable for follow-up monitoring as well as for comparison of the cytological results. PMID:23126030

  5. Application of liquid -based cytology with colposcopy in diagnosis of cervical lesions%液基细胞学结合阴道镜检查在诊断宫颈病变中的应用

    周晓花

    2011-01-01

    Objective To explore and evaluate the liquid -based cytology(TCT) and colposcopy for cervical lesions.Methods The diagnostic criteria for pathological results in our hospital colposcopy, biopsy and the cervical lesions TCT test results were analyzed.Results TCT compared with the biopsy tissue, benign coincidence rate was 98.4% , LSIL, HSIL, cancer diagnosis rate was 85.4% ,97% and 100%; Colposcopy compared with histologica findings, CIN or more colposcopy cervical lesions was 97.8% compliance.Conclusions TCT consistent with colposcopy was no significant difference( P > 0.05 ), application of TCT assisted colposcopy can improve cervical lesions and cancer detection rate.%目的 探讨和评价液基细胞学(TCT)结合阴道镜对宫颈病变的诊断价值.方法 以病理学结果为诊断标准,对在永城市人民医院进行阴道镜、活检及TCT的宫颈病变患者的检查结果进行分析.结果 TCT与活检病理组织学相比,良性符合率为98.4%,LSIL、HSIL、癌的诊断符合率分别为85.4%、97%和100%;阴道镜检查结果与组织学相比,CIN以上的宫颈病变阴道镜符合率为97.8%.结论 TCT与阴道镜检查符合率无统计学意义(P>0.05),应用TCT辅助阴道镜检查可提高宫颈癌前病变和癌变的检出率.

  6. The effect of human papillomavirus DNA testing and cervical cytology for screening of cervical precancerous lesions%人乳头瘤病毒DNA检测和宫颈细胞学检查对宫颈癌前病变筛查的效果

    梁瑜; 彭华丽

    2015-01-01

    Objective To investigate the effect of human papillomavirus (HPV) DNA testing and cervical cytology screening of cervical precancerous lesions. Methods 1100 patients admitted to our hospital who were carried out screening cervical precancerous lesions from January 2013 to June 2014 were selected,all were carried out HPV DNA testing,cervical cytology,colposcopy and cervical biopsy,pathological diagnosis was as the standard,the test results were analyzed. Results Positive rate of HPV DNA testing was 23.00% in 1100 patients,in which,positive rate of cervical cancer was 83.33%,positive rate of cervical intraepithelial neoplasia (CIN) Ⅰ was 44.44%,CIN II testing was 86.67%, CINⅢ positive rate was 94.12%.Cervical cytology results showed that there were 851 cases (77.36%) with no CIN,139 cases (12.64%) were atypical squamous cells,78 cases (7.09%) were low-grade squamous intraepithelial lesion,29 cases (2.64%) of high-grade squamous intraepithelial cells lesions,3 cases (0.27%) of squamous cell carcinoma.The compli-ance rate of colposcopy examination and pathological diagnosis was 62.79% (54/86). Conclusion The suitable cervical lesions screening method for patients can help to improve the detection rate,reduce the incidence rate of cervical cancer.%目的:探讨人乳头瘤病毒(HPV)DNA检测和宫颈细胞学检查对宫颈癌前病变筛查的效果。方法选取2013年1月~2014年6月来本院就诊并进行宫颈癌前病变筛查的1100例患者,均进行HPV DNA检测、宫颈细胞学检查、阴道镜检查与宫颈活检,以病理诊断为标准,对检测结果进行分析。结果1100例患者中,HPV DNA阳性率为23.00豫,其中宫颈癌阳性率为83.33豫,宫颈上皮内瘤变(CIN)Ⅰ阳性率为44.44豫,CINⅡ阳性率为86.67豫,CINⅢ阳性率为94.12豫。宫颈细胞学检查无CIN 851例(77.36豫),非典型鳞状上皮细胞139例(12.64豫),低度鳞状上皮细胞内病变78例(7.09豫),高度鳞状上皮细胞内病变29

  7. Detection of Cervical Liquid Based Cytology in the Meaning of the Lotus Pond Town Women Cervical Cancer Screening%宫颈液基细胞学检测在荷塘镇妇女宫颈癌筛查中的意义

    霍喜兰

    2014-01-01

    目的:探讨宫颈液基细胞学检查技术(TCT)在荷塘镇宫颈癌筛查中的应用价值。方法:对1328例本镇及外来务工已婚妇女使用液基细胞学检测(LCT)进行宫颈癌筛查。采用TBS诊断系统选择TCT报告ASCUS以上患者428例行电子阴道镜检并活检病理,将两者结果进行比对分析。结果:宫颈液基细胞学检查1328例中428例阳性,阳性率32.2%。ASCUS 128例,LSIL 86例,ASC-H 90例,HSIL 124例。对TCT检查阳性的428例进行阴道镜病理检查,正常164例,CIN Ⅰ级102例,CIN Ⅱ/Ⅲ级154例,鳞癌8例。宫颈液基细胞学检查结果与组织病理结果符合率,LSIL与CINⅠ级符合率84.3%(86/102),HSIL与CINⅡ/Ⅲ级符合率80.5%(124/154)。结论:基层医院积极开展宫颈癌筛查LCT检测,有助于癌前病变的早发现、早诊断、早治疗。%Objective:To study the cervical liquid based cytology examination technology (TCT) in the lotus pond,the value of cervical cancer screening. Method:The town and migrant workers,1328 cases of married women with a Liquid based cytology test (Liquid-based cytology test,LCT) for cervical cancer screening. Patients with ASCUS by TBS diagnosis system choice TCT report 428 routine electron microscopic examination of the vagina and biopsy pathology,to compare the two results were analyzed. Result:In 1328 patients with cervical liquid based cytology,428 cases of positive,positive rate was 32.2%. ASCUS 128 example, LSIL 86,ASC-H 90,HSIL 124 cases. For TCT examination of 428 patients with colposcope pathologic examination,the result:164 patients with normal,CINⅠgrade 102 cases,CINⅡ/Ⅲlevel of 154 cases squamous carcinoma,8 cases of cervical liquid based cytology examination results and the histopathological results coincidence rate,LSIL and CINⅡ/Ⅲlevel coincidence rate 84.3%(86/102),HSIL and CINⅡ/Ⅲlevel coincidence rate 80.5%(124/154). Conclusion:Basic-level hospital actively carry out cervical cancer

  8. HPV-Based Screening, Triage, Treatment, and Followup Strategies in the Management of Cervical Intraepithelial Neoplasia.

    Peralta-Zaragoza, Oscar; Deas, Jessica; Gómez-Cerón, Claudia; García-Suastegui, Wendy Argelia; Fierros-Zárate, Geny Del Socorro; Jacobo-Herrera, Nadia Judith

    2013-01-01

    Cervical cancer is the second most common cause of death from cancer in women worldwide, and the development of new diagnostic, prognostic, and treatment strategies merits special attention. Many efforts have been made to design new drugs and develop immunotherapy and gene therapy strategies to treat cervical cancer. HPV genotyping has potentially valuable applications in triage of low-grade abnormal cervical cytology, assessment of prognosis and followup of cervical intraepithelial neoplasia, and in treatment strategies for invasive cervical cancer. It is known that during the development of cervical cancer associated with HPV infection, a cascade of abnormal events is induced, including disruption of cellular cycle control, alteration of gene expression, and deregulation of microRNA expression. Thus, the identification and subsequent functional evaluation of host proteins associated with HPV E6 and E7 oncoproteins may provide useful information in understanding cervical carcinogenesis, identifying cervical cancer molecular markers, and developing specific targeting strategies against tumor cells. Therefore, in this paper, we discuss the main diagnostic methods, management strategies, and followup of HPV-associated cervical lesions and review clinical trials applying gene therapy strategies against the development of cervical cancer. PMID:23690785

  9. HPV-Based Screening, Triage, Treatment, and Followup Strategies in the Management of Cervical Intraepithelial Neoplasia

    Oscar Peralta-Zaragoza

    2013-01-01

    Full Text Available Cervical cancer is the second most common cause of death from cancer in women worldwide, and the development of new diagnostic, prognostic, and treatment strategies merits special attention. Many efforts have been made to design new drugs and develop immunotherapy and gene therapy strategies to treat cervical cancer. HPV genotyping has potentially valuable applications in triage of low-grade abnormal cervical cytology, assessment of prognosis and followup of cervical intraepithelial neoplasia, and in treatment strategies for invasive cervical cancer. It is known that during the development of cervical cancer associated with HPV infection, a cascade of abnormal events is induced, including disruption of cellular cycle control, alteration of gene expression, and deregulation of microRNA expression. Thus, the identification and subsequent functional evaluation of host proteins associated with HPV E6 and E7 oncoproteins may provide useful information in understanding cervical carcinogenesis, identifying cervical cancer molecular markers, and developing specific targeting strategies against tumor cells. Therefore, in this paper, we discuss the main diagnostic methods, management strategies, and followup of HPV-associated cervical lesions and review clinical trials applying gene therapy strategies against the development of cervical cancer.

  10. Psychological effects of diagnosis and treatment of cervical intraepithelial neoplasia

    Frederiksen, Maria Eiholm; Njor, Sisse; Lynge, Elsebeth; Rebolj, Matejka

    2015-01-01

    statistical testing, we estimated the statistical significance of the differences between the compared groups using unpaired t tests. MAIN RESULTS: From 5099 retrieved abstracts, 16 studies were included. Diagnosis and treatment of CIN were associated with worse psychological outcomes than normal cytology...... test results, but the impact decreased over time. In several but not all studies, CIN appeared to have similar psychological consequences to abnormal smears. No study showed a difference in psychological outcomes between CIN and cervical cancer diagnosis when these were measured some years after......BACKGROUND: Treatment of cervical intraepithelial neoplasia (CIN) is a common minor surgical procedure to prevent uterine cervical cancer. However, news of an abnormality detected at screening for cancer might cause the woman to worry. OBJECTIVES: To investigate the psychological consequences of...

  11. Comparing human papillomavirus prevalences in women with normal cytology or invasive cervical cancer to rank genotypes according to their oncogenic potential: a meta-analysis of observational studies

    Bernard, Erik; Pons-Salort, Margarita; Favre, Michel; Heard, Isabelle; Delarocque-Astagneau, Elisabeth; Guillemot, Didier; Thiébaut, Anne,

    2013-01-01

    BackgroundMucosal human papillomavirus (HPV) infection is a necessary cause of cervical cancer. Vaccine and non-vaccine genotype prevalences may change after vaccine introduction. Therefore, it appears essential to rank HPV genotypes according to their oncogenic potential for invasive cervical cancer, independently of their respective prevalences.MethodsWe performed meta-analyses of published observational studies and estimated pooled odds ratios with random-effects models for 32 HPV genotype...

  12. The Comparative Analysis of Liquid Based Cytology Diagnosis and Histological Diagnosis in 83 Cases of Cervical Squamous Cell Carcinoma%宫颈癌患者液基细胞学与组织学诊断的比较分析

    仇波; 彭悦; 邓亚平; 刘志红; 曾亮

    2012-01-01

    目的:通过对液基细胞学检测(TCT)与组织学活检的比较分析,探讨TCT出现漏诊的原因.方法:收集83例宫颈癌患者的宫颈活检组织蜡块和宫颈脱落细胞标本,组织蜡块行常规病理切片检查,脱落细胞标本进行TCT检测.结果:和组织病理学诊断结果比较,这些患者的TCT诊断漏诊18例.进行过抗HPV治疗的宫颈癌患者,其TCT漏诊率明显高于未治疗者(P<0.05).结论:TCT在宫颈癌筛查中存在一定的漏诊,其产生的原因与癌细胞分化程度、宫颈糜烂程度、非诊断细胞的干扰、不当的采集方法及抗HPV治疗有关.%Objective: To explore the causes of the errors of liquid based cytology test, through a comparative analysis of liquid based cytology test and histology of biopsy. Methods: The paraffin blocks of cervical biopsies and the cervical cytology specimens of 83 cases of cervical carcinoma were collected, the paraffin blocks were for routine HE staining and histological diagnosis, the cytology specimens were dectected with liquid based cytology test and diagnosis. Results: Compared to histological diagnosis, the diagnosis in the liquid based cytology of these patients showed that 18 cases were missed diagnosed. The rate of misdiagosis of these patients whot-had been regularly anti-HPV treated was significantly higher than that of the others (P<0.05). Conclusion: There were some errors in liquid based cytology test in cervical cancer screening, the reasons associated with the cell differentiation ,the degree of cervical erosion, the interference from non-diagnostic cells, the improper collection method and that the patients had been regularly anti-HPV treated.

  13. Clinical Value of Liquid-based Cytology in the Diagnosis of Cervical Lesions%液基细胞学检查在诊断宫颈病变中的临床价值

    姜丽红; 杨滨

    2011-01-01

    [目的]探讨宫颈液基细胞学检查(TCT)对宫颈病变的诊断价值及意义.[方法]回顾性分析中国医科大学附属盛京医院门诊57 784例TCT筛查结果.细胞学诊断采用TBS(2001)分级报告系统,阳性诊断包括意义不明确的不典型鳞状细胞(ASC-US)及以上病变,其中阳性者554例行阴道镜下宫颈活组织检查,其中317例同时又进行了宫颈高危型人乳头瘤病毒DNA(HPV-DNA)检测,对三者进行了对比分析.另外对经宫颈活检证实为宫颈癌并同时有TCT检测结果的103例患者结果也进行了对比分析.[结果]①TCT检查阳性结果与宫颈活检诊断符合率:鳞状细胞癌(SCC)3例及腺癌4例均符合组织病理学诊断;高级别鳞状上皮内病变(HSIL)符合率为86.67%(91/105),低级别鳞状上皮内瘤变(LSIL)符合率为33.93% (38/112);②经宫颈活检证实为原位癌和SCC患者TCT与宫颈活检诊断的符合率为28.57%(26/91),假阴性率38.46%(35/91),经宫颈活检证实为腺癌患者TCT与宫颈活检诊断的符合率为50.00%(6/12),假阴性率41.67%(5/12);③TCT提示HPV感染与宫颈HPV-DNA检测的符合率为79.00%(173/219);④宫颈高危型HPV-DNA 阳性检出率与组织病理学分级正相关.[结论]TCT用于宫颈病变筛查,能够及时发现大量的宫颈病变,TCT结果为HSIL及宫颈癌的患者与宫颈活检诊断的符合率较高.TCT提示HPV感染有较高的准确性,但TCT对宫颈癌筛查有较高的假阴性率.对于TCT检查阴性、而临床高度可疑恶性病变、年龄较大的患者应予以重视,进一步做阴道镜检查及高危型HPV-DNA检测和宫颈活组织检查,尤其是宫颈管诊刮,以降低宫颈癌的漏诊率.高危型HPV-DNA检测可以作为TCT诊断的客观控制指标,还可作为ASC-US及LSIL患者分流无病与患病人群的检查.%[Objective] To explore the value of liquid-based cervical cytology(TCT) for the diagnosis of cervical lesions and its significance. [Methods] The TCT

  14. 液基细胞学及HPV分型检测在宫颈病变筛查中的应用%Thinprep Cytology Test and HPV Genotyping in Screening of Cervical Lesions

    焦凤娟; 韩洁

    2013-01-01

    Objective: To investigate the clinical significance of thinprep cytology test (TCT) and HPV genotyping in cervical le-sions. Methods: TCT and HPV genotyping were done for 390 cases of cervical lesions, and did the biopsy for who was ≥ASCUS. Results: In the 390 cases, the positive rates of TCT and HPV were 26.41% and 28.72%; the rate of high-risk type of HPV in 103 cas-es of TCT-positive patients was 63.11%, and the biopsy showed that there were inflammation 46 cases, CIN I 24 cases, CIN II 12 cases, CIN III 18 cases and cervical cancer 3 cases. Conclusion: TCT and HPV genotyping can improve the detection rate of cervical cancer and precancerous lesions, it has important significance in early diagnosis and prevention for cervical cancer.%  目的:探讨液基细胞学(TCT)联合HPV 分型检测在宫颈病变筛查中的临床意义.方法:对390例宫颈病变患者行TCT 检查和 HPV 检测,对≥ASCUS 患者行组织活检.结果:390例患者中 TCT 和 HPV 阳性率分别为26.41%、28.72%;103例TCT阳性患者中高危型HPV阳性率为63.11%,组织活检结果为炎症46例、CIN I 24例、CIN II 12例、CIN III 18例和宫颈癌3例.结论:TCT联合HPV检测可提高对宫颈癌及癌前病变的检出率,对宫颈癌的早期诊断和防治有重要临床意义.

  15. 宫颈液基细胞学检查、HPV分型、LEEP环状电切术在宫颈疾病中的诊治意义%Diagnostic and therapeutic significance of thinprep cytologic test, HPV genotyping and loop electrosurgical excision procedure for cervical diseases

    谷新; 邓雷

    2012-01-01

    Objective To investigate the diagnostic and therapeutic significance and clinical value of thinprep cytologic test, HPV genotyping and loop electrosurgical excision procedure for cervical diseases. Methods From January to December 2010 in Enshi center hospital, 4 613 patients were taken gynecological examination and thinprep cytologic test, 336 cases with the positivity of thinprep cytologic test were taken electronic colposcopy and colposcopic cervical biopsy, diagnosed 125 cases of cervical intraepithelial neoplasia-like lesions and cervical cancer, they were taken HPV genotyping. cervical severe erosion and repeated physical therapy chronic cervicitis of CIN Ⅱ and some CIN I , and early diagnosis of cervical cancer conization were treated with loop electrosurgical excision procedure, the surgical removal of tissue were taken pathological examination. Results The diagnosis rate was 98.6% for cervical liquid-based brush cytology proposed line cervical biopsy of electronic colposcopy and colposcopy, HPV genotyping check, HPV genotyping check positive 125 cases and the the loop electrosurgical excision procedure after excision pathological examination, no case of intraoperative bleeding in the surgery, 5 cases with cervical wound after the scab off bleeding, and no case of postoperative infection. Conclusion Electronic colposcopy, thinprep cytologic test, HPV genotyping and cervical biopsy has important diagnostic value for cervical precancerous lesions; the loop electrosurgical excision procedure in the treatment of cervical disease has small risk of surgery, and simple operation, less bleeding and high success rate, loop electrosurgical excision has important clinical value in the diagnosis and treatment of cervical disease.%目的 探讨宫颈液基细胞学检查、HPV分型、LEEP环状电切术在宫颈疾病中的诊治意义及临床价值.方法 对2010年1~12月在恩施州中心医院就诊的4 613例患者行妇检、宫颈液基细胞学刷片检查,

  16. Analysis of cervical smears in a Muslim population

    Screening for the cancer of the cervix remains a neglected health care issue in Pakistan. To provide baseline data for future efforts to improve screening, we conducted a retrospective analysis of cervical smears taken in the obstetrics and gynaecological clinics of the Agha Khan University Hospital, Karachi, Pakistan. We collected data on cervical smear cytology for cervical smears taken from January 1, 1990 to December 31, 1996. We assessed risk factors for dysplasia, including age, age at first marriage, and number of pregnancies. The overall prevalence of abnormal smears in our study was 0.5%. Of 20,995 cervical smears, showed non-specific inflammation, 7302 (34.8%) were reported as normal, 809 (3.85%) showed monillial infection, 148 (0.71%) showed atypia, 105 (0.5%) had dyplastic cytology and 52 (0.25%) samples were inadequate. The highest incidence of dysplastic smears was seen in the age group 35 to 44 years. Of 105 patients with dysplasia 12 were pregnant, and all were asymptomatic. The low prevalence of abnormal smears, compared with the data from Western populations, could be due to the internet bias of health awareness in the women who attended our hospital. The results of this study may serve as baseline for for future comparisons. A large community-based study may establish the exact prevalence of malignant and premalignant lesions so as to plan for future screening. (author)

  17. Prevalence of cervicitis in dairy cows and its effect on reproduction.

    Hartmann, D; Rohkohl, J; Merbach, S; Heilkenbrinker, T; Klindworth, H P; Schoon, H A; Hoedemaker, M

    2016-01-15

    The objective of this study was to determine whether cervicitis in dairy cows is an independent disease or occurs concomitantly with inflammation of the uterus, and to clarify possible effects of cervicitis on reproductive performance. Dairy cows (n = 416) from 33 dairy farms were examined by rectal palpation and vaginoscopy between 42 and 50 days postpartum. Inclusion criteria for this study were absence of abnormal vaginal discharge and abnormalities of the uterus (fluctuation) at rectal palpation. Cervicitis was diagnosed when the second cervical fold was swollen and prolapsed with (C2) or without (C1) reddening. Cytobrush samples from the uterus (n = 370) and the cervix (n = 402) were collected, and the percentage of neutrophils in the uterus (PMNU) and the cervix as indicators of inflammation (threshold: ≥5%) was determined. In addition, endometrial biopsies for histology were collected, 300 of which were suitable for evaluation. Cervicitis (C1/C2) was diagnosed in 253 of 416 (60.8%) of cows. Of these, the prolapsed cervical mucosa was hyperemic (C2) in 29.1% of cases. Of 370 available uterine cytology samples, 221 cows had a clinical cervicitis; however, 170 (76.9%) had PMNU less than 5%. Of 300 uterine histologic examinations, 82 (27.3%) did not reveal any abnormalities; the remaining cows either had uterine inflammation and/or degenerative uterine changes such as endometriosis and angiosclerosis. Furthermore, of 300 biopsied animals, 184 revealed a cervicitis (C1/C2); however, 30.4% of these animals had no histopathologic uterine findings. For further analysis, only animals either without histopathologic findings and normal uterine cytology or with solely endometritis (defined as PMNU ≥ 5% and/or positive histopathology of the uterine tissue) were evaluated (n = 157). Of these, 95 cows had cervicitis. Unexpectedly, 63 of 95 (66.3%) cows had cervicitis without endometritis. With regard to reproductive performance, days to first service were

  18. Conjunctival impression cytology in contact lens wearers.

    Simon Priya

    2002-01-01

    Full Text Available PURPOSE: To evaluate the cytological changes in conjunctiva following regular contact lens wear and to determine the correlation, if any, between severity of cytological alteration and symptoms related to contact lens wear. METHODS: One hundred eyes (50 normal asymptomatic subjects who served as a control group were studied by conjunctival impression cytology (CIC. These subjects were fitted with rigid gas permeable (RGP or soft contact lenses and were followed up at the end of 3 and 6 months. At each follow-up visit the CIC was repeated. A filter paper with the impression specimen was stained with periodic acid schiff (PAS and haematoxylin stain to study goblet cell loss. Papanicolaou stain was done to study squamous metaplasia. The cytological changes were graded using the system described by Natadisastra et al. RESULTS: Severity of cytological changes increased with the duration of contact lens wear (P = 0.00001. At the end of 6 months, 60% of symptomatic eyes wearing soft contact lens and RGP lens showed abnormal CIC changes. None of the asymptomatic RGP contact lens wearing eyes showed abnormal CIC changes whereas 33.4% of the asymptomatic soft contact lens wearing eyes showed abnormal CIC changes (P = 0.033. Epithelial changes occurred within 3-6 months of contact lens fitting. CONCLUSION: Severity of cytological changes increased with duration of lens wear (P = 0.00001. Prevalence and severity of cytological alteration is more in symptomatic contact lens wearers. Soft contact lens wearers although asymptomatic showed severe CIC changes.

  19. ROLE OF COLPOSCOPY USING MODIFIED REID’S INDEX IN SCREENING OF CERVICAL CANCER IN WOMEN WITH ABNORMAL CERVIX ON NAKED EYE EXAMINATION

    Deshpande

    2014-01-01

    Full Text Available OBJECTIVE: To assess the validity of Colposcopy using Modified Reid's Index as a screening tool in cervical cancer in women with abnormal cervix on naked eye examination . METHODS: This observational study was carried out in Government medical college, Aurangabad from June 2011 to May 2013 . Total 392 women with abnormal cervix on naked eye examination of underwent colposcopy and diagnosis was made on the basis of Modified R eid’s Index. Colposcope directed biopsies were obtained from the abnormal areas. In women with normal colposcopic findings four quadrant biopsies from squamo - columnar junction were taken .Eight women were excluded from analysis owing to unsatisfactory colp oscopy. Results of colposcopy were validated by calculating sensitivity, specificity, positive predictive value, negative predictive value in diagnosing histopathologically confirmed lesions which served as gold standard. RESULTS: Overall sensitivity of colposcopy in all grades of lesions is around 90% or more, touching 100% in high order of histological lesions.Overall specificity is also high.It does have an excellent negative predictive value but comparatively lower positive predictive value especially in high order lesions with fair degree of accuracy in all grades of lesions in the hands of an experienced operator. CONCLUSION: Colposcopy using Modified Reid’s Index with high sensitivity and specificity is a good screening tool for cervical cancer

  20. A very rare case of HPV-53-related cervical cancer, in a 79-year-old woman with a previous history of negative Pap cytology

    Zappacosta R; Lattanzio G; Viola P; Ianieri MM; Gatta DMP; Rosini S

    2014-01-01

    Roberta Zappacosta,1 Giuseppe Lattanzio,2 Patrizia Viola,2 Manuel Maria Ianieri,3 Daniela Maria Pia Gatta,1 Sandra Rosini11Cytopathology Unit, Experimental and Clinical Sciences Department, Gabriele d’Annunzio University of Chieti-Pescara, Chieti, Italy; 2Surgical Pathology Unit, 3Obstetrics and Gynecology Unit, SS Annunziata Hospital, Chieti, ItalyAbstract: The introduction of organized cervical cancer (CC) screening programs has drastically reduced the prevalence of CC. However the in...

  1. The investigation on the cervical lesions in the combined use of cytology and the significance of hu-man papilloma virus detection%探讨子宫颈病变中联合应用细胞学及人类乳头状瘤病毒检测的意义

    刘禄; 杨娜; 杨槐; 蒲泽宴; 刘方久; 张薇珊; 崔丽娟; 罗启翅

    2016-01-01

    目的:研究子宫颈病变诊断中联合细胞学和人类乳头状瘤病毒检测对病理诊断的作用。方法:收集遂宁市中心医院病理科子宫颈活组织检查标本876例,分别进行细胞学检查及人类乳头状瘤病毒检测,采用统计学软件进行数据分析。结果:31~50岁为高危型 HPV 感染高发年龄,分别占26.7%和45.7%。子宫颈鳞状细胞癌在41~50岁年龄组占43.7%。结论:子宫颈脱落细胞学及高危型 HPV 检测在子宫颈癌筛查及诊断中具有重要作用,随着我国经济社会的发展,国家应加大筛查的宣传力度,子宫颈脱落细胞学及高危型 HPV 检测可以明显降低子宫颈癌的发病率。%Objective:To research joint cytological diagnosis of cervical lesions and human papilloma virus detection of pathological diagnosis. Methods:Collection of suining city central hospital,876 cases of cervical biopsy specimens,respectively for cytologic examination and detection of human papilloma virus using statistical software for data analysis. Results:31 to 50 years old in high - risk type HPV infection high - risk age,respectively,26. 7% ,45. 7% . Cervical squamous cell carcinoma (43. 7% )as the highest in group C. Conclusion:Type cervical exfoliated cytology and high - risk HPV detection in cervical cancer screening and diagnosis plays an important role,along with the development of China's economic and social,countries should step up the propaganda screening,cervical exfoliated cytology and high - risk type HPV testing can significantly reduce the incidence of cervical cancer.

  2. High risk human papillomavirus type 16 and 18 infection in the cervical lesions of women with epithelial cell abnormality in Pap smear: A cytohistomorphologic association in Bangladeshi women

    Urmila Banik

    2013-01-01

    Full Text Available Background: The aim of this study was to find out the extent of high-risk human papillomavirus (hrHPV type 16/18 infection in the cervical tissue of women with epithelial cell abnormality in Pap smear and to establish an association between hrHPV type 16/18 infection and cytohistomorphology. Materials and Methods: A cross-sectional descriptive study was carried out in 1699 patients who went through Pap smear examination. Prevalence of epithelial cell abnormality was calculated. Forty eight of these women underwent routine histopathology and 47 were evaluated for human papillomavirus (HPV type 16/18 by polymerase chain reaction assay. Results: Total 139 women revealed epithelial cell abnormality. Histopathology showed simple inflammation to malignancy. HPV type 16/18 infection was detected in 40.42% (19/47 of the patients. Individually type 16 and 18 were positive in 7 (14.9% cases each and dual infection with type 16 and 18 were seen in 5 (10.6% cases. While cervical intraepithelial neoplasia grade 1 (CIN 1 and < CIN 1 lesions showed 18.75% (3 out of 16 and 35% (7 out of 20 positivity respectively, ≥CIN 2 lesions revealed positivity of 81.82% (9 out of 11. Eighty percent HPV 16/18 positivity was seen in women of < 30 years of age. Conclusion: The findings of this study will contribute to HPV 16/18 knowledge in Bangladesh that will be useful in assessing the success of current vaccines with limited type spectra and augmenting cervical cancer screening strategies.

  3. Cervical screening in England: the past, present, and future.

    Albrow, Rebecca; Kitchener, Henry; Gupta, Nalini; Desai, Mina

    2012-04-25

    Cervical screening in England commenced in a disorganized fashion in 1964. The flaws of this approach became apparent in the mid-1980s and led to the inception of the National Health Service Cervical Screening Programme (NHSCSP). The main features of this program are its population-based registry, accessibility to all women within the screening age range, its systematic process of call and recall, national coordination, and quality assurance. Its success is in part based on its ability to evolve as evidence necessitates, and throughout the period of 2000-2010, it embarked upon a series of developments involving liquid-based cytology, which also provided the means to conduct reflex high-risk human papillomavirus (HR-HPV) testing and the potential to automate the screening process. As a result of evidence acquired since 2000, the NHSCSP is currently based on a system of primary cytology with HPV triage for low-grade abnormalities combined with cytology plus a HR-HPV "test of cure" for women who have received treatment for cervical intraepithelial neoplasia. Future challenges for the program will involve finding solutions to increasing screening uptake among women HPV primary screening. PMID:22367883

  4. Diffusion tensor magnetic resonance imaging may show abnormalities in the normal-appearing cervical spinal cord from patients with multiple sclerosis

    Fernanda Miraldi

    2013-09-01

    Full Text Available Objective This study aims to evaluate “in vivo” the integrity of the normal-appearing spinal cord (NASC in patients with multiple sclerosis (MS compared to controls, using diffusion tensor MR imaging. Methods We studied 32 patients with MS and 17 without any neurologic disorder. Fractional anisotropy (FA, axial diffusivity (AD, radial diffusivity (RD and mean diffusivity (MD were calculated within regions of interest at C2 and C7 levels in the four columns of the spinal cord. Results At C2, FA value was decreased in MS patients. Besides, RD value was higher in MS than in controls. At C7, MD values were increased in MS. Conclusion The NASC in the right column of the cervical spinal cord showed abnormal FA, RD and MD values, which is possibly related to demyelination, since the FA abnormality was related to the RD and not to the AD.

  5. Bereavement Is Associated with an Increased Risk of HPV Infection and Cervical Cancer: An Epidemiological Study in Sweden.

    Lu, Donghao; Sundström, Karin; Sparén, Pär; Fall, Katja; Sjölander, Arvid; Dillner, Joakim; Helm, Nathalie Ylitalo; Adami, Hans-Olov; Valdimarsdóttir, Unnur; Fang, Fang

    2016-02-01

    Grief over the loss of a family member may cause physical and mental illness, but an association between bereavement and cancer risk has not been established. Based on the Swedish National Cervical Screening Register (1969-2011) including 14,011,269 smears from 2,466,107 women, we conducted two nested case-control studies to examine the associations of bereavement (i.e., loss of a family member due to death) with abnormal cytology (390,310 first abnormal and 1,951,319 normal smears) and in situ/invasive cervical cancer (75,128 case and 375,640 control women), both individually matched on year of birth and screening adherence. Among 1,696 of the control women, we further investigated bereavement in association with human papillomavirus (HPV) infection, both HPV16 and other HPV types. Bereavement was consistently associated with a 4% to 9% increased risk for first abnormal cytology, in situ and invasive cervical cancer (all P viral load, and recurrent infection, and was also more strongly associated with HPV infections designated as high-risk compared with low-risk determinants of cervical carcinogenesis. Collectively, our findings demonstrate that bereavement is associated with an increased risk of developing cervical cancer. Further, they suggest that this association may be attributed to stress-induced oncogenic HPV infections. PMID:26634926

  6. Surgical treatment of lower cervical injuries combined with cervical congenital abnormalities%合并颈椎先天性畸形的下颈椎损伤的治疗策略

    谢宁; 倪斌; 叶晓健; 陈德玉; 肖建如; 袁文

    2008-01-01

    目的 探讨合并颈椎先天性畸形的下颈椎损伤的治疗策略. 方法 自1998年至2005年收治合并颈椎先天性畸形的下颈椎损伤患者11例,损伤类型包括急性C3/4椎间盘突出症1例,颈椎过伸伤7例,C5骨折1例,C4/5、C5/6脱位各1例.合并的颈椎先天性畸形包括Klippel-Feil综合征2例,颅底凹陷2例,颅底扁平5例,寰椎枕骨化9例,Chiari畸形1例.Frankel分级为A级1例,B级2例,c级5例,D级3例.合并Klippel-Feil综合征者实施了颈前路单间隙减压取髂骨植骨融合带锁钢板固定加后路短节段减压侧块螺钉固定术.1例颈椎过伸伤合并Chiari畸形实施了颈椎后路减压加枕大孔减压枕颈融合后路固定术.余患者依致压物范围和椎管狭窄程度分别实施了颈椎前路减压植骨钢板固定术或颈椎后路减压侧块螺钉固定术. 结果 所有患者获得4个月~6年(平均22个月)随访.术后3个月Frankel分级为B级1例,C级2例,D级3例,E级5例,平均提高1~2级.植骨平均于术后3个月愈合,未出现内置物相关并发症.随访期内未出现颈椎不稳以及颈椎畸形相关的临床症状. 结论 明确没有上颈椎损伤的合并颈椎先天性畸形的下颈椎损伤可以只处理下颈椎损伤,所合并的颈椎畸形根据不同类型区别考虑.对于合并颈椎畸形的下颈椎损伤没有必要为了防止颈椎畸形远期继发的神经症状而融合上颈椎或其他节段.%Objective To discuss strategies of treating lower cervical injuries combined with cervical congenital abnormalities. Methods Eleven cases of lower cervical injuries combined with cervical congenital abnormalities were treated from 1998 to 2005. The injuries included 1 case of C3/4 disc herniation, 7 cases of whiplash injury, 1 case of C5 vertebral body fracture, and 2 cases of C4/5 and C5/6 dislocation.Cervical abnormalities included Klippel-Feil syndrome (2), basilar impression (2), platybasia (5), occipitalization of atlas (9

  7. Liquid Based Cytology and Colposcopy in the Screening of Cervical Cancer and Precancerous Lesions%宫颈液基细胞学及阴道镜在宫颈癌及癌前病变中的筛查作用

    王清; 胡霞

    2015-01-01

    目的:分析液基细胞学和阴道镜在宫颈癌及癌前病变中的筛查作用,评估液基细胞学和阴道镜在宫颈癌及癌前病变筛查中的临床应用价值。方法回顾性分析2013年5月-2014年8月接受宫颈癌筛查的500例女性的临床资料,所有体检者都接受阴道镜检查和液基细胞学检查。结果阴道镜检测假阳性患者有11例,阴道镜检测的特异性为97.39%(412/423),漏诊率为1.00%(5/500);液基细胞学诊断的假阳性患者有15例,由检测结果可知液基细胞学检测宫颈癌的检测特异性为96.45%(408/423),漏诊率为6.40%(32/500)。结论液基细胞学和阴道镜在宫颈癌及癌前病变筛查中具有临床应用价值,阴道镜对宫颈癌及癌前病变的检出率较液基细胞学高。%Objective To study the application value of liquid based cytology and colposcopy in the screening of cervical cancer and precancerous lesions .Methods Retrospective analysis of clinical data of 500 female patients who underwent cervical cancer screening were conducted .All subjects received colposcopy and liquid based cytology .Results Colposcopy results showed that false positive were 11 cases,the specificity of colposcopy was 97.39%(412 /423),the rate of missed diagnosis was 1.00%(5 /500);liquid based cytology diagnosis showed that false positive were 15 cases,specificity was 96.45%(408/423),the rate of missed diagnosis was 6.40%(32 /500).Conclusion Liquid based cytology and colposcopy has clinical application value in the screening of cervical cancer and precancerous lesions ,Colposcopy for cervical cancer and precancerous lesions has higher detec -tion rate compared with liquid based cytology .

  8. Implementation and evaluation of a National External Quality Control Program for Cervical Cytology in Mexico Instrumentación y evaluación de un programa nacional de control de calidad externo para citología cervical en México

    Ana Flisser

    2002-09-01

    Full Text Available Objective. To evaluate cytology laboratories and the performance of cytotechnologists for establishing efficient external quality control for Mexico's National Program for the Prevention and Control of Cervical Cancer. Material and Methods. During January and February 1998, an on-site evaluation of all cytology laboratories of the Ministry of Health found that only 70% of the microscopes were in adequate working conditions, reagents were out of date, and working conditions were sub-optimal. A program for external quality control based on proficiency testing was established for cytotechnologists. Fifty slide sets with 20 Papanicolaou slides and 10 photographic slides were prepared. The sets were given to the cytotechnologists for evaluation and again one year later by courier. Results. Twenty-one percent of microscopes were repaired and 9% replaced; reagents were distributed and laboratory facilities improved. Only 16% of cytotechnologists passed the initial proficiency test. Cytotechnologists received a refresher training course: one year later 67% of them passed the proficiency test. To ascertain that each slide was correctly diagnosed, 41 sets were rescreened by expert cytopathologists or cytologists and their diagnoses compared to the original ones. Thirty-seven sets had 86% to 96% concordance. Conclusions. This new system for external quality control of cervical cytology allowed the opportune and reliable evaluation of the performance of cytotechnologists.Objetivo. Evaluar los laboratorios de citología y la capacidad de los citotecnólogos para establecer un programa eficiente de control de calidad externo para el Programa Nacional de Prevención y Control de Cáncer Cérvico Uterino de México. Material y métodos. Se realizó una evaluación de todos los laboratorios de citología de la Secretaría de Salud; sólo 70% de los microscopios estaban en buenas condiciones de trabajo, había reactivos caducos y condiciones subóptimas de

  9. Abnormal Pap Smear and Diagnosis of High-Grade Vaginal Intraepithelial Neoplasia: A Retrospective Cohort Study.

    Sopracordevole, Francesco; Mancioli, Francesca; Clemente, Nicolò; De Piero, Giovanni; Buttignol, Monica; Giorda, Giorgio; Ciavattini, Andrea

    2015-10-01

    The aim of this study was to analyze the correlation between the first diagnosis of high-grade Vaginal Intraepithelial Neoplasia (HG-VaIN: VaIN 2-VaIN 3) and the cytological abnormalities on the referral pap smear.All the women with histological diagnosis of HG-VaIN consecutively referred to the Gynecological Oncology Unit of the Aviano National Cancer Institute (Aviano, Italy) from January 1991 to April 2014 and with a pap smear performed in the 3 months before the diagnosis were considered, and an observational cohort study was performed.A total of 87 women with diagnosis of HG-VaIN were identified. Major cytological abnormalities (HSIL and ASC-H) on the referral pap smear were significantly more frequent than lesser abnormalities (ASC-US and LSIL) in postmenopausal women (64.9% vs 36.7%, P = 0.02) and in women with a previous diagnosis of HPV-related cervical preinvasive or invasive lesions (70.5% vs 39.5%, P = 0.01). Diagnosis of VaIN 3 was preceded by major cytological abnormalities in most of the cases (72.7% vs 27.3%, P diagnosis of HG-VaIN can be preceded by different abnormalities on referral pap smear. Major abnormalities are usually reported in postmenopausal women and in women with previous cervical HPV-related disease. However, ASC-US or LSIL do not exclude HG-VaIN, especially VaIN2. An accurate examination of the whole vaginal walls (or vaginal vault) must be performed in all the women who underwent colposcopy for an abnormal pap smear, and a biopsy of all suspicious areas is mandatory. PMID:26496321

  10. Randomized double-blind trial of beta-carotene and vitamin C in women with minor cervical abnormalities

    Mackerras, D; Irwig, L.; Simpson, J M; Weisberg, E; Cardona, M.; Webster, F.; Walton, L.; Ghersi, D

    1999-01-01

    A double-blind, placebo-controlled, randomized, factorial study using a daily oral administration of 30 mg beta-carotene and/or 500 mg vitamin C was conducted in 141 women with colposcopically and histologically confirmed minor squamous atypia or cervical intra-epithelial neoplasia (CIN) I. Over approximately 2 years of follow-up, 43 lesions regressed to normal and 13 progressed to CIN II. The regression rate was slightly higher, but not significantly so, in those randomized to beta-carotene ...

  11. CLINICAL ASSESSMENT AND CORRILATION OF PAP SMEAR AND LIQUID BASED CYTOLOGY IN BAD CERVIX

    Khushboo

    2014-10-01

    Full Text Available AIM: Aim of our study to analyze the prevalence of premalignant lesion based on Pap smear and liquid based cytology in patients of bad cervix. OBJECTIVE: To compare sensitivity and specificity of two methods for screening of bad cervix and to know IDR (increase detection rate of cervical cancer by conventional Pap smear and liquid based cytology. MATERIAL AND METHOD: 200 women attending Gynaecology OPD were random selection on the basis of inclusion criteria. All 200 selected women were subjected for down staging through per speculum examination for identification of bad cervix. Pap smears of all 200 selected women were taken and ensured that no local douche, antiseptic cream and no local internal examination was done on the day of test. The prepared smears were then stained according to Papanicolaou's technique. Liquid based cytology smears preparing by using cervical brush 1-1.5cm were inserted into the cervical os until the large outer bristles of the brush touch ectocervix. Data collected for sociodemographic, parity, down staging clinical examination Pap smear and LBC was organised, interpreted and analysis on appropriate statistical software. P value < 0.05 is considered significant RESULT: Analysis revealed that the maximum number of women in our study are from middle age group(31-40yrs, low socioeconomic status, married before 18 yrs, multipara, do not use any contraceptive, uneducated, urban, Muslim population.in this study more abnormal smear is seen in LBC as compared to pap smear. Sensitivity and specificity for LBC is more as compare to pap smear. CONCLUSION: In low resource setting like ours were facilities for radiology, chemo- radiotherapy and supportive care are limited or unavailable. It is important to identify which resources fill healthcare need most effectively and to consider alternative approaches, LBC is strongly advocated in the best interest of public health, by improving the quality of the sample and reducing the

  12. Separation of Normal and Premalignant Cervical Epithelial Cells Using Confocal Light Absorption and Scattering Spectroscopic Microscopy Ex Vivo

    Ling Yang

    2011-01-01

    Full Text Available Confocal light absorption and scattering spectroscopic (CLASS microscopy can detect changes in biochemicals and the morphology of cells. It is therefore used to detect high-grade cervical squamous intraepithelial lesion (HSIL cells in the diagnosis of premalignant cervical lesions. Forty cervical samples from women with abnormal Pap smear test results were collected, and twenty cases were diagnosed as HSIL; the rest were normal or low-grade cervical squamous intraepithelial lesion (LSIL. The enlarged and condensed nuclei of HSIL cells as viewed under CLASS microscopy were much brighter and bigger than those of non-HSIL cells. Cytological elastic scattered light data was then collected at wavelengths between 400 and 1000 nm. Between 600 nm to 800 nm, the relative elastic scattered light intensity of HSIL cells was higher than that of the non-HSIL. Relative intensity peaks occurred at 700 nm and 800 nm. CLASS sensitivity and specificity results for HSIL and non-HSIL compared to cytology diagnoses were 80% and 90%, respectively. This study demonstrated that CLASS microscopy could effectively detect cervical precancerous lesions. Further study will verify this conclusion before the method is used in clinic for early detection of cervical cancer.

  13. Clinical value of high-risk human papillomavirus DNA test,liquid-based cytology test in diagnosis of cervical cancer and precancerous lesion%高危型人乳头状瘤病毒DNA、液基薄层细胞检测在宫颈癌及前期病变诊断中的临床价值

    杨秀珍

    2014-01-01

    Objective To investigate the clinical significance of high-risk human papillomavirus (HPV) DNA test com-bined with cytology inspection in the screening of cervical precancerous lesions. Methods 5080 women were selected from February 2013 to January 2014 in our hospital,they were given screen of cervical precancerous lesions.Cervical cytology,high-risk HPV DNA testing,colposcopy and cervical biopsy were done in them,and the results were analyzed with statistical methods. Results ASC-US (atypical squamous meaning is not clear epithelial cells) group of 318 cases, LSIL (low-grade squamous intraepithelial lesions) 26 cases of group,HSIL (high-grade squamous intraepithelial lesion) group of 52 cases,6 cases of invasive group confirmed by histopathological examination. Sensitivity and negative predic-tive value of HPV +TCT (liquid-based cytology test) to detect cervical lesions were higher than those high-risk HPV DNA and TCT,the specificity of TCT detection of cervical lesions was higher than high-risk HPV DNA and HPV DNA+ TCT,the difference was significant (P<0.05). Conclusion The sensitivity and negative predictive value of high-risk HPV DNA testing combined with cytology testing in the cervical cancer screening are higher,and has positive im-plications for screening for cervical lesions.%目的:探讨高危型人乳头状瘤病毒(HPV)DNA检测联合宫颈细胞学检查对宫颈癌前病变筛查的临床意义。方法5080名女性均在2013年2月~2014年1月选择在本院就诊并进行宫颈癌前病变筛查,对其进行宫颈细胞学检查、高危型HPV DNA检测、阴道镜下行宫颈活检,使用统计学方法分析检测结果。结果经组织病理检查确诊ASC-US(不能明确意义的非典型鳞状上皮细胞)组318例,LSIL(低度鳞状上皮内病变)组26例,HSIL(高度鳞状上皮内病变)组52例,浸润癌组6例,HPV DNA+液基薄层细胞检测(TCT)检测宫颈病变的灵敏度及阴性预测值高于高危型HPV DNA检测及TCT,TCT

  14. An audit of cervicovaginal cytology in a teaching hospital: Are atypical glandular cells under-recognised on cytological screening?

    Crasta Julian

    2009-01-01

    Full Text Available Background: Cervical cytology screening for carcinoma of the cervix in India is mainly opportunistic in nature and is practiced mainly in urban centres. The effectiveness of cervical cytology screening depends on various factors. The quality of cervicovaginal cytology service is assessed by various quality indices and by cyto-histology correlation, which is the most important quality assurance measure. Aims: To describe the cervical cytology diagnoses, estimate the quality indices, and evaluate the discrepant cases on cytohistological correlation. Settings and Design: Retrospective observational study from a tertiary care centre in South India. Materials and Methods: Using a database search, all the cervicovaginal cytology reported during the period of 2002-2006 was retrieved and various diagnoses were described. The data was analysed to assess the quality indices. The cytohistologically discrepant cases were reviewed. Results: A total of 10,787 cases were retrieved, of which 98.14% were labeled negative and 1.36% were unsatisfactory for evaluation. A few (0.81% of the cases were labeled as squamous intraepithelial lesions and 0.38% as atypical squamous cells. The ASCUS: SIL ratio was 0.5. Cytohistological correlation revealed a total of ten cases with significant discrepancy. The majority of these were carcinomas that were misdiagnosed as atypical glandular cells. These cytology smears and the subsequent biopsies were reviewed to elucidate the reasons for the discrepancies. Conclusions: The cervical cytology service at our centre is well within the accepted standards. An increased awareness of cytological features, especially of glandular lesions, a good clinician-laboratory communication and a regular cytohistological review would further improve the diagnostic standards.

  15. Automatic Detection of Cervical Cancer Cells by a Two-Level Cascade Classification System

    Su, Jie; Xu, Xuan; He, Yongjun; Song, Jinming

    2016-01-01

    We proposed a method for automatic detection of cervical cancer cells in images captured from thin liquid based cytology slides. We selected 20,000 cells in images derived from 120 different thin liquid based cytology slides, which include 5000 epithelial cells (normal 2500, abnormal 2500), lymphoid cells, neutrophils, and junk cells. We first proposed 28 features, including 20 morphologic features and 8 texture features, based on the characteristics of each cell type. We then used a two-level cascade integration system of two classifiers to classify the cervical cells into normal and abnormal epithelial cells. The results showed that the recognition rates for abnormal cervical epithelial cells were 92.7% and 93.2%, respectively, when C4.5 classifier or LR (LR: logical regression) classifier was used individually; while the recognition rate was significantly higher (95.642%) when our two-level cascade integrated classifier system was used. The false negative rate and false positive rate (both 1.44%) of the proposed automatic two-level cascade classification system are also much lower than those of traditional Pap smear review. PMID:27298758

  16. The relationship between cerebral infarctive CT findings and cervical carotid arterial abnormalities; The accumulation of contrast media in angiography and carotid angio-CT

    Hatanaka, Mitsuaki (Towada City Hospital, Aomori (Japan)); Shimizu, Toshio; Manabe, Hiroshi; Suzuki, Naoya

    1990-04-01

    The relationship between cervical carotid arterial changes and cerebral occlusive or ischemic disease was discussed in 120 consecutive cases (60 abnormal and 60 normal CT findings) which had been examined by means both of angiography and of brain CT. Even the low-grade stenosis of the carotid artery (less than 50%) had influence on the infarctive changes in CT; in these low-grade stenotic cases, clinico-pathological study sometimes revealed intimal damage, calcification, and clot formation on the damaged inner wall. Angiographically, the focal accumulation of contrast media in the carotid pathological region is a radiological expression of focal circulatory disturbance, a transient staying of the carotid blood flow, of clot-formation. More dynamic circulatory findings were revealed by Cine-Angiography. In cases of positive brain CT findings, cortical and multiple lesions more frequently had carotid changes and the accumulation of contrast media than did the basal ganglia and subcortical lesions. Even in the cases of negative brain CT findings, carotid changes were observed in about 20% of the cases. Angiographical study has the limitation that it cannot reveal the abnormality of the carotid arterial wall itself. On the other hand, carotid angio-CT was able to reveal carotid wall changes - for instance, calcification at a high density and atheromatous change at a low density: it can also investigate the range and degree. It is also useful in the follow-up study of pre-operative and post-operative changes, or anti-platelet therapy. (author).

  17. Human Papillomavirus 16, 18, 31 and 45 viral load, integration and methylation status stratified by cervical disease stage

    Persistent infection with oncogenic Human Papillomavirus (HPV) is associated with the development of cervical cancer with each genotype differing in their relative contribution to the prevalence of cervical disease. HPV DNA testing offers improved sensitivity over cytology testing alone but is accompanied by a generally low specificity. Potential molecular markers of cervical disease include type-specific viral load (VL), integration of HPV DNA into the host genome and methylation of the HPV genome. The aim of this study was to evaluate the relationship between HPV type-specific viral load, integration and methylation status and cervical disease stage in samples harboring HPV16, HPV18, HPV31 or HPV45. Samples singly infected with HPV16 (n = 226), HPV18 (n = 32), HPV31 (n = 75) or HPV45 (n = 29) were selected from a cohort of 4,719 women attending cervical screening in England. Viral load and integration status were determined by real-time PCR while 3’L1-URR methylation status was determined by pyrosequencing or sequencing of multiple clones derived from each sample. Viral load could differentiate between normal and abnormal cytology with a sensitivity of 75% and a specificity of 80% (odds ratio [OR] 12.4, 95% CI 6.2–26.1; p < 0.001) with some variation between genotypes. Viral integration was poorly associated with cervical disease. Few samples had fully integrated genomes and these could be found throughout the course of disease. Overall, integration status could distinguish between normal and abnormal cytology with a sensitivity of 72% and a specificity of 50% (OR 2.6, 95% CI 1.0–6.8; p = 0.054). Methylation levels were able to differentiate normal and low grade cytology from high grade cytology with a sensitivity of 64% and a specificity of 82% (OR 8.2, 95% CI 3.8–18.0; p < 0.001). However, methylation varied widely between genotypes with HPV18 and HPV45 exhibiting a broader degree and higher magnitude of methylated CpG sites than HPV16 and HPV31. This

  18. Optoelectronic method for detection of cervical intraepithelial neoplasia and cervical cancer

    Pruski, D.; Przybylski, M.; Kędzia, W.; Kędzia, H.; Jagielska-Pruska, J.; Spaczyński, M.

    2011-12-01

    The optoelectronic method is one of the most promising concepts of biophysical program of the diagnostics of CIN and cervical cancer. Objectives of the work are evaluation of sensitivity and specificity of the optoelectronic method in the detection of CIN and cervical cancer. The paper shows correlation between the pNOR number and sensitivity/specificity of the optoelectronic method. The study included 293 patients with abnormal cervical cytology result and the following examinations: examination with the use of the optoelectronic method — Truscreen, colposcopic examination, and histopathologic biopsy. Specificity of the optoelectronic method for LGSIL was estimated at 65.70%, for HGSIL and squamous cell carcinoma of cervix amounted to 90.38%. Specificity of the optoelectronic method used to confirm lack of cervical pathology was estimated at 78.89%. The field under the ROC curve for the optoelectronic method was estimated at 0.88 (95% CI, 0.84-0.92) which shows high diagnostic value of the test in the detection of HGSIL and squamous cell carcinoma. The optoelectronic method is characterised by high usefulness in the detection of CIN, present in the squamous epithelium and squamous cell carcinoma of cervix.

  19. 宫颈液基薄层细胞学(LCT)及TBS报告系统在宫颈病变诊断中的应用价值%Study application value of Liquid-based thinlayer cytology and TBS for cervical diseases diagnosis

    汤峻; 范自然

    2010-01-01

    目的 探讨宫颈液基薄层细胞制片技术(LCT)及TBS报告系统在宫颈病变检查中的应用价值.方法 收集我院1257例宫颈细胞标本,采用液基薄层细胞制片技术和TBS报告系统诊断,对细胞学诊断阳性的标本进行阴道镜活检和组织病理学诊断,所有病例的诊断均双盲进行.结果 1257例中细胞学检出鳞状细胞癌(SCC)8例,高级别鳞状上皮病变(HSIL)21例,低级别鳞状上皮病变(LSIL)34例,与活检病理诊断符合例数分别为:SCC 100.00%(8/8),HSIL 90.47%(19/21)和LSIL 94.11%(32/34).结论 宫颈液基薄层细胞制片技术和TBS报告系统对宫颈病变检出阳性率较高,与组织学诊断符合率高,是临床宫颈病变检查的好方法.%Objective To study the value of liquid-based thinlayer cytology and TBS for cervical diseases diagnosis. Methods This study screen 1257women from August 2007 to August 2009 in this hospital. The cytologic diagnosis was performed using the Bethesda system (TBS)on the liquid-based thinlayer cytology. Theresults of cytologic diagnosis compare with the results of histopathologic diagnosis. All the diagnosises were performed in an independent and blinded fashion. Results All cases were able to detect 100% ( 8/8 ) of squamous cell carcinoma ( SCC )1, 90.47% ( 19/21 ) high grade squamous intraepithelial lesion ( HSIL), 94.11% ( 23/34 )low grade squamous intraepithelial lesion ( LSIL). Conclusion The liguidbased thinlayer cytology test and the Bethesda System(TBS) is a sensitive of cervical cancer diagnosis.

  20. Liquid-Based Cytology of Villoglandular Adenocarcinoma of the Cervix: A Report of 3 Cases

    Choi, Younghwa; Kim, Haeryoung; Choi, Haiyoung; Hwang, Daehyun; Choe, Gheeyoung; Chung, Jin-Haeng; Park, So Yeon; Lee, Hye Seung; Paik, Jin Ho; Park, Hyo Jin

    2012-01-01

    Villoglandular adenocarcinoma (VGA) is a rare subtype of cervical adenocarcinoma with a more favorable prognosis compared to conventional adenocarcinomas. Although the tumors are usually recognized on colposcopic examination due to the mainly exophytic growth pattern, they may be underdiagnosed as benign lesions by cytology because of their minimal cytologic atypia. We report the liquid-based cytology (LBC) findings of three histologically confirmed VGAs which we have recently identified. The...

  1. Human Papillomavirus prevalence, viral load and cervical intraepithelial neoplasia in HIV-infected women

    Levi José E.

    2002-01-01

    Full Text Available HIV-infected women from São Paulo city were enrolled in a cross-sectional study on Human Papillomavirus (HPV and cervical intraepithelial neoplasia (CIN prevalence and their association with laboratory markers of AIDS, namely HIV viral load and CD4+ cell counts. A cervical specimen was collected and submitted to Hybrid Capture, a test for HPV viral load determination. HPV-DNA was detected in 173 of 265 women (64.5%. Twenty (7.5% women were infected by one or more low-risk viruses, 89 (33% by one or more high-risk viruses, and 64 (24% harbored at least one HPV type from each risk group. Abnormal smears were observed in 19% of the patients, though there were no invasive carcinomas. Severely immunosuppressed patients (CD4/µL <100 were at the greatest risk of having a cytological abnormality and a high high-risk HPV viral load.

  2. Epidemiology and Early Detection of Cervical Cancer.

    Hillemanns, Peter; Soergel, Phillip; Hertel, Hermann; Jentschke, Matthias

    2016-01-01

    The new German S3 guideline 'Prevention of Cervical Cancer' published in 2016 is based on the latest available evidence about cervical cancer screening and treatment of cervical precancer. Large randomized controlled trials indicate that human papillomavirus (HPV)-based screening may provide better protection against cervical cancer than cytology alone through improved detection of premalignant disease in the first screening round prior to progression. Therefore, women aged 30 years and older should preferably be screened with HPV testing every 3-5 years (cytology alone every 2 years is an acceptable alternative). Co-testing is not recommended. Screening should start at 25 years using cytology alone every 2 years. The preferred triage test after a positive HPV screening test is cytology. Women positive for HPV 16 and HPV 18 should receive immediate colposcopy. Another alternative triage method is p16/Ki-67 dual stain cytology. The mean yearly participation rate in Germany is between 45 and 50%. Offering devices for HPV self-sampling has the potential to increase participation rates in those women who are at higher risk of developing cervical cancer. Regarding primary prevention, the 9-valent vaccine may provide protection against up to 85% of cervical intraepithelial neoplasia (CIN) 3 and 90% of cervical cancer, and is available in Europe as a 2-dose schedule from May 2016. PMID:27614953

  3. Diagnosis of cervical cancer with transvaginal color Doppler sonography

    Li-bo DENG; Wei ZHOU; Chang, Shu-Fang; Ming-jie LIN

    2011-01-01

    Objective To investigate the imaging features of cervical cancer by transvaginal color Doppler sonography(TVCS),and evaluate the diagnostic value of TVCS.Methods A hundred and thirty cases of cervical intraepithelial neoplasia(CIN) grade Ⅰ-Ⅱ and cervical cancer,diagnosed by Thinprep cytologic test(TCT),cervical biopsy and pathological examination,received TVCS examination.The image characters and color Doppler flow imaging(CDFI) were collected and analyzed.Another 41 cases with normal cervice...

  4. Validation of cervical cancer screening methods in HIV positive women from Johannesburg South Africa.

    Cynthia Firnhaber

    Full Text Available BACKGROUND: HIV-infected women are at increased risk for developing cervical cancer. Women living in resource-limited countries are especially at risk due to poor access to cervical cancer screening and treatment. We evaluated three cervical cancer screening methods to detect cervical intraepithelial neoplasia grade 2 and above (CIN 2+ in HIV-infected women in South Africa; Pap smear, visual inspection with 5% acetic acid (VIA and human papillomavirus detection (HPV. METHODS: HIV-infected women aged 18-65 were recruited in Johannesburg. A cross-sectional study evaluating three screening methods for the detection of the histologically-defined gold standard CIN-2 + was performed. Women were screened for cervical abnormalities with the Digene HC2 assay (HPV, Pap smear and VIA. VIA was performed by clinic nurses, digital photographs taken and then later reviewed by specialist physicians. The sensitivity, specificity and predictive valves for CIN-2 + were calculated using maximum likelihood estimators. RESULTS: 1,202 HIV-infected women participated, with a median age of 38 years and CD4 counts of 394 cells/mm(3. One third of women had a high grade lesion on cytology. VIA and HPV were positive in 45% and 61% of women respectively. Estimated sensitivity/specificity for HPV, Pap smear and VIA for CIN 2+ was 92%/51.4%, 75.8%/83.4% and 65.4/68.5% (nurse reading, respectively. Sensitivities were similar, and specificities appeared significantly lower for the HPV test, cytology and VIA among women with CD4 counts ≤200 cells/mm(3 as compared to CD4 counts >350 cells/mm(3. CONCLUSIONS: Although HPV was the most sensitive screening method for detecting CIN 2+, it was less specific than conventional cytology and VIA with digital imaging review. Screening programs may need to be individualized in context of the resources and capacity in each area.

  5. Clinical Application of Liquid-based Cytology, HPV-DNA or Colposcopy in Cervical Cancer Screening%液基细胞、HPV检测与阴道镜宫颈癌的筛查方面的应用研究

    胡芳艳; 金志红; 刘国华; 杨金艳; 王艳芳

    2013-01-01

    Objective: To compare the diagnosis value of liquid-based cytology, HPV-DNA and colposcopy in early diagnosis of cervical cancer. Methods: 92 cases were retrospectively studied which liquid-based cytology were diagnosed as typical squamous cell of undetermined significance (ASCUS). All these patients were taken human papilloma virus (HPV) DNA detection, colposcopy and biopsies were taken. The results of the different tests were compared with the pathological examination of biopsy for further analysis. Results: The pathological and histological examination of biopsy was set as the standards, and all the results from other test were compared with them. Colposcopy had highest sensitivity in 3 methods (P<0.05), and plays an important role in screening of cervical lesions. The infection rate of HR-HPV increased significantly along with the increase of cervical lesion severity, there were obvious differences between ASCUS and squamous intraepithelial lesion (SIL) (P<0.05). With the grade of biopsy increased, the incidence of positive rate increased in all three methods. The detection rate of CIN and cervical cancer in ASCUS patients were more commonly in the stage of age between 30 and 50. Conclusion: Liquid base cervical cytological examination (LCT) was a good method with higher detection rate for early detection of higher cervical lesions. High-risk type HPV-DNA testing and Colposcopy could reduce the omission diagnose rate and improve the diagnostic accuracy. The cervical lesion screening of women over 30 year-old should cause much attention, especially for the women of 30-50 years old.%目的:探讨液基薄层细胞学检查、HPV-DNA检测、阴道镜检查在宫颈癌早期诊断中的临床应用价值.方法:回顾性分析92例宫颈液基薄层细胞学检查未能明确诊断意义的宫颈非典型鳞状细胞病变患者,进行HPV-DNA检测与阴道镜检查,将检测的结果进行对比研究.结果:阴道镜与宫颈液基薄层细胞检查(TCT)

  6. Cost-effectiveness of conventional cytology and HPV DNA testing for cervical cancer screening in Colombia Costo-efectividad de la citología y la tamización con pruebas de ADN-VPH para cáncer de cuello uterino en Colombia

    Oscar Andrés-Gamboa

    2008-08-01

    Full Text Available OBJECTIVE: To assess cost-effectiveness of conventional cytology and HPV DNA testing for cervical-cancer screening in Colombia. MATERIAL AND METHODS: The National Cancer Institute of Colombia (NCIC in 2007 developed a Markov model on the natural history of cervical cancer; no screening, conventional cytology, and HPV DNA testing were compared. Only direct costs were used. Outcomes comprise cervical cancer mortality, years of life saved, and lifetime costs. Discounted incremental cost-effectiveness ratios were estimated and sensitivity analyses were conducted for key parameters. RESULTS: Depending on the screening strategy a 69-81% mortality reduction might be expected. The HPV DNA testing every five years is a cost-effective strategy (Incremental Cost-Effectiveness Ratio (ICER: USD$44/YLS if the cost per test is under USD$31. The effectiveness was sensitive to coverage and primarily to follow-up. CONCLUSIONS: HPV DNA testing is a cost-effective alternative for screening in Colombia. Not only high coverage but high follow-up rates are critical for successful screening programs.OBJETIVO: evaluar el costo-efectividad de la citología convencional y la prueba de ADN-VPH para tamización de cáncer cervical en Colombia. MATERIAL Y MÉTODOS: el Instituto Nacional de Cancerología de Colombia construyó en 2007 un modelo de Markov de historia natural del cáncer cervical. Se comparó "no tamización", citología convencional y prueba de ADN-VPH. Se utilizaron costos directos. Los desenlaces fueron mortalidad, años de vida ganados y costos. Se calcularon razones de costo-efectividad incremental. Se realizaron análisis de sensibilidad para parámetros clave. RESULTADOS: la mortalidad se redujo 69-81% según la estrategia. La tamización con ADN-VPH cada cinco años es costo-efectiva (ICER (Razón de Costo-Efectividad incremental por sus siglas en inglés: 44 dólares por año de vida saludable si los costos por prueba son menores a 31 dólares. La

  7. The role of HPV in diagnosis and management of cervical premalignancies

    Hamont, D. van

    2008-01-01

    Cervical cytological pathology is not uncommon. Prevention of cervical cancer by detection of the disease in an early and pre-malignant stage is practised globally either through population-based screening programmes or more optimistically non-organised ones. High-grade cervical intraepithelial neoplasia (CIN) detected by cervical cytological screening are extensively visualised by colposcopy and successively treated by, for instance, large loop electro-surgical excision of the transformation...

  8. Molecular testing of human papillomavirus in cervical specimens

    Objective was to improve the diagnosis of cervical neoplasia by early detection of human papillomavirus (HPV) in uterine cervix, by adding molecular testing of HPV using hybrid capture 2 (HC2) and polymerase chain reaction (PCR) tests to Papanicoalou (Pap) test. One hundred women were enrolled in this study. The mean age (mean+-SD) was 41.97+- 8.76 years and range was 27-65 years. All women had undergone cervical cytological screening with cervical cytology, HPV DNA testing by HC2 and PCR, during the period from January to December 2006, at King Abdul-Aziz University Hospital (KAAUH) and King Fahd research Center, Jeddah, Saudi Arabia. The results were obtained by HC2 for detection of HPV were 5(5%) high-risk HPV, one low-risk HPV (1%) and 94(94%) negative cases. The PCR detected only 4(4%) cases. Using the HC2 test as a reference, sensitivity, specificity, positive predictive, negative predictive values and accuracy of base line Pap were 50, 85, 17.7, 96.4 and 83%; of final Pap smear were 100, 96.8, 66.7, 100, and 97% and for PCR were 66.7, 100, 100, 97.9 and 98%. The Pap test was repeated within a year for patients with abnormal Pap test with positive HPV DNA. Combined screening by cytology and HPV testing using both HC2 and PCR sensitively detects women with existing disease. The absence of HPV DNA provides reassurance that patients are unlikely to develop cancer for several years. We suggest using Pap with HC2 and PCR in screening programs to ensure that women with the double negative result at baseline might safely be screened at longer intervals. (author)

  9. Analysis of Sensitivity, Specificity, and Positive and Negative Predictive Values of Smear and Colposcopy in Diagnosis of Premalignant and Malignant Cervical Lesions.

    Barut, Mert Ulaş; Kale, Ahmet; Kuyumcuoğlu, Umur; Bozkurt, Murat; Ağaçayak, Elif; Özekinci, Server; Gül, Talip

    2015-01-01

    BACKGROUND This study aimed to examine the positive and negative predictive value in the diagnosis of premalignant and malignant lesions of cervical colposcopy, the sensitivity and specificity of smear, and to evaluate the correlation with histopathology of abnormal cytology and colposcopy. MATERIAL AND METHODS The criteria for inclusion of patients with unhealthy cervix in the study were: Erosion, Chronic cervicitis, and Healed lacerations, Hypertrophied cervix, bleeding on touch, suspicious growth/ulcer/polyp on the cervix, and abnormal discharges from the cervix. Women with frank carcinoma cervix, pregnant females, patients with bleeding per vaginum at the time of examination, and those who had used vaginal medications, vaginal contraceptives or douches in the last 48 h of examination were excluded from the study. Demographic analysis was performed for 450 patients who were admitted to the clinic. Sensitivity, specificity, positive predictive value and negative predictive values of patients to identify cervical pathologies of smear and colposcopy were histopathologically calculated. The statistical software package SPSS 15.0 (SPSS Inc., Chicago, IL, USA) and Spearman's and Chi-Square tests were used for statistical analysis. RESULTS Sensitivity, specificity, PPD and NDP of smear were 0.57%, 0.76%, 0.26%, 0.92% respectively. Sensitivity, specificity, PPD and NDP of colposcopy were 0.92%, 0.67%, 0.52%, 0.96% respectively. A statistically significant correlation was found between abnormal cytology and histopathology, and abnormal colposcopy finding and histopathology. CONCLUSIONS Women with clinical diagnosis of unhealthy cervix should be evaluated by cytology to detect any premalignant or malignant lesions. It was concluded that Pap smear, colposcopy and histopathology should be collectively evaluated to evaluate cervical findings in low socio-economic regions. PMID:26655816

  10. 液基薄层细胞学、活检病理和宫颈环形电切术(LEEP)诊断早期宫颈癌及宫颈上皮细胞内瘤样病变的比较研究%Comparison of Liquid Based Cytology, Biopsy, and Loop Electrosurgical Excisional Procedure(LEEP)for Diagnosis of Cervical Cancer and Cervical Intraepithelial Neoplasia

    杨波; 杨凤云; 曹云桂; 顾萍; 朱梅娟; 甘晓卫

    2012-01-01

    Objective: To compare liquid based cytology, biopsy, and loop electrosurgical excisional procedure (LEEP) histopathology for diagnosis of cervical cancer and cervical intraepithelial neoplasia (CIN). Methods: A total of 201 patients who referred for LEEP were enrolled in this study. The diagnostic results of thinprep cytologic tests (TCT), previous biopsies, and LEEP pathology were compared and evaluated. Results: In LEEP pathology of 201 patients, 92 cases (45.8%) were identified to have CIN2 or above lesion, and 4 cases were confirmed as invasive cancer. Among them, 71 (71/92) biopsy was CIN2 or above cervical lesions. Biopsy and LEEP determined 22 and 23 CIN2 or above cases in 66 LSIL cases by TCT, respectively. The concordance rate of biopsy and LEEP was 86.5%, and the Kappa value was 0.718. Among 113 CIN1 patients conformed by biopsy, LEEP pathology found 16 cases of CIN2 or above. Conclusion: Biopsy may improve the diagnosis of CIN2 or above cervical lesions in LSIL patients by TCT, and will be helpful for determination of index for LEEP in clinical practice.%目的:比较细胞学、活检病理和宫颈环形电切术(loop electrosurgical excisional procedure,LEEP)病理诊断早期宫颈癌和宫颈上皮细胞内瘤样病变(cervical intraepithelial neoplasia,CIN)的准确性.方法:回顾性比较分析201例进行LEEP患者术后病理、术前活检病理和液基薄层细胞学(thinprep cytologic test,TCT)3种诊断方法的检测结果.结果:201例LEEP术后组织病理分析显示92例(45.8%)患者具有CIN2~3病变及4例浸润癌患者,其中71例患者术前病理为CIN2及以上鳞状上皮内瘤样病变.在细胞学检查结果为LSIL的66例患者中活检病理和LEEP病理结果为CIN2及以上病变的分别有22例和23例.活检病理与LEEP病理符合率为86.5%,Kappa值为0.718.活检病理结果为CIN1的113例患者中有16例LEEP病理结果为CIN2及以上病变.结论:活检病理可以提高细胞学结果为LSIL的患