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Sample records for abnormal cervical cytology

  1. Abnormal cervical cytology and health care use

    DEFF Research Database (Denmark)

    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...... cervical cancer screening program. We included a study population of 40,153 women with abnormal cytology (exposed) and 752,627 women with normal cytology (non-exposed). We retrieved data from the Danish Civil Registration System, the Danish Pathology Data Bank, the National Health Service, the National......" 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...

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

    LENUS (Irish Health Repository)

    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.

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    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.

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

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    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. Cervical cytology in serous and endometrioid endometrial cancer

    NARCIS (Netherlands)

    Roelofsen, T.; Geels, Y.P.; Pijnenborg, J.M.A.; Ham, M.A.P.C. van; Zomer, S.F.; Tilburg, J.M. van; Snijders, M.P.; Siebers, A.G.; Bulten, J.; Massuger, L.F.A.G.

    2013-01-01

    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

  6. Outcomes of cervical liquid-based cytology suggesting a glandular abnormality.

    Science.gov (United States)

    Finall, A I; Olafsdottir, R

    2009-12-01

    To ascertain the positive predictive value of both ?glandular neoplasia (national standard code 6) and borderline change (national standard code 8) in glandular cells in liquid-based cervical cytology specimens in Cardiff and Vale NHS Trust and to outline the histological outcomes of these cases. Eighty-nine liquid-based (Surepath) cervical cytology cases were retrospectively identified from a 2-year period (January 2005 to December 2006) and correlated with histopathological diagnoses. Initial punch biopsy histology revealed 18 cases (21%) of cervical glandular intraepithelial neoplasia (CGIN). A further nine cases (10%) of CGIN were identified following local excision or hysterectomy. Ten cases of invasive malignancy were identified: four endocervical adenocarcinomas (all node negative, TNM stage T1b1), five endometrial adenocarcinomas and one squamous cell carcinoma. There were 10 with high-grade cervical intraepithelial neoplasia (CIN) alone. Women diagnosed with endometrial malignancy presented later with an average age of 64.6 years compared with 34.9 years for endocervical lesions. Taking high-grade CIN or worse as a positive outcome, the overall positive predictive value (PPV) of glandular abnormalities on cytology (both code 6 and 8) was 58.1% [95% confidence interval (CI) 47.8, 68.4]. PPV for borderline change in glandular cells alone was 24.1% (95% CI 8.5, 39.6) and for ?glandular neoplasia alone 75.4% (95% CI 64.3, 86.5). With our interpretation of the classification, women with cytological diagnoses of glandular neoplasia of the cervix should initially be investigated by local resection rather than punch biopsy, and those with borderline change in glandular cells with repeat cytology.

  7. The use of telemedicine in primary care for women with cervical cytological abnormalities.

    Science.gov (United States)

    Etherington, lan J; Watts, Anne D; Hughes, Elisabeth; Lester, Helen E

    2002-01-01

    Telemedicine can be used in two different ways in the context of the National Health Service Cervical Screening Programme. The first method allows primary health-care providers to offer direct online booking of clinic appointments according to predefined algorithms based on the woman's cytological abnormality. The second method is telecolposcopy, which is designed to be used by nurses in primary care. Preliminary data confirm that such a system can be used reliably to make diagnoses. The technology is easily adaptable for realtime teleconsultation.

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

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    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.

  9. [Risk factors associated with abnormal cervical cytology among Chilean women: a case control study].

    Science.gov (United States)

    Solis, María Teresa; Aguayo, Francisco; Vargas, Macarena; Olcay, Fabiola; Puschel, Klaus; Corvalán, Alejandro; Ferreccio, Catterina

    2010-02-01

    Cervical cancer is the third cause of cancer death among Chilean women, affecting mainly women from low socioeconomic status. To determine main risk factors (RF) including human papiloma virus (HPV) types associated with abnormal cervical cytology (Atypical Squamous Cells of Undetermined Significance or ASCUS) among Chilean women from low socioeconomic status in Santiago, Chile. A random population based sample of 616 women from La Pintana (a low-income district in Santiago) participated in 2001 in a HPV prevalence study and were re-evaluated in 2006 through a risk factors questionnaire, Papanicolaou test and DNA detection for HPV. The Papanicolaou test was analyzed in Santiago and HPV analysis (PCR_GP5+/GP6+) was conducted in Vrije University, Amsterdam. Cases included 42 women with cervical lesions and controls included 574 women with normal cytology during the period 2001-2006. Logistic regression with uni and multivariate analysis was performed to identify RF for cervical lesions. During the study period, there was a significant increase in the proportion of single women, from 8.3 to 14.8% (p ASCUS). High risk HPV was the most significant factor associated with cervical lesions (odds ratio (OR) = 9.695% > confidence intervals (CI) = 4.4-21.1) followed by oral contraceptive use (OR = 2.58 95% > CI = 1.2-5.7). Among women infected by high risk HPV, the use of oral contraceptives was a risk factor while compliance with screening was protective for cervical lesions. From 2001 to 2006, there was an increase in the proportion of women with high-risk HPV infections.

  10. Prevalence of high risk human papillomavirus types 16/18 in cytologically abnormal cervical smears in Alexandria, Egypt. A cytological and molecular study

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    Mona Sobhy Elkharashy

    2013-12-01

    Conclusion: The study generates epidemiological data of prevalence of HPV 16/18 in cytologically abnormal cervical smears in women seeking routine gynecologic care at the outpatient clinics of the Obstetrics and Gynecology Department at El Shatby University. High-risk HPV DNA testing by PCR of cervical samples diagnosed according to the Bethesda 2001 guidelines may benefit the management of patients with abnormal cervical smears, especially among women aged 46 years and older, in menopausal women and in women complaining of PMB. Therefore, HPV DNA testing should be made use of as an adjunct to cervical smears.

  11. HPV genotype prevalence in cervical specimens with abnormal cytology: a report from north-east Italy.

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    Rassu, Mario; Bertoloni, Giulio; Mengoli, Carlo; Peron, Antonella; Benedetti, Paolo; Palu', Giorgio

    2005-01-01

    We have investigated the prevalence of HPV DNA in cervical samples collected from 1335 women with abnormal Pap test and analysed the degree of association of HPV genotype with cervical cytological abnormality and also with patient age. The study was principally aimed at providing some cross-sectional figures on the epidemiology of HPV in our area, where the ethnic background is expected to rapidly evolve due to extensive immigration from overseas. 471 (35.3%) of the 1335 patients screened were positive for HPV DNA. A clear association was observed between cytological findings and the proportion of patients with positive HPV PCR, namely 24.0% HPV positivity in the ASCUS group (atypical squamous cells of undetermined significance), 48.7% in LSIL group (low grade squamous intraepithelial lesions), and 71.9% in HSIL group (high grade squamous intraepithelial lesions) (p-value < 0.001). High-risk (HR) HPV prevalence appeared to be different from other areas of the world; we have detected a high prevalence rate of HPV-16, 31, and 58 and a low prevalence rate of HPV-18 and 11. The prevalence of both HR and low risk (LR) genotype groups was clearly related to age (p-value < 0.001), since the prevalence of LR group had a nadir between 41 and 50 y of age and 2 peaks at 15-20 y and at over 60 y, while the curve of prevalence of HR genotypes displayed an almost inverse trend.

  12. Prevalence and distribution of cervical high-risk human papillomavirus and cytological abnormalities in women living with HIV in Denmark - the SHADE

    DEFF Research Database (Denmark)

    Thorsteinsson, Kristina; Storgaard, Merete; Katzenstein, Terese L

    2016-01-01

    and cytological abnormalities in WLWH compared with WGP in Denmark. Predictors of HPV and cytological abnormalities were estimated in WLWH. METHODS: WLWH consecutively enrolled in the Study on HIV, cervical Abnormalities and infections in women in Denmark (SHADE) in 2011 and were examined for cervical HPV...... and cytological abnormalities. WLWH were matched on age and prior cytological findings with WGP from an earlier study. HIV demographics were retrieved from the nationwide Danish HIV Cohort Study. Logistic regression was used to estimate predictors of hrHPV and cytological abnormalities. RESULTS: Of 334 included...... (adjusted OR 2.05 (95 % CI 1.03-4.10)) and CD4 Cytological abnormalities were prevalent in 10.4 % vs. 5.2 % (p = 0.0003) of WLWH and WGP. In WLWH with hrHPV, short duration of HAART predicted cervical dysplasia (adjusted OR per year 0.83 (95 % CI 0...

  13. Untypable human papillomavirus infection and risk of cervical intraepithelial neoplasia among women with abnormal cervical cytology.

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    Spinillo, Arsenio; Gardella, Barbara; Roccio, Marianna; Alberizzi, Paola; Silini, Enrico Maria; Dal Bello, Barbara

    2014-07-01

    The risk of cervical intraepithelial neoplasia and/or invasive cervical cancer associated with untypable human papillomavirus (HPV) infections has been not investigated fully. HPV infection caused by 18 high-risk and 7 low-risk genotypes as detected by the INNO-LIPA genotyping system, was investigated in 4,258 women with abnormal Pap smear referred to a colposcopic service. The prevalence of HPV infection was 76.1%. Rates of cervical intraepithelial neoplasia grade 3+ were 0.88% (9/1,017) in HPV-negative subjects, 1.8% (7/380) in subjects with untypable HPV infection, 3.2% (11/343) in subjects with single/multiple low-risk types, 28.3% (201/709) in subjects with multiple low and high-risk types, 15.2% (162/1,069) in subjects with single high-risk types, and 31.2% (229/733) in those with multiple high-risk types. Compared to women without any HPV infection, the odds ratios of cervical intraepithelial neoplasia grade 2+ or grade 3+ in subjects with untypable or low-risk HPV genotypes were 5.73 (95% CI = 2.79-11.78) and 12.4 (95% CI = 6.31-24.5, P = 0.014 compared to untypable) and 3.1 (95% CI = 1.11-8.16) and 7.1 (95% CI = 2.9-17.2, P = 0.07 compared to untypable), respectively. In the subgroup of subjects with cervical intraepithelial neoplasia grade 1 or negative colposcopy/biopsy, the progression to cervical intraepithelial neoplasia grade 2+ at follow-up (median 25 months, range 6-70) was 2% (14/684), 3.4% (7/205), and 5.6% (11/195, P = 0.04 compared to negative) among negative, untypable, and low-risk HPV infection, respectively. The risk of cervical intraepithelial neoplasia associated with untypable HPV infection was higher than that recorded among uninfected women, but lower than the risk associated with low- or high-risk HPV genotypes. © 2014 Wiley Periodicals, Inc.

  14. Cytologic detection of cervical abnormalities using liquid-based compared with conventional cytology: a randomized controlled trial.

    NARCIS (Netherlands)

    Siebers, A.G.; Klinkhamer, P.J.; Arbyn, M.; Raifu, A.O.; Massuger, L.F.A.G.; Bulten, J.

    2008-01-01

    OBJECTIVE: To compare test positivity rates of liquid-based and conventional cytology. METHODS: This study was a cluster randomized controlled trial with family practice as the unit of randomization, performed within the Dutch national cervical screening program. Women aged 30-60 years (n=89,784) re

  15. Cytologic detection of cervical abnormalities using liquid-based compared with conventional cytology: a randomized controlled trial.

    NARCIS (Netherlands)

    Siebers, A.G.; Klinkhamer, P.J.; Arbyn, M.; Raifu, A.O.; Massuger, L.F.A.G.; Bulten, J.

    2008-01-01

    OBJECTIVE: To compare test positivity rates of liquid-based and conventional cytology. METHODS: This study was a cluster randomized controlled trial with family practice as the unit of randomization, performed within the Dutch national cervical screening program. Women aged 30-60 years (n=89,784) re

  16. CYTO - HISTO CORRELATION OF ATYPICAL GLANDULAR CELLS OF ENDOMETRIAL ORIGIN ON CERVICAL CYTOLOGY IN ABNORMAL UTERINE BLEEDING CASES

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    Lopa Mudra

    2015-02-01

    Full Text Available BACKGROUND: An association has been reported with presence of endometrial cells on cervical smears and clinically significant uterine lesions. Hence for early detection of endometrial pathology , t he 2001 Bethesda system has suggested the mandatory reporting of presence of any atypical endometrial cells regardless of age and menstrual status and out of phase normal looking endometrial cells in women aged 40 years or more. OBJECTIVES: To assess the association between atypical glandular cells of endometrial origin in cervical cytology and histopathological findings in abnormal uterine bleeding cases . SETTINGS AND DESIGN : The study was conducted at JSS hospital , Mysore in the department of pathology. This was a descriptive type of study. The sample was collected fro m patients attending the gynecology OPD with the complaints of abnormal uterine bleeding in JSS hospital . MATERIALS AND METHODS : Smears for cervical cytology are collected using either pap smear or manual liquid based smear from 82 patients in the age grou p of 20 - 75 years with complaints of abnormal bleeding history. The results of cervical cytology were compared and confirmed with the endometrial pathology. RESULTS : Out of 82 abnormal uterine bleeding cases 14 showed atypical endometrial cells. On follow u p of these cases , the results indicated an association between atypical endometrial cells in cervical cytology with endometrial carcinoma in 8 cases (60% , 1 case with complex hyperplasia with atypia (10% . CONCLUSION : Presence of atypical endometrial cell s in all women with abnormal uterine bleeding has considerable clinical implications & further diagnostic evaluation by endometrial sampling is of utmost importance.

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

    DEFF Research Database (Denmark)

    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...

  18. Cost analysis of colposcopy for abnormal cytology in post-treatment surveillance for cervical cancer.

    Science.gov (United States)

    Tergas, Ana I; Havrilesky, Laura J; Fader, Amanda N; Guntupalli, Saketh R; Huh, Warner K; Massad, L Stewart; Rimel, B J

    2013-09-01

    The aim of this study was to estimate cost and outcomes associated with colposcopy following abnormal Pap for women with a history of cervical cancer. Decision models compared the costs and number of isolated local recurrences (ILR) detected using two strategies, colposcopy and no colposcopy, for women with a history of cervical cancer and low grade or high grade Pap. Clinical data for input were derived from a cohort of women with a history of cervical cancer undergoing surveillance Paps at 2 institutions. Costs were obtained using national reimbursement data. Five hundred fifty-six patients underwent 2900 surveillance Paps. Twenty-seven of 50 women with a low grade Pap underwent colposcopy. One of 3 recurrences in the colposcopy group was an ILR diagnosed colposcopically. Colposcopy following low grade Pap costs $354 more and resulted in a lower rate of diagnosis of ILR compared to no colposcopy (3.7% vs 8.6%). Sixty of 78 women with a high grade Pap underwent colposcopy. Three of 15 recurrences in the colposcopy group were ILR diagnosed colposcopically. Colposcopy following high grade Pap costs $623 more than no colposcopy but resulted in a higher rate of diagnosis of ILR (5% vs 0%; $7481 per additional ILR). Colposcopy following low or high grade surveillance Pap smear adds substantial cost to the management of women with cervical cancer. Only colposcopy following a high grade Pap is associated with a higher probability that cervical cancer recurrence will be detected when salvageable. These findings support withholding colposcopy for abnormal surveillance Pap tests less than high grade. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Predictors of persistent cytologic abnormalities after treatment of cervical intraepithelial neoplasia in Soweto, South Africa: a cohort study in a HIV high prevalence population

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    McIntyre James A

    2008-07-01

    Full Text Available Abstract Background In the presence of both HIV infection and cervical intraepithelial neoplasia (CIN, the risk of cancer development despite treatment may be greater. We investigated clinical predictors of persistent cytological abnormalities in women who had had a large loop excision of the transformation zone (LLETZ. Methods Women with high grade squamous intraepithelial lesions or worse (HSIL, less severe abnormalities which persisted and any abnormality in women who are HIV-infected, were referred to the colposcopy clinic. HIV infection was ascertained by self-report. A LLETZ was performed on all patients with HSIL or higher on Papanicolaou (Pap smear or colposcopy, LSIL or higher in patients who are HIV-infected, where the colposcopy is inadequate, and when there was a discrepancy between colposcopy and cytology by one or more grades. Women with abnormal follow-up smears were compared to those with normal smears. We examined the association between abnormal follow-up smears and demographic and clinical predictors using logistic regression Results The median time between LLETZ and first follow-up Pap smear was rather short at 122 days. Persistent cytological abnormalities occurred in 49% of our patients after LLETZ. Predictors of persistence included the presence of disease at both margins and HIV infection. Among the latter, disease at the excision margins and CD4+ cell count were important predictors. In these women, disease at the endocervical margin, both margins, and disease only at the ectocervical margin were associated with increased odds of persistent abnormalities on follow-up cervical smear. Conclusion We showed extremely high risk of cytological abnormality at follow-up after treatment more so in patients with incomplete excision and in the presence of immunocompromise. It remains uncertain whether recurrent CIN is a surrogate marker for invasive cervical cancer.

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

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    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.

  1. CIGARETTE-SMOKING AND HUMAN PAPILLOMAVIRUS IN PATIENTS WITH REPORTED CERVICAL CYTOLOGICAL ABNORMALITY

    NARCIS (Netherlands)

    BURGER, MPM; HOLLEMA, H; GOUW, ASH; PIETERS, WJLM; QUINT, WGV

    1993-01-01

    Objective-To assess the relation between two risk factors for cervical neoplasia: smoking and infection with oncogenic human papillomavirus. It has been suggested that smoking causes a local immunological defect, which could facilitate the infection and persistence of human papillomavirus. Design-Cr

  2. Management of Cervical Cytology with HPV Test

    Centers for Disease Control (CDC) Podcasts

    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.

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

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    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.

  4. Multiple human papillomavirus infection with or without type 16 and risk of cervical intraepithelial neoplasia among women with cervical cytological abnormalities.

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    Spinillo, Arsenio; Gardella, Barbara; Roccio, Marianna; Alberizzi, Paola; Cesari, Stefania; Patrizia, Morbini; Silini, Enrico

    2014-12-01

    To evaluate the impact of multiple human papillomavirus (HPV) infections on the risk of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) in subjects with cervical cytological abnormalities. A cross-sectional study of 3,842 women attending a colposcopy service was carried out. Genotyping of 18 high-risk, seven low-risk, and two undefined-risk HPVs was carried out by the INNO-LiPA genotyping system. The final colposcopic/pathological diagnoses were as follows: 1,933 (50.3 %) subjects were negative; 1,041 (27.1 %) CIN1; 280 (7.3 %) CIN2; 520 (13.5 %) CIN3; and 68 (1.8 %) invasive cervical cancer. The prevalence of HPV infection was 75.8 % (2,911/3,842), whereas multiple HPVs were detected in 34.5 % of HPV-positive subjects (2,255/3,842). The adjusted risks of CIN3+ in the group with multiple compared to the group with single infection were 2.31 (95 % CI = 1.54-3.47), among HPV16-positive women, and 3.25 (95 % CI = 2.29-4.61, p = 0.21 compared with HPV16-positive subjects), in HPV16-negative subjects. Out of a total of 1,285 subjects with mild lesions, followed up for a median of 16.1 months (interquartile range = 8.9-36.8), the rate of progression to CIN2-3 was 0.6 % (5/541) among subjects negative or with low-risk HPVs, 1.7 % (8/463) among those with single high-risk HPV, and 5 % (14/281, p infection by multiple high-risk HPVs increased the risk of CIN3+ in both HPV16-positive and HPV16-negative subjects. These findings suggest a potential synergistic interaction between high-risk HPVs, favoring the progression of CIN lesions.

  5. Prevalence and type distribution of human papillomavirus infection among women with different degrees of cervical cytological abnormalities in Sicily (Italy

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    Concetta Franchina

    2016-06-01

    Full Text Available Human papillomaviruses (HPVs are etiological agents of cervical cancer. In the absence of Pap smear alterations, high-risk HPV DNA can be detected in cervical samples. The prevalence of papillomavirus infection and their genotype distribution varies greatly across populations. The aims of this study were: i to assess the prevalences of HPV genotypes in people living in Eastern Sicily (Italy and the frequency of HPV multiple infections; ii to evaluate the association between HPV genotypes and cervical lesions in order to improve the epidemiological knowledge useful for monitoring or treating infected women. Nested PCR and reverse dot/blot hybridization were used for the detection and typing of HPV DNA in 315 women who had had an abnormal PAP-smear. HPV DNA test was positive in 70.5% cases; the prevalence was 50% in atypical squamous cells of undetermined significance (ASCUS, 80.8% in low grade-, and 76.2% in high grade-squamous intraepithelial lesion (H-SIL. The genotype distribution showed a predominance of HPV-16 (56.7% followed by HPV-18 (12.2%, HPV-31 (9.5% and HPV-6 (9.5%. Multiple infections were detected in 35.1% of the infected patients. High frequency of positive results for HPV was confirmed and, even in case of ASCUS, patients should be taken into account for genotyping. Our data indicate that multiple infections are consistent in women with low-grade lesions while they are less frequent in women with H-SIL. This could reinforce the theory of the multi-stage cancer model, by which one HPV type becomes predominant along with the progression of cervical lesion severity.

  6. 不孕症妇女宫颈细胞学异常的分析%Analysis of abnormal cervical cytology in women with infertility

    Institute of Scientific and Technical Information of China (English)

    孟宪玲; 陈忠领; 李丽莎; 刘甦

    2012-01-01

    目的 应用液基细胞学比较不孕妇女和正常育龄妇女宫颈细胞学异常的发生率.方法 应用为期2年以上的回顾性病例对照研究方法,比较病例组(290例)和对照组(5 132例)的宫颈细胞学异常发生率.病例组包括所有在治疗不孕过程中应用了宫颈细胞学检查的不孕症妇女,并细分为原发性和继发性不孕.对照组为同期进行宫颈细胞学筛查的正常育龄妇女.两组患者的年龄和人口组成特点相似.应用卡方检验进行统计分析.结果 病例组(25/290,8.6%)与对照组(67/5132,1.3%)宫颈鳞状上皮病变比较差异有统计学意义(P<0.05).继发性病例组比原发性病例组上皮细胞异常发生率更高,病损级别更高.结论 在相似的年龄及人口组成特点下,病例组较对照组在统计学上上皮细胞损伤的发生率更高.经常进行宫颈细胞学筛查对于不孕不育的妇女有益.%Objective To compare the incidence of abnormal cervical cytology in infertile women and nor-mal women of similar age by using liquid-based cytology tests (ThinPrep pap test). Methods A retrospective case-control study over a period of two years was conducted. The study group (n=290) included infertile women under-going liquid-based cytology tests in the treatment, which were subdivided into primary infertility subgroup and second-ary infertility subgroup. The control group (n=5 132) included women without infertility problems who received rou-tine liquid-based cytology test in the same period. Age and demographic characteristics were similar in the two groups. Chi-square test was used for statistical analysis. Results The study group showed significantly (P<0.05) more cervical squamous epithelial abnormalities (25/290, 8.6%) than the control group (67/5132, 1.3%). Women with secondary infertility had more epithelial abnormalities and more high-grade lesions than women with primary infertility. Conclusion Infertile women tend to have

  7. A Virtual Microscopy System to Scan, Evaluate and Archive Biomarker Enhanced Cervical Cytology Slides

    Directory of Open Access Journals (Sweden)

    Niels Grabe

    2010-01-01

    Full Text Available Background: Although cytological screening for cervical precancers has led to a reduction of cervical cancer incidence worldwide it is a subjective and variable method with low single-test sensitivity. New biomarkers like p16 that specifically highlight abnormal cervical cells can improve cytology performance. Virtual microscopy offers an ideal platform for assisted evaluation and archiving of biomarker-stained slides.

  8. Novel E6 and E7 oncogenes variants of human papillomavirus type 31 in Brazilian women with abnormal cervical cytology.

    Science.gov (United States)

    Chagas, Bárbara Simas; Batista, Marcus Vinicius de Aragão; Crovella, Sergio; Gurgel, Ana Pavla Almeida Diniz; Silva Neto, Jacinto da Costa; Serra, Ivi Gonçalves Soares Santos; Amaral, Carolina Maria Medeiros; Balbino, Valdir Queiroz; Muniz, Maria Tereza Cartaxo; Freitas, Antonio Carlos

    2013-06-01

    HPV-31 has been widely described as an important oncogenic type, showing high incidence in worldwide and especially in Northeastern Brazil. We sought to identify the presence of specific mutations in HPV-31 E6 and E7 oncogenes in women with abnormal cervical smear. We enrolled 150 gynecological patients from Sergipe State, Northeastern Brazil. HPV screening was carried out by polymerase chain reaction (MY09/11). E6 and E7 oncogenes were amplified with specific primers and sequenced. The sequences obtained were aligned with the GenBank reference sequences in order to search for genetic variants. We identified genetic variants in E6 and E7 sequences from HPV-31. Two new nucleotide changes in E6 and E7 were described for the first time in this study. A novel mutation in E6 resulted in amino acid change in a site belonging to T-cell epitope with MHC II binding activity. There was no significant difference in the distribution of HPV-31 E6 and E7 variants when compared to all selected clinical/epidemiological characteristics. HPV-31 isolates have been clustered into three main groups called lineages A, B and C. We describe new HPV-31 variants in Brazil, contributing to better understand the genomic diversity of these viruses. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. Follow-up of women with cervical cytological abnormalities showing atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion: a nationwide cohort study.

    Science.gov (United States)

    Sundström, Karin; Lu, Donghao; Elfström, K Miriam; Wang, Jiangrong; Andrae, Bengt; Dillner, Joakim; Sparén, Pär

    2017-01-01

    Atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion in abnormal cervical cytology among young women in cervical cancer screening is an increasing health burden, and comparative effectiveness studies of different management options for such diagnoses are needed. The objective of the study was to compare the incidence of invasive cervical cancer, following different management options pursued after an atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion index smear. In this nationwide cohort study, we included all women aged 22-50 years and resident in Sweden 1989-2011 and with at least 1 cervical smear registered during the study period (n = 2,466,671). Follow-up of a first atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion cytological diagnosis within 25 months was classified as repeat cytology, colposcopy/biopsy, or without further assessment. Incidence rate ratios and 95% confidence intervals of subsequent cervical cancer within 6.5 years following atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion were estimated using Poisson regression by age group and management strategy. Women managed with repeat cytology within 6 months after atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion cytology had a similar risk of cervical cancer compared with colposcopy/biopsy (incidence rate ratio, 1.1, 95% confidence interval, 0.5-2.5, and incidence rate ratio, 2.0, 95% confidence interval, 0.6-6.5, respectively) among women aged 22-27 years. For women aged 28 years and older, women managed with repeat cytology had a higher risk for cervical cancer than women managed with colposcopy/biopsy. Our findings suggest that women with a first cytological diagnosis of atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion up to

  10. 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

    Directory of Open Access Journals (Sweden)

    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.

  11. Human Papillomavirus Assays and Cytology in Primary Cervical Screening of Women Aged 30 Years and Above

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Bonde, Jesper; Preisler, Sarah

    2016-01-01

    In women aged ≥30 years, Human Papillomavirus testing will replace cytology for primary cervical screening. We compared Hybrid Capture 2 (HC2), cobas, CLART, and APTIMA HPV assays with cytology on 2869 SurePath samples from women undergoing routine screening at 30-65 years in Copenhagen, Denmark....... Women with cytological abnormalities were managed according to routine recommendations, with 92% completeness. Those with cytology-normal/HPV-positive samples (on any of the four assays) were invited for repeated cytology and HPV testing in 1.5 year, and 58% had additional testing. HPV testing detected...... more ≥CIN3 than cytology (HC2: 35, cobas, CLART: 37, APTIMA: 34, cytology: 31), although statistically the differences were not significant. Cobas and CLART detected significantly more ≥CIN2 than cytology (cobas, CLART: 49, cytology: 39). The proportion of women with false-positive test results...

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

    Institute of Scientific and Technical Information of China (English)

    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

  13. Type-specific prevalence of human papillomavirus by cervical cytology among women in Brasov, Romania.

    Science.gov (United States)

    Moga, Marius Alexandru; Irimie, Marius; Oanta, Alexandru; Pascu, Alina; Burtea, Victoria

    2014-01-01

    The oncogenic role of human papillomavirus (HPV) in triggering cervical cancer, the second most common cancer in women worldwide, is well established. Romania ranks in first place in Europe in terms of the incidence of cervical cancer. Geographical widespread data on HPV type-distribution are essential for estimating the impact of HPV vaccines and cervical cancer screening programmes. In this study we aimed to identify the prevalence of HPV genotypes and to establish correlations with abnormal cervical cytology among the female population of Brasov County, Romania. A total of 1,000 women aged 17.3-57 years, attending routine cervical examination in the Obstetrics and Gynecology Hospital of Brasov, Romania, and undergoing both cytological examination and HPV genotyping were screened. Infection with 35 different HPV genotypes was detected in 39.6% of cytological specimens. Overall HPV infections were highest in young women under 25 years (p<0.0001), in which cervical cytological abnormalities also reached the highest prevalence. Patients infected by HPV-16 or HPV-18 showed the highest prevalence of cervical cytological abnormalities. Some 48.2% of women with abnormal cytology were infected with high-risk HPV types whereas less than 3% of them were infected only with low-risk HPV types. Our study showed that the prevalence of high-risk HPV infection among Romanian women is higher compared to other studies in other geographic areas. Thus, we consider that in areas where there is an increased prevalence of high-risk HPV infections, HPV genotyping should be performed in all women aged between 18 and 45 years, and Pap test should be performed every 6 months in women with high-risk HPV infection, even those with previous normal cervical cytology.

  14. Introduction of liquid-based cytology and human papillomavirus testing in cervical cancer screening in Luxembourg.

    Science.gov (United States)

    Latsuzbaia, Ardashel; Hebette, Gaëtan; Fischer, Marc; Arbyn, Marc; Weyers, Steven; Vielh, Philippe; Schmitt, Fernando; Mossong, Joël

    2017-05-01

    In 2014, liquid-based cytology with HPV triage replaced conventional cytology. The aim of our study was to compare conventional and liquid-based cytology (LBC), estimate the prevalence of abnormal cervical cytology and high risk HPV (hrHPV) infection and their correlation, among screened women in Luxembourg. Between the first January 2013 and 31st December 2015, 315,868 cervical samples from 150,815 women (mean age 42.2 years) were investigated by the national cytology laboratory. Slides were prepared and screened according to European Guidelines. All cytological results were classified according to the Bethesda 2001 system terminology. The prevalence of abnormal cervical lesions was as follows: atypical squamous cells of undetermined significance (ASC-US), 1.3%; low-grade squamous intraepithelial lesion (LSIL), 1.9%; high-grade squamous intraepithelial lesion (HSIL), 0.4%. The detection rate of cytological lesions was significantly higher with LBC than with conventional cytology. Based on 11,838 samples with concomitant cytology and HPV testing, hrHPV was detected in 9.5, 45.3, 70.0, and 92.6% of women with negative cytology, ASC-US, LSIL, and HSIL, respectively. More cervical lesions were identified using LBC compared to conventional cytology. HrHPV infection was correlated with the severity of intraepithelial lesions. The current findings provide important information to evaluate the prevention of cervical cancer in Luxembourg and for monitoring the future impact of HPV vaccination. Diagn. Cytopathol. 2017;45:384-390. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  15. Clinical significance of colposcopy on screening cervical intraepithelial neoplasia in cytological negative and smooth cervices

    Institute of Scientific and Technical Information of China (English)

    Dianyun Shi; Saiying Chen; Yan Sun

    2014-01-01

    Objective:The aim of the study was to evaluate the clinical value of the video colposcopy in screening cervical intraepithelial neoplasia (CIN) in cytological negative and smooth cervices by optical y gynecological examination. Methods:The 1050 women, whose cervices had been shown smooth and cytological negative by optical examine, were examined with electronic colposcopy in gynecological clinic, and biopsy was taken when the double abnormality of aceto-white epithelium and iodine negative, and other abnormal images were shown. A retrospective analysis of these cases was performed. Re-sults:(1) The 514 samples from 458 cases, including 458 samples of abnormal tissues under colposcopy and 56 samples of polyp or polypoid tumors by optical y, were examined by biopsy. Among them, 68 samples were found to be CIN, including 11 cases of CINII/CINIII;(2) The 72 of 1050 cases showed the double-abnormality of aceto-white epithelium and iodine nega-tive. Among them, 64 cases were CIN determined by biopsy. And the positive predictive value of the double-abnormality of aceto-white epithelium and iodine negative under colposcopy was 88.9%, with a false negative rate of 3.3%;(3) Among 458 women examined by biopsy, only one of 350 samples from cervical polyp tissue was CIN (0.3%), while 67 of 164 samples from the tissues with abnormal colposcopic images were found to be CIN (40.9%), indicating the close relation between abnormal colposcopic findings and CIN;(4) The results of age-distribution analysis showed that, in the 164 cases with abnormal features under colposcopy, the incidence of double abnormality of aceto-white epithelium and iodine negative was higher in the age of sexual activity, just the same as the age distribution feature of CIN;while single abnormality of iodine negative appeared more in the age of over 50 years. Conclusion:Abnormal features displayed by colposcopy, especial y the double abnormality of aceto-white epithelium and iodine negative, has an important

  16. Benefits of Cervical Cancer Screening by Liquid-Based Cytology as Part of Routine Antenatal Assessment.

    Science.gov (United States)

    Parkpinyo, Nichamon; Inthasorn, Perapong; Laiwejpithaya, Somsak; Punnarat, Tippawan

    2016-01-01

    To determine the prevalence of abnormal cervical cytology, as diagnosed using a liquid-based cytology technique, in pregnant women attending the Antenatal Care (ANC) clinic at Siriraj Hospital. This cross-sectional study included 655 first-visit pregnant women who attended ANC clinic at Siriraj Hospital during June to November 2015 study period. After receiving routine antenatal care, cervical cytology screening was performed with the Siriraj liquid-based cytology technique. All specimens were reviewed by a certi ed cytopathologist using Bethesda System 2001 criteria. Patients with abnormal PAP results characterized as epithelial cell abnormalities were referred to a gynecologic oncologist for further management according to ASCCP Guidelines 2012. Mean age of participants was 28.9±6.2 years. Prevalence of abnormal cervical cytology was 3.4% (95% CI: 2.0-4.7). Among this group, there were ASC-US, ASC-H, LSIL, HSIL for 12(1.8%), 2(0.3%), 7(1.1%) and 1(0.2%), respectively. In 633 specimens of the normal group, infection was identified in 158 specimens (24.1%) which were caused by Candida spp. and Trichomonas vaginalis. Regarding patient perception about the importance of cervical cancer screening, although most women perceived screening to be important, 54% of participants had never been screened for cervical cancer. Rate of loss to follow-up in the postpartum period was as high as 41.8%. Prevalence of abnormal cervical cytology in pregnant women attending the ANC clinic at Siriraj Hospital was 3.4%. Inclusion of cervical cancer screening as part of antenatal assessment can help to identify precancerous lesions or cervical cancers in patients who might otherwise not be screened, thereby facilitating early treatment and improved patient outcomes.

  17. Abnormal Cervical Cancer Screening Test Results

    Science.gov (United States)

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

  18. Routine Treatment of Cervical Cytological Cell Changes

    Science.gov (United States)

    Huber, J.; Pötsch, B.; Gantschacher, M.; Templ, M.

    2016-01-01

    Introduction: Diagnosis and treatment of vaginal and cervical cytological cell changes are described in European and national guidelines. The aim of this data collection was to evaluate the remission rates of PAP III and PAP III D cytological findings in patients over a period of 3–4 months. Method: The current state of affairs in managing suspicious and cytological findings (PAP III, and III D) in gynecological practice was assessed in the context of a data collection survey. An evaluation over a period of 24 months was conducted on preventative measures, the occurrence and changes to normal/suspect/pathological findings and therapy management (for suspicious or pathological findings). Results: 307 female patients were included in the analysis. At the time of the survey 186 patients (60.6 %) had PAP III and 119 (38.8 %) had PAP III D findings. The spontaneous remission rate of untreated PAP III patients was 6 % and that of untreated PAP III D patients was 11 %. The remission rates of patients treated with a vaginal gel were 77 % for PAP III and 71 % for PAP III D. Conclusion: A new treatment option was used in gynecological practice on patients with PAP III and PAP III D findings between confirmation and the next follow-up with excellent success. PMID:27761030

  19. Comparison of liquid-based cytology with conventional cytology for detection of cervical cancer precursors: a randomized controlled trial.

    NARCIS (Netherlands)

    Siebers, A.G.; Klinkhamer, P.J.; Grefte, J.M.M.; Massuger, L.F.A.G.; Vedder, J.E.; Beijers-Broos, A.; Bulten, J.; Arbyn, M.

    2009-01-01

    CONTEXT: Liquid-based cytology has been developed as an alternative for conventional cervical cytology. Despite numerous studies and systematic reviews, controversy remains about its diagnostic accuracy. OBJECTIVE: To assess the performance of liquid-based cytology compared with conventional

  20. 妊娠期妇女子宫颈细胞学检查结果异常的相关因素分析%Factors associated with abnormal cervical cytology in pregnant women

    Institute of Scientific and Technical Information of China (English)

    范玲; 邹丽颖; 吴玉梅; 张为远

    2010-01-01

    Objective To investigate the risk factors associated with abnormal cervical cytology findings in pregnant women. Methods From Sep. 2007 to Sep. 2008, 12 112 pregnant women who underwent their antenatal examinations at 12-36 gostational weeks in Beijing Obsteties and Gynecology Hospital were enrolled in this study. They were all excluded from the following pathologic obstetrics factors including threatened abortion, premature rupture of membranes or placental previa Thinprep cytology test (TCT) were given at their first examination, meanwhile, a personal clinic file was established to record her occupation, education, address, family income, nationality, age of first intercourse, number of sex partners, contraception, marriage and pregnancy, current gynecologic diseases, family history of gynecologic tumors, history of gynecologic diseases and smoking and result of pelvic examination. Those risk factors leading to abnormal cervical cytology were analyzed. Results The complete clinical data were collected from 11 906 cases(98.30%, 11 906/12 112). It was found that 10 354 women were shown with normal TCT result, however, 1134 women (9.52%, 1134/11 906) with atypical squamaous cells of undetermined significance(ASCUS), 112 women (0.94%, 112/11 906) with atypical glandular cells of undetermined significance(AGUS), 229 women (1.92%, 229/11 906) with low grade squamaous intraepithelial(LSIL),74 women (0.62%, 74/11906) with high grade squamaous intraepithelial(HSIL). Multiple factorial non-conditioned logistic regression analysis showed that age of first sexual intercourse (OR_(ASCUS)=2.90, OR_(AGUS)=7. 32), number of sex partners (OR_(AGUS)=1.49, OR_(AGUS)=2. 02), number of abortion (OR_(ASCUS)=1.68,OR_(AGUS)=3.50) were correlated with ASCUS and AGUS. In LSIL group and HSIL group, age of first sexual intercourse (OR_(LSIL)=6. 34, OR_(HSIL)=9.26), number of sex partners (OR_(LSIL)=1.69, OR_(HSIL)=1.6.5),number of abortion (OR_(LSIL)=1.53, OR_(HSIL)=5. 33), smoking (OR

  1. Outcomes in cervical screening using various cytology technologies

    DEFF Research Database (Denmark)

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

    2013-01-01

    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......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...... 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...

  2. Economic analysis of human papillomavirus triage, repeat cytology, and immediate colposcopy in management of women with minor cytological abnormalities in Sweden.

    Science.gov (United States)

    Ostensson, Ellinor; Fröberg, Maria; Hjerpe, Anders; Zethraeus, Niklas; Andersson, Sonia

    2010-10-01

    To assess the cost-effectiveness of using human papillomavirus testing (HPV triage) in the management of women with minor cytological abnormalities in Sweden. An economic analysis based on a clinical trial, complemented with data from published meta-analyses on accuracy of HPV triage. The study takes perspective of the Swedish healthcare system. The Swedish population-based cervical cancer screening program. A decision analytic model was constructed to evaluate cost-effectiveness of HPV triage compared to repeat cytology and immediate colposcopy with biopsy, stratifying by index cytology (ASCUS = atypical squamous cells of undetermined significance, and LSIL = low-grade squamous intraepithelial lesion) and age (23-60 years, cytological abnormalities. Today, immediate colposcopy with biopsy is a cost-effective alternative compared to HPV triage and repeat cytology.

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

    Science.gov (United States)

    Rask, J; Lynge, E; Franzmann, M; Hansen, B; Hjortebjerg, A; Rygaard, C; Schledermann, D; Wåhlin, A; Rebolj, M

    2014-05-01

    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 a third laboratory using manually read conventional cytology continually. Data were collected from the Danish National Health Care Registers. For each laboratory, we compared proportions of abnormal cytology defined as atypical squamous cells of undetermined significance or worse (ASCUS+) by age and 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 6.1%, relative proportion (RP): 1.31 [95% confidence interval (CI): 1.08-1.61], and a decrease in women aged 45-59 years from 2.9 to 2.0%, RP: 0.71 (95% CI: 0.60-0.83). Implementation of ThinPrep LBC was followed by a decrease in abnormal cytology both in women aged 23-29 years from 7.7 to 6.8%, RP: 0.89 (95% CI: 0.78-1.02) and in women aged 45-59 years from 3.4 to 1.0%, RP: 0.30 (95% CI: 0.24-0.37). With implementation of imaging-assisted reading, regardless of the brand of technology, the proportion of abnormality increased by around 30% in all age groups (range from 19 to 41%). In the laboratory with unchanged technology no trends in abnormality proportions were observed. The impact of LBC implementation on cytological abnormality proportions varied considerably across age groups.

  4. Cervicovaginal cytology in the detection of recurrence after cervical cancer treatment.

    Science.gov (United States)

    Rimel, B J; Ferda, Aaron; Erwin, Jamie; Dewdney, Summer B; Seamon, Leigh; Gao, Feng; DeSimone, Christopher; Cotney, Kristen K; Huh, Warner; Massad, L Stewart

    2011-09-01

    To evaluate the utility of liquid-based cytology in detecting recurrent cervical cancer among treated cervical cancer patients. A retrospective multi-institution study identified patients treated for cervical cancer from January 1, 2000, to November 1, 2009, through local cancer registries and patient databases. Patients were excluded if they lacked follow-up or treatment data. In all, 4,167 cytology results from 929 women were identified. Of these, 626 (15%) Pap test results from 312 (34%) women were abnormal, including 296 atypical squamous cells of undetermined significance (ASC-US; 47%); 179 low-grade squamous intraepithelial lesions (LSIL; 29%), 59 atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesions (ASC-H; 9%); 55 high-grade squamous intraepithelial lesions (HSIL; 9%); 14 atypical glandular cells (2%), and 23 favor neoplasia (4%). Abnormal Pap test results led to 201 colposcopies in 135 women. Only 45 women had cervical intraepithelial neoplasia (CIN) 2 or worse, 25 had CIN 3, and 12 had cancer. Only 5 of 475 (1%) women with ASC-US or LSIL had CIN 3. Cancer recurred in 147 women, with 12 (8.1%) detected by Pap test; all but one had Pap test results of ASC-H or worse. One patient with ASC-US and human papillomavirus had a visible lesion on return for assessment 2 months after Pap testing. Colposcopy for cytology less than HSIL without a visible lesion on examination did not detect any recurrence or CIN 3. When stratified by stage and institution, patients treated with radiation had a higher risk of abnormal Pap test results (P<.001). A third of cervical cancer survivors will have abnormal cytology during follow-up, but in the absence of a visible lesion, those with ASC-US or LSIL can be followed without colposcopy unless abnormalities persist. Women with ASC-H, HSIL, and similar abnormalities deserve colposcopy. II.

  5. Comparison of liquid-based cytology with conventional cytology for detection of cervical cancer precursors: a randomized controlled trial.

    NARCIS (Netherlands)

    Siebers, A.G.; Klinkhamer, P.J.; Grefte, J.M.M.; Massuger, L.F.A.G.; Vedder, J.E.; Beijers-Broos, A.; Bulten, J.; Arbyn, M.

    2009-01-01

    CONTEXT: Liquid-based cytology has been developed as an alternative for conventional cervical cytology. Despite numerous studies and systematic reviews, controversy remains about its diagnostic accuracy. OBJECTIVE: To assess the performance of liquid-based cytology compared with conventional cytolog

  6. Comparison of liquid-based cytology with conventional cytology for detection of cervical cancer precursors: a randomized controlled trial.

    NARCIS (Netherlands)

    Siebers, A.G.; Klinkhamer, P.J.; Grefte, J.M.M.; Massuger, L.F.A.G.; Vedder, J.E.; Beijers-Broos, A.; Bulten, J.; Arbyn, M.

    2009-01-01

    CONTEXT: Liquid-based cytology has been developed as an alternative for conventional cervical cytology. Despite numerous studies and systematic reviews, controversy remains about its diagnostic accuracy. OBJECTIVE: To assess the performance of liquid-based cytology compared with conventional cytolog

  7. Five-Year Cervical (Pre)Cancer Risk of Women Screened by HPV and Cytology Testing.

    Science.gov (United States)

    Uijterwaal, Margot H; Polman, Nicole J; Van Kemenade, Folkert J; Van Den Haselkamp, Sander; Witte, Birgit I; Rijkaart, Dorien; Berkhof, Johannes; Snijders, Peter J F; Meijer, Chris J L M

    2015-06-01

    Primary human papillomavirus (HPV)-based cervical screening will be introduced in the Netherlands in 2016. We assessed the 5-year cervical (pre)cancer risk of women with different combinations of HPV and cytology test results. Special attention was paid to risks for cervical intraepithelial neoplasia grade 3 and 2 or more (CIN3+/2+) of HPV-positive women with a negative triage test, because this determines the safety of a 5-year screening interval for HPV-positive, triage test-negative women. In addition, age-related effects were studied. A total of 25,553 women were screened by HPV testing and cytology in a screening setting. Women were managed on the presence of HPV and/or abnormal cytology. Five-year cumulative incidences for CIN3+/2+ were calculated. Five-year CIN3+(2+) risk was 10.0% (17.7%) among HPV-positive women. When stratified by cytology, the CIN3+(CIN2+) risk was 7.9% (12.9%) for women with normal cytology and 22.2% (45.3%) for women with equivocal or mildly abnormal (i.e., BMD) cytology. For HPV-negative women, the 5-year CIN3+(2+) risk was 0.09% (0.21%). Additional triage of HPV-positive women with normal cytology by repeat cytology at 12 months showed a 5-year CIN3+(2+) risk of 4.1% (7.0%). HPV-non 16/18-positive women with normal cytology at baseline had comparable risks of 3.5% (7.9%). HPV-non 16/18-positive women with normal baseline cytology and normal repeat cytology had a 5-year CIN3+ risk of 0.42%. No age-related effects were detected. In conclusion, HPV-positive women with normal cytology and a negative triage test, either repeat cytology after 12 months or baseline HPV 16/18 genotyping, develop a non-negligible CIN3+ risk over 5 years. Therefore, extension of the screening interval over 5 years only seems possible for HPV screen-negative women. ©2015 American Association for Cancer Research.

  8. Detecting uterine glandular lesions: Role of cervical cytology

    Directory of Open Access Journals (Sweden)

    Baneet Bansal

    2016-01-01

    Full Text Available 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 < 0.05. Conclusions: The prevalence of GCA in 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.

  9. Detecting uterine glandular lesions: Role of cervical cytology

    Science.gov (United States)

    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 < 0.05). Conclusions: The prevalence of GCA in 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

  10. Screening for cervical cancer precursors with p16/Ki-67 dual-stained cytology: results of the PALMS study.

    Science.gov (United States)

    Ikenberg, Hans; Bergeron, Christine; Schmidt, Dietmar; Griesser, Henrik; Alameda, Francisco; Angeloni, Claudio; Bogers, Johannes; Dachez, Roger; Denton, Karin; Hariri, Jalil; Keller, Thomas; von Knebel Doeberitz, Magnus; Neumann, Heinrich H; Puig-Tintore, Luis M; Sideri, Mario; Rehm, Susanne; Ridder, Ruediger

    2013-10-16

    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, can provide high sensitivity for CIN2+ in screening while maintaining high specificity. Results were compared with Pap cytology and HPV testing. A total of 27,349 women 18 years or older attending routine cervical cancer screening were prospectively enrolled in five European countries. Pap cytology, p16/Ki-67 immunostaining, and HPV testing were performed on all women. Positive test results triggered colposcopy referral, except for women younger than 30 years with only positive HPV test results. Presence of CIN2+ on adjudicated histology was used as the reference standard. Two-sided bias-corrected McNemar P values were determined. The p16/Ki-67 dual-stained cytology positivity rates were comparable with the prevalence of abnormal Pap cytology results and less than 50% of the positivity rates observed for HPV testing. In women of all ages, dual-stained cytology was more sensitive than Pap cytology (86.7% vs 68.5%; P p16/Ki-67 dual-stained cytology combines superior sensitivity and noninferior specificity over Pap cytology for detecting CIN2+. It suggests a potential role of dual-stained cytology in screening, especially in younger women where HPV testing has its limitations.

  11. The status of cervical cytology in Swaziland, Southern Africa: A descriptive study

    Directory of Open Access Journals (Sweden)

    Okonda Sylvain

    2009-01-01

    Full Text Available Background: Cancer of the cervix is the most common cancer in women in Swaziland where most women never undergo cervical screening. The extremely high prevalence of HIV/AIDS in Swaziland complicates the management of preinvasive and invasive cervical cancer. The purpose of this study was to assess the current status of cervical cytology in Swaziland, its strengths and limitations. Methods: The study is a retrospective review of 12,188 conventional cervical smears received by the Central Public Health Laboratory in Swaziland from June 2004 to May 2006. Results: Review of results showed very high rates of cytologic abnormalities with 43.2% of smears screened reported as abnormal. The percentages of abnormalities were as follows: atypical squamous cells of undermined significance (ASC-US, 19.8%; atypical squamous cells, cannot exclude HSILs (ASC-H, 8.8%; low-grade squamous intraepithelial lesions (LSIL, 9.0%; high-grade squamous intraepithelial lesions (HSIL, 4.6%; squamous cell carcinomas, 0.5%; atypical endocervical cells, 0.6%; and atypical endometrial cells, 0.4%. Just over 5% of smears were inadequate. The highest rates of HSILs and invasive squamous carcinoma occurred in women aged 50-59 years. Conclusions: This study underscores the need to reduce the incidence of cervical cancer and its precursor lesions in Swaziland women. Based on studies of human papillomavirus (HPV types in other Southern African countries, current HPV vaccines would reduce the incidence and mortality from cervical cancer in the future, but cervical screening would still be required, both for women already infected with the HPV and for HPV subtypes not covered by current vaccines. The most cost-effective combination of screening modalities such as visual inspection, HPV DNA testing, and cytology should be investigated. Cervical cancer reduction needs to be managed within the greater framework of the HIV/AIDS epidemic.

  12. Two cytological methods for screening for cervical cancer

    DEFF Research Database (Denmark)

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

    2008-01-01

    -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...... of cervical precancerous lesions with liquid-based cytology. Follow-up histology showed no increase of false positive tests, whilst the share of tests which were "unsatisfactory for evaluation" decreased significantly. Overall, the liquid-based technique would seem to have several advantages compared...

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Two cytological methods for screening for cervical cancer

    DEFF Research Database (Denmark)

    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...

  15. Differentiating between endocervical glandular neoplasia and high grade squamous intraepithelial lesions in endocervical crypts: cytological features in ThinPrep and SurePath cervical cytology samples.

    Science.gov (United States)

    Thiryayi, Sakinah A; Marshall, Janet; Rana, Durgesh N

    2009-05-01

    A recent audit at our institution revealed a higher number of cases diagnosed as endocervical glandular neoplasia on ThinPrep (TP) cervical cytology samples (9 cases) as opposed to SurePath (SP) (1 case), which on histology showed only high-grade cervical intraepithelial neoplasia (CIN) with endocervical crypt involvement (CI). We attempted to ascertain the reasons for this finding by reviewing the available slides of these cases, as well as slides of cases diagnosed as glandular neoplasia on cytology and histology; cases diagnosed as high-grade squamous intraepithelial lesions (HSIL) on cytology which had CIN with CI on histology and cases with mixed glandular and squamous abnormalities diagnosed both cytologically and histologically. Single neoplastic glandular cells and short pseudostratified strips were more prevalent in SP than TP with the cell clusters in glandular neoplasia 3-4 cells thick, in contrast to the dense crowded centre of cell groups in HSIL with CI. The cells at the periphery of groups can be misleading. Cases with HSIL and glandular neoplasia have a combination of the features of each entity in isolation. The diagnosis of glandular neoplasia remains challenging and conversion from conventional to liquid based cervical cytology requires a period of learning and adaptation, which can be facilitated by local audit and review of the cytology slides in cases with a cytology-histology mismatch.

  16. Longitudinal Analysis of Carcinogenic Human Papillomavirus Infection and Associated Cytologic Abnormalities in the Guanacaste Natural History Study: Looking Ahead to Cotesting

    Science.gov (United States)

    Rodriguez, Ana C.; Burk, Robert D.; Hildesheim, Allan; Herrero, Rolando; Wacholder, Sholom; Hutchinson, Martha; Schiffman, Mark

    2012-01-01

    Background. Few studies have addressed the timing of cervical cytologic abnormalities and human papillomavirus (HPV) positivity during the course of an infection. It remains largely unknown how infections detected by HPV and cytology wax and wane relative to each other. The aim of this analysis was to assess the longitudinal relationship of abnormal cytology and HPV positivity in a 7-year prospective study of 2500 women in Guanacaste, Costa Rica. Methods. At each semiannual or annual visit, cervical specimens were screened using liquid-based cytology and tested for >40 HPV types with use of MY09/MY11 L1 degenerate primer polymerase chain reaction–based methods. On the basis of previous work, we separated prevalent and newly detected infections in younger and older women. Results. Among newly detected HPV- and/or cytology-positive events, HPV and cytology appeared together ∼60% of the time; when discordant, HPV tended to appear before cytology in younger and older women. Combining newly and prevalently detected events, HPV and cytology disappeared at the same time >70% of the time. When discordant, HPV tended to disappear after cytology in younger and older women. Conclusions. Detection of HPV DNA and associated cytological abnormalities tend to come and leave together; however, when discordant, detection of HPV DNA tends to precede and/or last longer than associated cytologic abnormalities. PMID:22147792

  17. Cervical cytology and the diagnosis of cervical cancer in older women.

    Science.gov (United States)

    Landy, Rebecca; Castanon, Alejandra; Dudding, Nick; Lim, Anita Wey Wey; Hollingworth, Antony; Hamilton, Willie; Sasieni, Peter D

    2015-12-01

    Most non-screen-detected cervical cancers are advanced stage. We assess the potential for cytology to expedite diagnosis when used outside of routine call and recall screening for cervical cancer. Two cohorts of women with cytology that did not appear to have been taken as part of routine screening, nested within a census of cervical cytology, in England between April 2007 and March 2010 were studied: 93,322 women aged 40-69 at first cytology, and 14,668 women aged ≥70. The diagnostic performance of high grade cervical squamous intraepithelial lesion (HSIL) or worse cytology was estimated. We also estimated case-fatality from stage distribution in women aged ≥66 with and without cytology in the year prior to diagnosis. There were 259 cancers diagnosed in women aged 40-69 at first cytology, and 78 in women aged ≥70. The sensitivity of cytology ≥ HSIL for cancer was 89% and 83% respectively, and the number of women needed to test to identify one cancer was 404 (95% confidence interval [CI]: 355-462) and 226 (95% CI: 177-292) respectively. Women aged ≥66 with cytology within a year of diagnosis had earlier stage cancers than those without, corresponding to a 17-22% reduction in case fatality. Cervical cytology is an excellent identifier of cancer among women tested outside routine screening call and recall. Its use as a triage tool, for instance in women with vague gynaecological symptoms, could facilitate earlier stage diagnosis and reduce cervical cancer mortality. © The Author(s) 2015.

  18. Automatic recognition of abnormal cells in cytological tests using multispectral imaging

    Science.gov (United States)

    Gertych, A.; Galliano, G.; Bose, S.; Farkas, D. L.

    2010-03-01

    Cervical cancer is the leading cause of gynecologic disease-related death worldwide, but is almost completely preventable with regular screening, for which cytological testing is a method of choice. Although such testing has radically lowered the death rate from cervical cancer, it is plagued by low sensitivity and inter-observer variability. Moreover, its effectiveness is still restricted because the recognition of shape and morphology of nuclei is compromised by overlapping and clumped cells. Multispectral imaging can aid enhanced morphological characterization of cytological specimens. Features including spectral intensity and texture, reflecting relevant morphological differences between normal and abnormal cells, can be derived from cytopathology images and utilized in a detection/classification scheme. Our automated processing of multispectral image cubes yields nuclear objects which are subjected to classification facilitated by a library of spectral signatures obtained from normal and abnormal cells, as marked by experts. Clumps are processed separately with reduced set of signatures. Implementation of this method yields high rate of successful detection and classification of nuclei into predefined malignant and premalignant types and correlates well with those obtained by an expert. Our multispectral approach may have an impact on the diagnostic workflow of cytological tests. Abnormal cells can be automatically highlighted and quantified, thus objectivity and performance of the reading can be improved in a way which is currently unavailable in clinical setting.

  19. Abnormal cervical cytology requiring colposcopy among women ...

    African Journals Online (AJOL)

    countries. This policy advised screening at 3-yearly intervals from the time of sexual debut; however, ... resources involved in screening women at low risk could be better spent ... (GSH), Cape Town, for assessment and appropriate clinical.

  20. Prevalence of type-specific HPV infection by age and grade of cervical cytology: data from the ARTISTIC trial.

    Science.gov (United States)

    Sargent, A; Bailey, A; Almonte, M; Turner, A; Thomson, C; Peto, J; Desai, M; Mather, J; Moss, S; Roberts, C; Kitchener, H C

    2008-05-20

    Human papillomavirus (HPV) infection causes cervical cancer and premalignant dysplasia. Type-specific HPV prevalence data provide a basis for assessing the impact of HPV vaccination programmes on cervical cytology. We report high-risk HPV (HR-HPV) type-specific prevalence data in relation to cervical cytology for 24,510 women (age range: 20-64; mean age 40.2 years) recruited into the ARTISTIC trial, which is being conducted within the routine NHS Cervical Screening Programme in Greater Manchester. The most common HR-HPV types were HPV16, 18, 31, 51 and 52, which accounted for 60% of all HR-HPV types detected. There was a marked decline in the prevalence of HR-HPV infection with age, but the proportion due to each HPV type did not vary greatly with age. Multiple infections were common below the age of 30 years but less so between age 30 and 64 years. Catch-up vaccination of this sexually active cohort would be expected to reduce the number of women with moderate or worse cytology by 45%, but the number with borderline or mild cytology would fall by only 7%, giving an overall reduction of 12% in the number of women with abnormal cytology and 27% in the number with any HR-HPV infection. In the absence of broader cross-protection, the large majority of low-grade and many high-grade abnormalities may still occur in sexually active vaccinated women.

  1. Overall accuracy of cervical cytology and clinicopathological significance of LSIL cells in ASC-H cytology.

    Science.gov (United States)

    Kim, S H; Lee, J M; Yun, H G; Park, U S; Hwang, S U; Pyo, J-S; Sohn, J H

    2017-02-01

    The aims of this study were (i) to investigate the diagnostic accuracy of Papanicolaou (Pap) smears and (ii) to evaluate the clinicopathological significance of the presence of low-grade squamous intraepithelial lesion (LSIL) cells in atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (HSIL) (ASC-H) cytology. We retrospectively reviewed paired cytological and histological findings from 3141 patients. ASC-H cytology was classified as either ASC-H or LSIL with some features suggestive of the presence of a concurrent HSIL (LSIL-H). Clinicopathological characteristics were evaluated through a retrospective study and meta-analysis. The accuracy of the cytological diagnosis was 93.7% (2942 of 3141 cases). The positive predictive value (PPV) of ASC-H for cervical intraepithelial neoplasia grade 2 or worse (CIN 2+ ) was 51.4%. In cases of LSIL-H, CIN 2+ histology was more prevalent in the pre-menopausal period (19-44 years) than in peri- and postmenopausal periods (older than 45 years) (P = 0.024). There was no difference in the ability of LSIL-H and ASC-H to predict CIN 2+. The Pap smear is a good cervical cancer screening method. Although there was no difference in the predictive value for CIN 2+ between LSIL-H and ASC-H, the presence of definite LSIL cells was more predictive of CIN 2+ in younger patients than in older patients. © 2016 John Wiley & Sons Ltd.

  2. ATR microspectroscopy with multivariate analysis segregates grades of exfoliative cervical cytology.

    Science.gov (United States)

    Walsh, Michael J; Singh, Maneesh N; Pollock, Hubert M; Cooper, Leanne J; German, Matthew J; Stringfellow, Helen F; Fullwood, Nigel J; Paraskevaidis, Evangelos; Martin-Hirsch, Pierre L; Martin, Francis L

    2007-01-05

    Although cervical cancer screening in the UK has led to reductions in the incidence of invasive disease, this programme remains flawed. We set out to examine the potential of infrared (IR) microspectroscopy to allow the profiling of cellular biochemical constituents associated with disease progression. Attenuated total reflection-Fourier Transform IR (ATR) microspectroscopy was employed to interrogate spectral differences between samples of exfoliative cervical cytology collected into liquid based cytology (LBC). These were histologically characterised as normal (n = 5), low-grade (n = 5), high-grade (n = 5) or severe dyskaryosis (? carcinoma) (n = 5). Examination of resultant spectra was coupled with principal component analysis (PCA) and subsequent linear discriminant analysis (LDA). The interrogation of LBC samples using ATR microspectroscopy with PCA-LDA facilitated the discrimination of different categories of exfoliative cytology and allowed the identification of potential biomarkers of abnormality; these occurred prominently in the IR spectral region 1200 cm(-1) - 950 cm(-1) consisting of carbohydrates, phosphate, and glycogen. Shifts in the centroids of amide I (approximately 1650 cm(-1)) and II (approximately 1530 cm(-1)) absorbance bands, indicating conformational changes to the secondary structure of intracellular proteins and associated with increasing disease progression, were also noted. This work demonstrates the potential of ATR microspectroscopy coupled with multivariate analysis to be an objective alternative to routine cytology.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. A Multi-Institutional Feasibility Study on the Use of Automated Screening Systems for Quality Control Rescreening of Cervical Cytology.

    Science.gov (United States)

    Sugiyama, Yuko; Sasaki, Hiroshi; Komatsu, Kyoko; Yabushita, Ryuji; Oda, Mizue; Yanoh, Kenji; Ueda, Masatsugu; Itamochi, Hiroaki; Okugawa, Kaoru; Fujita, Hiromasa; Tase, Toru; Nakatani, Eiji; Moriya, Takuya

    2016-01-01

    To evaluate the efficacy of the automated screening system FocalPoint for cervical cytology quality control (QC) rescreening. False-negative rates (FNRs) were evaluated by a multi-institutional retrospective study. Cervical cytology slides that had already been reported as negative for intraepithelial lesion or malignancy (NILM) were chosen arbitrarily for FocalPoint rescreening. Slides stratified into the highest 15% probability of being abnormal were rescreened by a cytotechnologist. The slides that were abnormal were reevaluated by a cytopathologist to be false negatives. Rescreening of 12,000 slides, i.e. 9,000 conventional slides and 3,000 liquid-based cytology (LBC) slides, was performed; 9,826 (7,393 conventional and 2,433 LBC) were satisfactory for FocalPoint (2,174 were determined unsatisfactory) and those within the highest 15% of probability (1,496, i.e. 1,123 conventional and 373 LBC) were rescreened. As a result, 117 (96 conventional and 21 LBC) were determined as abnormal (other than NILM) and the FNR was 1.19%. Among these 117 slides, 40 (35 conventional and 5 LBC) were determined as high-grade squamous intraepithelial lesion and greater (HSIL+). Of 117 (1.19%) abnormal slides detected, 40 (0.41%) were determined to be HSIL+. This result suggests that FocalPoint is effective for QC rescreening of cervical cytology. © 2016 The Author(s) Published by S. Karger AG, Basel.

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

    OpenAIRE

    Vikrant Bhar Singh; Nalini Gupta; Raje Nijhawan; Radhika Srinivasan; Vanita Suri; Arvind Rajwanshi

    2015-01-01

    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 sa...

  6. Age-specific prevalence of human papillomavirus by grade of cervical cytology in Tibetan women

    Institute of Scientific and Technical Information of China (English)

    JIN Qiong; SHEN Keng; LI Hui; ZHOU Xian-rong; HUANG Hui-fang; LENG Jin-hua

    2010-01-01

    Background Human papillomavirus (HPV) is believed to be the most common sexually transmitted infection. However,little is known about the prevalence and distribution of HPV types in China. We aimed to assess the prevalence and the distribution of HPV types as well as risks for abnormal cervical cytology in women who reside in the Tibetan Autonomous Region of China.Methods A cross-sectional study was performed involving a sample of 3036 women. An epidemiological questionnaire was applied and cervical specimens were obtained for liquid-based cytology and HPV DNA detection. Statistical analysis included chi-square and Logistic regression model.Results In this population, 3.66% (111/3036) had atypical squamous cells of undetermined significance (ASCUS),1.45% (44/3036) low-grade squamous intraepithelial lesions (LSIL) and 1.09% (33/3036) had high-grade squamous intraepithelial lesions (HSIL). Tibetan women (5.74%, 137/2387) exhibited lower abnormal cytology rates than non-Tibetan women (8.01%, 52/649, P=0.03). The overall prevalence of HPV infection was 9.19% (279/3036). We failed to identify any differences in HPV prevalence by age. In the groups with normal, ASCUS, LSIL and HSIL, the overall HPV prevalences were 7.41% (211/2847), 24.32% (27/111), 56.82% (25/44) and 45.45% (15/33), respectively. HPV 16 (1.52%,46/3036) was the most common type, and was also the most prevalent in women with ASCUS (8.11%, 9/111) and HSIL (15.15%, 5/33). The most common HPV type for Tibetan women was HPV 16 (1.42%, 34/2387), whereas for non-Tibetan individuals it was HPV 33 (2.31%, 15/649). Of the 279 HPV-infected women, 40 individuals (14.34%) presented with multiple HPV positivity. Women who had two pregnancies were more likely to have abnormal cytology smear (OR=1.67;95% CI: 1.07-2.61).Conclusions A low prevalence of HPV positivity was observed in women who reside in the Tibetan Autonomous Region of China. The prevalence of abnormal cervical cytology and HPV type distributions were

  7. European guidelines for quality assurance in cervical cancer screening: recommendations for cervical cytology terminology.

    NARCIS (Netherlands)

    Herbert, A.; Bergeron, C.; Wiener, H.; Schenck, U.; Klinkhamer, P.; Bulten, J.; Arbyn, M.

    2007-01-01

    There are many different systems of cytology classification used in the member states of the European Union (EU) and many different languages. The following short annexe to Chapter 3 of the European Guidelines for Quality Assurance in Cervical Cancer Screening provides a framework that will allow di

  8. Automation-assisted versus manual reading of cervical cytology (MAVARIC): a randomised controlled trial.

    Science.gov (United States)

    Kitchener, Henry C; Blanks, Roger; Dunn, Graham; Gunn, Lionel; Desai, Mina; Albrow, Rebecca; Mather, Jean; Rana, Durgesh N; Cubie, Heather; Moore, Catherine; Legood, Rosa; Gray, Alastair; Moss, Sue

    2011-01-01

    The standard for reading cervical cytology is for a cytoscreener to manually search across an entire slide for abnormal cells using a conventional microscope. Automated technology can select fields of view to assess abnormal cells, which allows targeted reading by cytoscreeners. In the Manual Assessment Versus Automated Reading In Cytology (MAVARIC) trial, we compared the accuracy of these techniques for the detection of underlying disease. For this randomised controlled trial, women aged 25-64 years undergoing primary cervical screening in Manchester, UK, were randomly assigned (1:2) to receive either manual reading only or paired reading (automation-assisted reading and manual reading), between March 1, 2006, and Feb 28, 2009. In the paired arm, two automated systems were used-the ThinPrep Imaging System and the FocalPoint GS Imaging System. General practices and community clinics were randomised to either ThinPrep or to SurePath (for the FocalPoint system) liquid-based cytology with block randomisation stratified by deprivation index. Samples were then individually randomised to manual reading only or paired reading only. Laboratory staff were unaware of the allocation of each slide and concealment was maintained until the end of the reporting process. The primary outcome was sensitivity of automation-assisted reading relative to manual reading for the detection of underlying cervical intraepithelial neoplasia grade 2 or worse (CIN2+) in the paired arm. This trial is registered, number ISRCTN66377374. 73,266 liquid-based cytology samples were obtained from women undergoing primary cervical screening; 24,688 allocated to the manual-only arm and 48,578 to the paired-reading arm. Automation-assisted reading was 8% less sensitive than manual reading (relative sensitivity 0·92, 95% CI 0·89-0·95), which was equivalent to an absolute reduction in sensitivity of 6·3%, assuming the sensitivity of manual reading to be 79%. Specificity of automation-assisted reading

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

    Science.gov (United States)

    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'.

  10. The Relation of Recent Tampon Use, Douching, Coitus, and Vaginal Medications for Reported Cervical Cytology Results

    Science.gov (United States)

    1993-01-01

    or cervical intraepithelial neoplasia (CIN) on the pathology report. Assumptions Tampon use is drying to the vaginal epithelium and has been...SUBTITLE 5, FUNDING NUMBERS The Relation of Recent Tamplon Use, Douching, Coitus, and Vaginal Medications for Reported Cervical Cytology Results. 6. AUTHOR...11¾ .. ?j’ 󈧎 U..- THE RELATION OF RECENT TAMPON USE, DOUCHING, COITUS, AND VAGINAL MEDICATIONS TO REPORTED CERVICAL CYTOLOGY RESULTS By MARYANN

  11. Improved segmentation of abnormal cervical nuclei using a graph-search based approach

    Science.gov (United States)

    Zhang, Ling; Liu, Shaoxiong; Wang, Tianfu; Chen, Siping; Sonka, Milan

    2015-03-01

    Reliable segmentation of abnormal nuclei in cervical cytology is of paramount importance in automation-assisted screening techniques. This paper presents a general method for improving the segmentation of abnormal nuclei using a graph-search based approach. More specifically, the proposed method focuses on the improvement of coarse (initial) segmentation. The improvement relies on a transform that maps round-like border in the Cartesian coordinate system into lines in the polar coordinate system. The costs consisting of nucleus-specific edge and region information are assigned to the nodes. The globally optimal path in the constructed graph is then identified by dynamic programming. We have tested the proposed method on abnormal nuclei from two cervical cell image datasets, Herlev and H and E stained liquid-based cytology (HELBC), and the comparative experiments with recent state-of-the-art approaches demonstrate the superior performance of the proposed method.

  12. Transformation zone sampling rate used as a performance indicator for cervical liquid-based cytology sample-takers.

    Science.gov (United States)

    Faraker, C A; Greenfield, J

    2013-08-01

    To investigate the sampling performance of individual cervical cytology practitioners using the transformation zone sampling rate (TZSR) as a performance indicator and to assess the impact of dedicated on site training for those identified with a low TZSR. The TZSR was calculated for all practitioners submitting ThinPrep(®) cervical cytology specimens to the Conquest laboratory between January 2010 and November 2011. After excluding those with less than 30 qualifying samples the 10th percentile of the TZSR was calculated. Practitioners with a TZSR below the 10th percentile were visited by a specialist cervical cytology screening facilitator after which the TZSR of these practitioners was closely monitored. After exclusions there were 175 practitioners who had collected 24 358 qualifying liquid-based cytology (LBC) samples. The average TZSR was 70% (range 12-96%). The 10th percentile was 44%; 18 scored below the 10th percentile. Failure to apply sufficient pressure when sampling was identified as the most common reason for a low TZSR. In some cases there was suspicion that the cervix was not always adequately visualized. Continuous monitoring after assessment identified improvement in the TZSRs of 13/18 practitioners. Identification of practitioners with low TZSRs compared with their peers allows these individuals to be selected for personalized observation and training by a specialist in cervical cytology which can lead to an improvement in TZSR. As previous studies show a significant correlation between the TZSR and the detection rate of cytological abnormality it is useful to investigate low TZSRs. © 2013 John Wiley & Sons Ltd.

  13. Cytology in the diagnosis of cervical cancer in symptomatic young women: a retrospective review.

    Science.gov (United States)

    Lim, Anita Ww; Landy, Rebecca; Castanon, Alejandra; Hollingworth, Antony; Hamilton, Willie; Dudding, Nick; Sasieni, Peter

    2016-12-01

    Cervical cancer in young women presents a diagnostic challenge because gynaecological symptoms are common but underlying disease is rare. To explore the potential for using cytology as a diagnostic aid for cervical cancer in young women. Retrospective review of primary care records and cytology data from the national cervical screening database and national audit of cervical cancers. Four datasets of women aged 20-29 years in England were examined: primary care records and national screening data from an in-depth study of cervical cancers; cytology from the national audit of cervical cancers; whole-population cytology from the national screening database; and general-population primary care records from the Clinical Practice Research Datalink. The authors explored the sensitivity and positive predictive value (PPV) of symptomatic cytology (earliest cytology. Cytology has value beyond screening, and could be used as a diagnostic aid for earlier detection of cervical cancer in young women with gynaecological symptoms by ruling in urgent referral. © British Journal of General Practice 2016.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Risk Stratification using Human Papillomavirus Testing among Women with Equivocally Abnormal Cytology: Results from a State-wide Surveillance Program

    Science.gov (United States)

    Gage, Julia C; Hunt, William C; Schiffman, Mark; Katki, Hormuzd A; Cheung, Li C; Cuzick, Jack; Myers, Orrin; Castle, Philip E; Wheeler, Cosette M.

    2016-01-01

    Background Clinical guidelines for cervical cancer screening have incorporated comparative risks of cervical intraepithelial neoplasia grade 3 or cancer (CIN3+) for various screening outcomes to determine management. Few cohorts are large enough to distinguish CIN3+ risks among women with minor abnormalities vs. negative cytology because of low incidence. The New Mexico HPV Pap Registry offers a unique opportunity to evaluate cervical cancer screening in a diverse population across a broad-spectrum of health service delivery. Methods Kaplan-Meier and logistic-Weibull survival models were used to estimate cumulative risks of CIN3+ among women aged 21–64 who were screened in New Mexico between 2007–2011 with negative, equivocal or mildly abnormal cytology, i.e., atypical squamous cells of undetermined significance (ASC-US; with or without HPV triage), or low-grade squamous intraepithelial lesions. Results We identified 452,045 women meeting the selection criteria. The 3-year CIN3+ risks for women with negative, ASC-US and LSIL cytology were: 0.30%, 2.6%, and 5.2%, respectively. HPV triage of ASC-US stratified 3-year CIN3+ risks were 0.72% for HPV-negative and 7.7% for HPV-positive. Risks tended to decline after age 30 for all screening results. Conclusions In this state-wide population-based cohort, cytology and HPV triage of ASC-US stratified women’s CIN3+ risk into similar patterns observed previously, suggesting the validity of screening guidelines for diverse populations in the United States (U.S.). Absolute risk estimates should be compared across other large populations. Impact Strategies for HPV triage of ASC-US derived from clinical trials are upheld in large clinical practice settings and across diverse screening populations in the U.S.. PMID:26518316

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

    NARCIS (Netherlands)

    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

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

    NARCIS (Netherlands)

    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

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

    DEFF Research Database (Denmark)

    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...

  19. Validity and reliability of using a self-lavaging device for cytology and HPV testing for cervical cancer screening: findings from a pilot study.

    Directory of Open Access Journals (Sweden)

    Heidi E Jones

    Full Text Available Self-sampling could increase cervical cancer screening uptake. While methods have been identified for human papillomavirus (HPV testing, to date, self-sampling has not provided adequate specimens for cytology. We piloted the validity and reliability of using a self-lavaging device for cervical cytology and HPV testing. We enrolled 198 women in New York City in 2008-2009 from three ambulatory clinics where they received cervical cancer screening. All were asked to use the Delphi Screener™ to self-lavage 1-3 months after clinician-collected index cytological smear (100 normal; 98 abnormal. Women with abnormal cytology results from either specimen underwent colposcopy; 10 women with normal results from both specimens also underwent colposcopy. We calculated sensitivity of self-collected cytology to detect histologically confirmed high grade lesions (cervical intraepithelial neoplasia, CIN, 2+; specificity for histology-negative (CIN 1 or lower, paired cytology negative, or a third cytology negative; and kappa for paired results. One hundred and ninety-seven (99.5% women self-collected a lavage. Seventy-five percent had moderate to excellent cellularity, two specimens were unsatisfactory for cytology. Seven of 167 (4% women with definitive results had CIN2+; one had normal and six abnormal cytology results with the self-lavage (sensitivity = 86%, 95% Confidence Interval, CI: 42, 100. The kappa for paired cytology was low (0.36; 95% CI: 0.25, 0.47 primarily due to clinician specimens with atypical squamous cells of undetermined significance (ASC-US and low grade squamous intraepithelial lesion (LSIL coded as normal using Screener specimens. However, three cases of HSIL were coded as ASC-US and one as normal using Screener specimens. Seventy-three women had paired high-risk HPV tests with a kappa of 0.66 (95% CI: 0.49, 0.84. Based on these preliminary findings, a larger study to estimate the performance of the Screener for co-testing cytology and

  20. Cytology versus HPV testing for cervical cancer screening in the general population.

    Science.gov (United States)

    Koliopoulos, George; Nyaga, Victoria N; Santesso, Nancy; Bryant, Andrew; Martin-Hirsch, Pierre Pl; Mustafa, Reem A; Schünemann, Holger; Paraskevaidis, Evangelos; Arbyn, Marc

    2017-08-10

    Cervical cancer screening has traditionally been based on cervical cytology. Given the aetiological relationship between human papillomavirus (HPV) infection and cervical carcinogenesis, HPV testing has been proposed as an alternative screening test. To determine the diagnostic accuracy of HPV testing for detecting histologically confirmed cervical intraepithelial neoplasias (CIN) of grade 2 or worse (CIN 2+), including adenocarcinoma in situ, in women participating in primary cervical cancer screening; and how it compares to the accuracy of cytological testing (liquid-based and conventional) at various thresholds. We performed a systematic literature search of articles in MEDLINE and Embase (1992 to November 2015) containing quantitative data and handsearched the reference lists of retrieved articles. We included comparative test accuracy studies if all women received both HPV testing and cervical cytology followed by verification of the disease status with the reference standard, if positive for at least one screening test. The studies had to include women participating in a cervical cancer screening programme who were not being followed up for previous cytological abnormalities. We completed a 2 x 2 table with the number of true positives (TP), false positives (FP), true negatives (TN), and false negatives for each screening test (HPV test and cytology) used in each study. We calculated the absolute and relative sensitivities and the specificities of the tests for the detection of CIN 2+ and CIN 3+ at various thresholds and computed sensitivity (TP/(TP + TN) and specificity (TN/ (TN + FP) for each test separately. Relative sensitivity and specificity of one test compared to another test were defined as sensitivity of test-1 over sensitivity of test-2 and specificity of test-1 over specificity of test-2, respectively. To assess bias in the studies, we used the Quality Assessment of Diagnostic test Accuracy Studies (QUADAS) tool. We used a bivariate random

  1. Concordância entre citologia, colposcopia e histopatologia cervical Agreement between cytology, colposcopy and cervical histopathology

    Directory of Open Access Journals (Sweden)

    Letícia Maria Correia Katz

    2010-08-01

    Full Text Available OBJETIVO: avaliar a concordância da citologia convencional por Papanicolaou repetida no momento da colposcopia com os achados colposcópicos e a histopatologia. MÉTODOS: o estudo foi realizado no Laboratório Central de Saúde Pública do Estado de Pernambuco (LACEN, de janeiro a julho de 2008, em 397 mulheres com exame citopatológico alterado encaminhadas para avaliação colposcópica. No momento da colposcopia, repetiu-se a citologia em meio convencional, pesquisando-se os achados colposcópicos anormais. A nomenclatura citológica utilizada foi a de Bethesda e a histopatológica, da Organização Mundial de Saúde. A citologia no momento da colposcopia e a colposcopia foram comparadas entre si e com o resultado do histopatológico obtido por biópsia dirigida. A concordância entre os métodos foi avaliada pelo coeficiente Kappa (K, além do teste χ2 a um nível de significância de 5%. RESULTADOS: foi encontrada uma concordância fraca entre a citologia realizada no momento da colposcopia e a colposcopia, K=0,33 (IC95%=0,21-0,45 e entre a colposcopia e a histopatologia, K=0,35 (IC95%=0,39-0,51. Para a concordância entre citologia no momento da colposcopia e histopatologia, o Kappa foi de 0,41 (IC95%=0,29-0,530, considerado moderado. CONCLUSÕES: houve melhor concordância entre citologia e histopatologia do que entre colposcopia e citologia ou colposcopia e histopatologia.PURPOSE: to evaluate the agreement between conventional cytology using the Papanicolaou test, repeated at the time of colposcopy, with colposcopic and histopathological findings. METHODS: the study was carried out at the central public health laboratory of the state of Pernambuco between January and July, 2008, involving 397 women referred for colposcopic evaluation following an abnormal cervical smear test. Cytology was repeated at the time of colposcopy using conventional method, with particular attention being paid to the presence of abnormal colposcopic findings

  2. Primary screening for cervical cancer precursors by the combined use of liquid-based cytology, computer-assisted cytology and HPV DNA testing.

    Science.gov (United States)

    Vassilakos, P; Petignat, P; Boulvain, M; Campana, A

    2002-02-01

    Primary screening for cervical cancer precursors has considerably evolved with the introduction of new technology to improve the early detection of disease. The objective of this study was to elaborate a diagnostic pathway integrating liquid-based and computer-assisted cytology and human papillomavirus DNA testing to focus screening on women at risk which may be more cost-effective for the healthcare system. A single laboratory analysis was conducted during a 5-month period using liquid-based cytology followed by human papillomavirus DNA testing for women with an abnormal result or with previous abnormal cytology. Human papillomavirus prevalence was estimated by testing 909 consecutive unselected samples. All slides were then rescreened using automated cytologic testing and triaged into a high- or low-score group according to computer results. Of the 8676 slides scanned, 352 had a test result of atypical squamous cells of undetermined significance or worse. Two hundred and ninety-seven (84.3%) samples with an atypical squamous cells of undetermined significance or worse result and 100% of those with detection of high-grade squamous intraepithelial lesions and carcinomas (HSIL+) were triaged into the high-score group. The combination of instrument scores and human papillomavirus results indicated that 51.0% of high score/human papillomavirus-positive cases should be considered as ASCUS+, while 99.6% of low-score/human papillomavirus negative cases remained negative in the final cytologic diagnosis, representing 49.0% of all cases. Of the screened women 89.5% should test negative for human papillomavirus and be reported as such in the final cytologic diagnosis. In conclusion, preliminary results suggest that this diagnostic pathway has the potential to improve primary cervical cancer screening and cost-effectiveness. By using a combination of testing methods to focus screening and clinical attention to cases at risk, it would be possible to lengthen screening

  3. Molecular Triage of Premalignant Lesions in Liquid-Based Cervical Cytology and Circulating Cell-Free DNA from Urine, Using a Panel of Methylated Human Papilloma Virus and Host Genes

    NARCIS (Netherlands)

    Guerrero-Preston, Rafael; Valle, Blanca L.; Jedlicka, Anne; Turaga, Nitesh; Folawiyo, Oluwasina; Pirini, Francesca; Lawson, Fahcina; Vergura, Angelo; Noordhuis, Maartje; Dziedzic, Amanda; Perez, Gabriela; Renehan, Marisa; Guerrero-Diaz, Carolina; Rodriguez, Edgar De Jesus; Diaz-Montes, Teresa; Orengo, Jose Rodriguez; Mendez, Keimari; Romaguera, Josefina; Trock, Bruce J.; Florea, Liliana; Sidransky, David

    2016-01-01

    Clinically useful molecular tools to triage women for a biopsy upon referral to colposcopy are not available. We aimed to develop a molecular panel to detect cervical intraepithelial neoplasia (CIN) grade 2 or higher lesions (CIN2(+)) in women with abnormal cervical cytology and high-risk HPV (HPV+)

  4. Effects of Contraception on Cervical Cytology: Data from Mardin City

    Directory of Open Access Journals (Sweden)

    Işık İkbal BARIŞ

    2013-01-01

    Full Text Available Objective: Mardin is an area of low socioeconomic level with low rates of contraceptive method use. Our aim in this study was to evaluate the effects of the contraceptive methods used in the area on epithelial cell abnormalities and vaginal flora changes.Material and Method: Cervical smear samples received at the Pathology Department between 2010 and 2012 of 526 patients who had used a contraceptive method and 112 who had never used one were included in the study. The cases were divided into 3 groups as those using hormonal contraception (107, 20.3%, those using an intrauterine device (343, 65.2% and those using a barrier method (76, 14.4%. The evaluation was made using the Bethesda 2001 criteria for cervical epithelial abnormalities and specific cervicovaginal infections.Results: There was no significant difference between the groups for epithelial cell abnormalities while bacterial vaginitis (12%, p=0.03 and Trichomonas vaginalis (7.6% were more common in the IUD users. The Actinomyces rate in RIA users was 1.3%. There was only 1 case of bacterial vaginitis in the barrier group and none of the other patients had a specific infection.Discussion: We did not find a significant cytopathic effect of using a IUD or hormonal contraception in our study. There was a low rate of epithelial abnormality in the barrier method group. IUD was seen to increase the incidence of bacterial vaginitis, Trichomonas vaginalis and Actinomyces. We did not find a significant effect of hormone use on the vaginal flora.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    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......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....... Selection criteria Studies asking women to state a preference between active follow-up and observation for the management of low-grade abnormalities on screening cytology or HPV tests. Data collection and analysis Information on study design, participants and outcomes was retrieved using a prespecified form...

  7. A comparison of liquid-based cytology with conventional cytology.

    Science.gov (United States)

    Celik, C; Gezginç, K; Toy, H; Findik, S; Yilmaz, O

    2008-02-01

    To evaluate the 2 methods of cytologic screening to detect abnormalities of the cervical epithelium. This study with 3 groups of women was performed at Selcuk University Meram Medical School between January 2004 and March 2006. In one group (paired sample for specimen collection) women were screened with conventional cytology; in another group (paired sample for specimen collection) they were screened with liquid-based cytology; and in the third group (split sample for specimen collection) they were screened by both methods. The rate of unsatisfactory results was lower in the liquid-based than in the conventional cytology group (6.1% vs. 2.6%; Pliquid-based method, but the difference was not statistically significant. Also, no statistically significant differences between liquid-based and conventional cytology were observed in the detection of other epithelial abnormalities (P>0.05). The liquid-based and conventional cytology methods were found to be equivalent in the detection of cervical epithelial abnormalities.

  8. Cervical cancer incidence after normal cytological sample in routine screening using SurePath, ThinPrep, and conventional cytology

    DEFF Research Database (Denmark)

    Rozemeijer, Kirsten; Naber, Steffie K; Penning, Corine

    2017-01-01

    Objective To compare the cumulative incidence of cervical cancer diagnosed within 72 months after a normal screening sample between conventional cytology and liquid based cytology tests SurePath and ThinPrep.Design Retrospective population based cohort study.Setting Nationwide network and registry...... of histo- and cytopathology in the Netherlands (PALGA), January 2000 to March 2013.Population Women with 5 924 474 normal screening samples (23 833 123 person years).Exposure Use of SurePath or ThinPrep versus conventional cytology as screening test.Main outcome measure 72 month cumulative incidence...... was 58.5 (95% confidence interval 54.6 to 62.7) per 100 000 normal conventional cytology samples, compared with 66.8 (56.7 to 78.7) for ThinPrep and 44.6 (37.8 to 52.6) for SurePath. Compared with conventional cytology, the hazard of invasive cancer was 19% lower (hazard ratio 0.81, 95% confidence...

  9. HPV immunisation and cervical screening—confirmation of changed performance of cytology as a screening test in immunised women: a retrospective population-based cohort study

    Science.gov (United States)

    Palmer, T J; McFadden, M; Pollock, K G J; Kavanagh, K; Cuschieri, K; Cruickshank, M; Cotton, S; Nicoll, S; Robertson, C

    2016-01-01

    Background: To document the effect of bivalent HPV immunisation on cervical cytology as a screening test and assess the implications of any change, using a retrospective analysis of routinely collected data from the Scottish Cervical Screening Programme (SCSP). Methods: Data were extracted from the Scottish Cervical Call Recall System (SCCRS), the Scottish Population Register and the Scottish Index of Multiple Deprivation. A total of 95 876 cytology records with 2226 linked histology records from women born between 1 January 1988 and 30 September 1993 were assessed. Women born in or after 1990 were eligible for the national catch-up programme of HPV immunisation. The performance of cervical cytology as a screening test was evaluated using the key performance indicators used routinely in the English and Scottish Cervical Screening Programmes (NHSCSP and SCSP), and related to vaccination status. Results: Significant reductions in positive predictive value (16%) and abnormal predictive value (63%) for CIN2+ and the mean colposcopy score (18%) were observed. A significant increase (38%) in the number of women who had to be referred to colposcopy to detect one case of CIN2+ was shown. The negative predictive value of negative- or low-grade cytology for CIN2+ increased significantly (12%). Sensitivity and specificity, as used by the UK cervical screening programmes, were maintained. Conclusions: The lower incidence of disease in vaccinated women alters the key performance indicators of cervical cytology used to monitor the quality of the screening programme. These findings have implications for screening, colposcopy referral criteria, colposcopy practice and histology reporting. PMID:26931370

  10. p16/Ki-67 dual-stained cytology for detecting cervical (pre)cancer in a HPV-positive gynecologic outpatient population.

    Science.gov (United States)

    Luttmer, Roosmarijn; Dijkstra, Maaike G; Snijders, Peter J F; Berkhof, Johannes; van Kemenade, Folkert J; Rozendaal, Lawrence; Helmerhorst, Theo J M; Verheijen, René H M; Ter Harmsel, W Abraham; van Baal, W Marchien; Graziosi, Peppino G C M; Quint, Wim G V; Spruijt, Johan W M; van Dijken, Dorenda K E; Heideman, Daniëlle A M; Meijer, Chris J L M

    2016-08-01

    Women who test positive for a high-risk type of the human papillomavirus (HPV) require triage testing to identify those women with cervical intraepithelial neoplasia grade 3 or cancer (≥CIN3). Although Pap cytology is considered an attractive triage test, its applicability is hampered by its subjective nature. This study prospectively compared the clinical performance of p16/Ki-67 dual-stained cytology to that of Pap cytology, with or without HPV16/18 genotyping, in high-risk HPV-positive women visiting gynecologic outpatient clinics (n=446 and age 18-66 years). From all women, cervical scrapes (for Pap cytology, HPV16/18 genotyping, and p16/Ki-67 dual-stained cytology) and colposcopy-directed biopsies were obtained. The sensitivity of p16/Ki-67 dual-stained cytology for ≥CIN3 (93.8%) did neither differ significantly from that of Pap cytology (87.7%; ratio 1.07 and 95% confidence interval (CI): 0.97-1.18) nor from that of Pap cytology combined with HPV16/18 genotyping (95.1%; ratio 0.99 and 95% CI: 0.91-1.07). However, the specificity of p16/Ki-67 dual-stained cytology for ≥CIN3 (51.2%) was significantly higher than that of Pap cytology (44.9%; ratio 1.14 and 95% CI: 1.01-1.29) and Pap cytology combined with HPV16/18 genotyping (25.8%; ratio 1.99 and 95% CI: 1.68-2.35). After exclusion of women who had been referred because of abnormal Pap cytology, the specificity of p16/Ki-67 dual-stained cytology for ≥CIN3 (56.7%) remained the same, whereas that of Pap cytology (60.3%) increased substantially, resulting in a similar specificity of both assays (ratio 0.94 and 95% CI: 0.83-1.07) in this sub-cohort. In summary, p16/Ki-67 dual-stained cytology has a good clinical performance and is an interesting objective microscopy-based triage tool for high-risk HPV-positive women.

  11. Superior performance of liquid-based versus conventional cytology in a population-based cervical cancer screening program

    NARCIS (Netherlands)

    Beerman, H.; van Dorst, E. B. L.; Kuenen-Boumeester, V.; Hogendoorn, P. C. W.

    2009-01-01

    Objective. Liquid-based cytology may offer improvements over conventional cytology for cervical cancer screening. The two cytology techniques were compared in a group of 86,469 women who participated in a population-based screening program. Using a nation-wide pathology database containing both cerv

  12. Superior performance of liquid-based versus conventional cytology in a population-based cervical cancer screening program

    NARCIS (Netherlands)

    Beerman, H.; van Dorst, E. B. L.; Kuenen-Boumeester, V.; Hogendoorn, P. C. W.

    2009-01-01

    Objective. Liquid-based cytology may offer improvements over conventional cytology for cervical cancer screening. The two cytology techniques were compared in a group of 86,469 women who participated in a population-based screening program. Using a nation-wide pathology database containing both cerv

  13. Superior performance of liquid-based versus conventional cytology in a population-based cervical cancer screening program

    NARCIS (Netherlands)

    Beerman, H.; van Dorst, E. B. L.; Kuenen-Boumeester, V.; Hogendoorn, P. C. W.

    Objective. Liquid-based cytology may offer improvements over conventional cytology for cervical cancer screening. The two cytology techniques were compared in a group of 86,469 women who participated in a population-based screening program. Using a nation-wide pathology database containing both

  14. Prevalence of human papillomavirus infection & cervical abnormalities in HIV-positive women in eastern India.

    Science.gov (United States)

    Chakravarty, Jaya; Chourasia, Ankita; Thakur, Minaxi; Singh, Abhishek Kumar; Sundar, Shyam; Agrawal, Nisha Rani

    2016-01-01

    India has the third highest burden of HIV and highest number of cervical cancer in the world. A cross-sectional study was performed to determine the prevalence and types of human papillomavirus (HPV) infection, and the factors associated with HPV infection and abnormal cervical cytology in HIV-positive women attending the Antiretroviral Therapy (ART) Centre in a tertiary care hospital in eastern India. We screened 216 HIV- positive women with Papanicolau smear cytology and HPV testing. HPV DNA was detected by using consensus primers followed by sequencing. Of the 216 HIV-positive women screened, 58 (26.85%) were HPV-positive; 56 (25.9%) were of high-risk (HR) HPV type. The most prevalent HPV type was HPV-16 (7.9%); non 16 and 18 HPV types were present in 17.6 per cent patients. Age ≤ 35 yr [(OR), 2.56 (1.26-5.19)], illiteracy [OR, 2.30 (1.19-4.46)], rural residence [OR, 3.99 (1.27-12.56)] and CD4 ≤ 350/µl [OR, 2.46 (1.26-4.83)] were associated with increased risk of acquisition of HPV. One hundred thirty nine (74.33%) patients had normal/ negative for intraepithelial lesions (NILM) cytology, three (1.60%) had atypical squamous cells of undetermined significance (ASCUS), 32 (17.11%) had low-grade squamous intraepithelial lesions (LSIL), 10 (5.35%) had high-grade squamous intraepithelial lesions (HSIL) and three (1.60%) had carcinoma cervix. WHO clinical Stage III and IV [OR, 2.83 (1.07-7.49)] and CD4 ≤ 350/µl [OR, 2.84 (1.30-6.20)] were risk factors for abnormal cytology. Our study showed 26.85 per cent HPV positivity in HIV infected women in this region, with HPV-16 as the commonest genotype. Abnormal cervical cytology was seen in about 25 per cent women. Regular Pap smear screening as recommended by the National AIDS Control Organization will help in early detection of cervical abnormalities in HIV- positive women.

  15. Prevalence of human papillomavirus infection & cervical abnormalities in HIV-positive women in eastern India

    Directory of Open Access Journals (Sweden)

    Jaya Chakravarty

    2016-01-01

    Full Text Available Background & objectives: India has the third highest burden of HIV and highest number of cervical cancer in the world. A cross-sectional study was performed to determine the prevalence and types of human papillomavirus (HPV infection, and the factors associated with HPV infection and abnormal cervical cytology in HIV-positive women attending the Antiretroviral Therapy (ART Centre in a tertiary care hospital in eastern India. Methods: We screened 216 HIV- positive women with Papanicolau smear cytology and HPV testing. HPV DNA was detected by using consensus primers followed by sequencing. Results: Of the 216 HIV-positive women screened, 58 (26.85% were HPV-positive; 56 (25.9% were of high-risk (HR HPV type. The most prevalent HPV type was HPV-16 (7.9%; non 16 and 18 HPV types were present in 17.6 per cent patients. Age ≤ 35 yr [(OR, 2.56 (1.26-5.19], illiteracy [OR, 2.30 (1.19-4.46], rural residence [OR, 3.99 (1.27-12.56] and CD4 ≤350/µl [OR, 2.46 (1.26-4.83] were associated with increased risk of acquisition of HPV. One hundred thirty nine (74.33% patients had normal/ negative for intraepithelial lesions (NILM cytology, three (1.60% had atypical squamous cells of undetermined significance (ASCUS, 32 (17.11% had low-grade squamous intraepithelial lesions (LSIL, 10 (5.35% had high-grade squamous intraepithelial lesions (HSIL and three (1.60% had carcinoma cervix. WHO clinical Stage III and IV [OR, 2.83 (1.07-7.49] and CD4 ≤350/µl [OR, 2.84 (1.30-6.20] were risk factors for abnormal cytology. Interpretation &conclusions: Our study showed 26.85 per cent HPV positivity in HIV infected women in this region, with HPV-16 as the commonest genotype. Abnormal cervical cytology was seen in about 25 per cent women. Regular Pap smear screening as recommended by the National AIDS Control Organization will help in early detection of cervical abnormalities in HIV- positive women.

  16. Prevalence of human papillomavirus infection & cervical abnormalities in HIV-positive women in eastern India

    Science.gov (United States)

    Chakravarty, Jaya; Chourasia, Ankita; Thakur, Minaxi; Singh, Abhishek Kumar; Sundar, Shyam; Agrawal, Nisha Rani

    2016-01-01

    Background & objectives: India has the third highest burden of HIV and highest number of cervical cancer in the world. A cross-sectional study was performed to determine the prevalence and types of human papillomavirus (HPV) infection, and the factors associated with HPV infection and abnormal cervical cytology in HIV-positive women attending the Antiretroviral Therapy (ART) Centre in a tertiary care hospital in eastern India. Methods: We screened 216 HIV- positive women with Papanicolau smear cytology and HPV testing. HPV DNA was detected by using consensus primers followed by sequencing. Results: Of the 216 HIV-positive women screened, 58 (26.85%) were HPV-positive; 56 (25.9%) were of high-risk (HR) HPV type. The most prevalent HPV type was HPV-16 (7.9%); non 16 and 18 HPV types were present in 17.6 per cent patients. Age ≤ 35 yr [(OR), 2.56 (1.26-5.19)], illiteracy [OR, 2.30 (1.19-4.46)], rural residence [OR, 3.99 (1.27-12.56)] and CD4 ≤350/μl [OR, 2.46 (1.26-4.83)] were associated with increased risk of acquisition of HPV. One hundred thirty nine (74.33%) patients had normal/ negative for intraepithelial lesions (NILM) cytology, three (1.60%) had atypical squamous cells of undetermined significance (ASCUS), 32 (17.11%) had low-grade squamous intraepithelial lesions (LSIL), 10 (5.35%) had high-grade squamous intraepithelial lesions (HSIL) and three (1.60%) had carcinoma cervix. WHO clinical Stage III and IV [OR, 2.83 (1.07-7.49)] and CD4 ≤350/μl [OR, 2.84 (1.30-6.20)] were risk factors for abnormal cytology. Interpretation &conclusions: Our study showed 26.85 per cent HPV positivity in HIV infected women in this region, with HPV-16 as the commonest genotype. Abnormal cervical cytology was seen in about 25 per cent women. Regular Pap smear screening as recommended by the National AIDS Control Organization will help in early detection of cervical abnormalities in HIV- positive women. PMID:26997018

  17. 荧光原位杂交检测宫颈脱落细胞端粒酶基因扩增临床价值的探讨%Fluorescence in situ hybridization detection of abnormal cervical cytology in the clinical significance of telomerase

    Institute of Scientific and Technical Information of China (English)

    吕丽丽; 娄阁; 刘运铎; 姬宏飞

    2011-01-01

    OBJECTIVE: To investigate the amplification detection rate of the telomerase gene in exfoliated cells of cervical state for the diagnostic value of cervical lesions.METHODS: from July 27th 2007 to January ninth 2009, in the third affiliated clinical medical school of haerbin medical university, 113 cases of cervical exfoliated cells gynecological specimens, 27 cases in which atypical squamous cells (ASC) patients, light-grade squamous intraepithelial lesion (LSIL) 33 patients, high-grade squamous intraepithelial lesion (HSIL) 26 patients, 2 cases of cervical squamous cell carcinoma (SCC), normal cytology in 25 cases of women using fluorescence in situ hybridization (FISH) to detect exfoliated cells of human chromosome ends gene (human telomerase gene, hTERC) hTERC gene amplification.These results above of ASC were compared with histopathological results.RESULTS: hTERC gene in the group of ASC, LSIL, HSIL, SCC, and normal women with cervical cytology in exfoliated cells, amplification of hTERC detection rate was 44.4%(12/27), 57.6%(19/33), 92.3%(24/26) and 100.0%(2/2), 0.Comparison between groups (P<0.001), hTERC gene amplification detection rate difference was statistically significant.hTERC gene in CIN Ⅰ , CIN Ⅱ / Ⅲ and SCC, the amplification rates were 60.0%(18/30), 73.9% (34/46) and 100.0% (5/5).CIN Ⅰ ,CIN Ⅱ/Ⅲ, SCC group compared with the normal control group,there was significant difference (P = 0.001).CONCLUSION:hTERC gene in CIN and SCC in the abnormal expression and its copy numbers are increased with the serious degree of pathological and cytological grades, can be used as an effective indicator of cervical cancer screening and precancerous lesions of progress monitoring indicators of biological genetics.%目的:检测宫颈脱落细胞中端粒酶基因扩增的检出率,探讨其在宫颈病变中诊断的价值.方法:收集2007-07-27-2009-01-09哈尔滨医科大学附属第三临床医学院妇科113例宫颈脱

  18. Quantitative exfoliative cytology of normal and abnormal oral mucosal squames: preliminary communication.

    Science.gov (United States)

    Cowpe, J G

    1984-01-01

    Quantitative techniques have been applied to the exfoliative cytology of normal and abnormal human oral mucosal squames. This study is ongoing but early results indicate that a normal baseline for clinically normal oral squames, related to age and site, may be difficult to achieve. However, results obtained for the pathological smears suggest that these techniques may improve the diagnostic sensitivity of cytology in the management of oral cancer. PMID:6389859

  19. Quantitative exfoliative cytology of normal and abnormal oral mucosal squames: preliminary communication.

    OpenAIRE

    Cowpe, J G

    1984-01-01

    Quantitative techniques have been applied to the exfoliative cytology of normal and abnormal human oral mucosal squames. This study is ongoing but early results indicate that a normal baseline for clinically normal oral squames, related to age and site, may be difficult to achieve. However, results obtained for the pathological smears suggest that these techniques may improve the diagnostic sensitivity of cytology in the management of oral cancer.

  20. 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

    Science.gov (United States)

    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

    Abstract 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 for factors associated with abnormal anal cytology [≥atypical squamous cells of undetermined significance, (ASC-US)]. Characteristics of the 863 participants included: median age 42 years, 57% non-white, 79% current CD4+ T-cell count >350 cells/mm3, 53% HIV-1 viral load anal specimens contained ≥1 HR-HPV genotype; 31% had abnormal anal cytology [14% ASC-US, 11% low-grade squamous intra-epithelial lesion, (LSIL); 2% atypical squamous cells-cannot exclude high-grade SIL (ASC-H); 4% high-grade SIL/cancer (HSIL+)]. In multivariate analysis, cervical LSIL+, nadir CD4+ T-cell count ≤50 cells/mm3, HIV-1 viral load ≥50 copies/mL, and anal HPV 6, 11, 16, 18, 33, 45, 52, 56, and 58 were associated with ≥anal ASC-US (panal cytology and HR-HPV prevalences were high. HIV-infected women with cervical LSIL+, low nadir CD4+ counts, or detectable HIV-1 viral loads should be a particular focus for enhanced anal SCC screening efforts. PMID:25361401

  1. STUDY OF VAGINAL INFECTIONS, CERVICAL CYTOLOGY AND PREVALENCE OF MENSTRUAL PROBLEMS IN HIV INFECTED PATIENTS

    Directory of Open Access Journals (Sweden)

    Balvin Kaur

    2015-07-01

    Full Text Available OBJECTIVE: To study vaginal infections, cervical cytology and prevalence of menstrual problems in HIV seropositive patients. METHODS: Study D esign: hospital based non - randomized prospective observational study. Study Type: case control study. SAMPLE SIZE: 130 cases & 100 contols. INCLUSION CRITERIA: All married women in the age group of 20 - 55 yrs. Cases were taken from the seropositive women register ed at the ART C entre willing to participate. Controls were HIV seronegative women attending gynaecology OPD. RESULTS: Out of the 130 cases, 78.4% were on ART & 21.5% were not on ART. In the present study, 87.09% of cases had abnormal Pap smear results comp ared to 29.09% of controls. 20% of cases had SILs compared to 8.18% of controls. Low grade intraepithelial lesions were 4.56 times more prevalent in cases. In the present study, it was found that 44.4% of SILs were found in cases with CD4 cell count <200/μ l. When studied for lower reproductive tract infections, 54.6% of cases had LRTIs compared to 30% of controls. The most common infection was candidiasis, found in 20% cases vs . 10% controls. CONCLUSION: The present study has shown that the prevalence of Pa p smear abnormalities & LRTIs is higher in HIV seropositive women. Hence, periodic gynaecological testing, Pap smear examination & vaginal swab testing should be done in HIV seropositive women to provide timely treatment & early identification of risk fact ors of malignancy.

  2. Human papillomavirus testing versus cytology in primary cervical cancer screening: End-of-study and extended follow-up results from the Canadian cervical cancer screening trial.

    Science.gov (United States)

    Isidean, Sandra D; Mayrand, Marie-Hélène; Ramanakumar, Agnihotram V; Gilbert, Laura; Reid, Stephanie L; Rodrigues, Isabel; Ferenczy, Alex; Ratnam, Sam; Coutlée, François; Franco, Eduardo L

    2016-12-01

    The Canadian Cervical Cancer Screening Trial was a randomized controlled trial comparing the performance of human papillomavirus (HPV) testing and Papanicolaou cytology to detect cervical intraepithelial neoplasia of grades 2 or worse (CIN2+) among women aged 30-69 years attending routine cervical cancer screening in Montreal and St. John's, Canada (n = 10,154). We examined screening and prognostic values of enrollment cytologic and HPV testing results. Extended follow-up data were available for St. John's participants (n = 5,754; 501,682.6 person-months). HPV testing detected more CIN2+ than cytology during protocol-defined (82.9 vs. 44.4%) and extended (54.2 vs. 19.3%) follow-up periods, respectively. Three-year risks ranged from 0.87% (95% CI: 0.37-2.05) for HPV-/Pap- women to 35.77% (95% CI: 25.88-48.04) for HPV+/Pap+ women. Genotype-specific risks ranged from 0.90% (95% CI: 0.40-2.01) to 43.84% (95% CI: 32.42-57.24) among HPV- and HPV16+ women, respectively, exceeding those associated with Pap+ or HPV+ results taken individually or jointly. Ten-year risks ranged from 1.15% (95% CI: 0.60-2.19) for HPV-/Pap- women to 26.05% (95% CI: 15.34-42.13) for HPV+/Pap+ women and genotype-specific risks ranged from 1.13% (95% CI: 0.59-2.14) to 32.78% (95% CI: 21.15-48.51) among women testing HPV- and HPV16+, respectively. Abnormal cytology stratified risks most meaningfully for HPV+ women. Primary HPV testing every 3 years provided a similar or greater level of reassurance against disease risks as currently recommended screening strategies. HPV-based cervical screening may allow for greater disease detection than cytology-based screening and permit safe extensions of screening intervals; genotype-specific testing could provide further improvement in the positive predictive value of such screening.

  3. Switch from cytology-based to human papillomavirus test-based cervical screening: implications for colposcopy.

    Science.gov (United States)

    Porras, Carolina; Wentzensen, Nicolas; Rodríguez, Ana C; Morales, Jorge; Burk, Robert D; Alfaro, Mario; Hutchinson, Martha; Herrero, Rolando; Hildesheim, Allan; Sherman, Mark E; Wacholder, Sholom; Solomon, Diane; Schiffman, Mark

    2012-04-15

    Human papillomavirus (HPV) testing is more sensitive than cytology; some cervical cancer prevention programs will switch from cytology to carcinogenic HPV test-based screening. The objective of our study is to evaluate the clinical implications of a switch to HPV test-based screening on performance and workload of colposcopy. Women in the population-based, 7-year Guanacaste cohort study were screened at enrollment using cytology. We also took another specimen for HPV DNA testing and collected magnified cervical photographic images (cervigrams). A final case diagnosis (≥cervical intraepithelial neoplasia [CIN] grade 3, CIN2, lesions at referral to colposcopy and the sensitivity versus specificity trade-off of the colposcopic impressions would be similar to programs using cytology (≥ atypical squamous cells of unknown significance [ASCUS]) for referral. The major concern with switching from cytology to more sensitive HPV screening is management of the many HPV-positive women, including those with still nonvisible ≥CIN2 lesions. Our data support the need for a nonvisual diagnostic method to guide management and treatment of HPV-positive women. Copyright © 2011 UICC.

  4. The EVVA Cohort Study: Anal and Cervical Type-Specific Human Papillomavirus Prevalence, Persistence, and Cytologic Findings in Women Living With HIV.

    Science.gov (United States)

    de Pokomandy, Alexandra; Kaufman, Elaina; de Castro, Christina; Mayrand, Marie-Hélène; Burchell, Ann N; Klein, Marina; Charest, Louise; Auger, Manon; Rodrigues-Coutlée, Sophie; Coutlée, François

    2017-08-15

    The risk of anal cancer due to high-risk human papillomavirus (HR-HPV) is higher in women living with human immunodeficiency virus (HIV) than in the general population. We present findings of cervical and anal HPV and cytologic tests at baseline in the EVVA cohort study and HPV persistence data 6 months after baseline. Semiannual visits included questionnaires, chart reviews, cervical/anal cytologic and cervical/anal HPV testing for 2 years. Genotyping for 36 HPV genotypes was performed using the Roche Linear Array HPV genotyping test. A total of 151 women living with HIV were recruited. At baseline, 75% had anal HPV, 51% had anal HR-HPV, 50% had cervical HPV, and 29% had cervical HR-HPV. Anal HPV-16 and HPV-51 were more frequent in women born in Canada (31% and 29%, respectively, compared with ≤16% for other women). Most anal HR-HPV types detected at 6 months (57%-93%) were persistent from baseline. Findings of anal cytologic tests were abnormal for 37% of women. Anal HPV is highly prevalent in women living with HIV, and type distribution varies by place of birth. High-resolution anoscopy was indicated in more than one third of results. As anal cancer is potentially preventable, these important findings need to be considered when selecting the best approach for anal cancer screening programs.

  5. Liquid compared with conventional cervical cytology: a systematic review and meta-analysis.

    NARCIS (Netherlands)

    Arbyn, M.; Bergeron, C.; Klinkhamer, P.; Martin-Hirsch, P.; Siebers, A.G.; Bulten, J.

    2008-01-01

    OBJECTIVE: To compare test performance characteristics of conventional Pap tests and liquid-based cervical cytology samples. DATA SOURCES: Eligible studies, published between 1991 and 2007, were retrieved through PubMed/EmBase searching and completed by consultation of other sources. METHODS OF STUD

  6. Liquid compared with conventional cervical cytology: a systematic review and meta-analysis.

    NARCIS (Netherlands)

    Arbyn, M.; Bergeron, C.; Klinkhamer, P.; Martin-Hirsch, P.; Siebers, A.G.; Bulten, J.

    2008-01-01

    OBJECTIVE: To compare test performance characteristics of conventional Pap tests and liquid-based cervical cytology samples. DATA SOURCES: Eligible studies, published between 1991 and 2007, were retrieved through PubMed/EmBase searching and completed by consultation of other sources. METHODS OF STUD

  7. Prevalence of human papillomavirus, Chlamydia trachomatis, and Trichomonas vaginalis infections in Amazonian women with normal and abnormal cytology.

    Science.gov (United States)

    Costa-Lira, E; Jacinto, A H V L; Silva, L M; Napoleão, P F R; Barbosa-Filho, R A A; Cruz, G J S; Astolfi-Filho, S; Borborema-Santos, C M

    2017-04-28

    Sexually transmitted infections are an important cause of morbidity among sexually active women worldwide, and have been implicated as cofactors in the pathogenesis of cervical cancer. We investigated the prevalence of human papillomavirus (HPV), Chlamydia trachomatis (CT), and Trichomonas vaginalis (TV), and accessed the diversity of HPV in women with normal and abnormal cytology in Manaus, Brazil. We used polymerase chain reaction and HPV genotyping by direct sequencing. The chi-square test was used to calculate the absolute and relative frequencies of the categorical variables, and Fisher's test was used when P < 0.05. The level of significance was set at 5%. All statistical analyses were performed using R 2.9.0. There were statistically significant differences in age (P = 0.0395), education level (P = 0.0131), sexual partners (P = 0.0211), condom use (P = 0.0039), marital status (P < 0.0001), and pregnancy (P = 0.0003) between the normal and abnormal groups. HPV DNA was found in 36.56 and 93.88% of subjects in the normal and abnormal groups, respectively. A total of 19 genotypes were detected; HPV16 was the most common, followed by HPV58. The percentages of TV and CT DNA were 18.04 and 9.02% in the normal group, respectively. The percentages of HPV/TV and HPV/CT coinfection were 12.5% each in women with normal cytology. These findings improve our understanding of HPV, CT, and TV, and the distribution of HPV types, which may be relevant to vaccination strategies for protecting women from the north of Brazil from cervical cancers and precancerous lesions.

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

    Directory of Open Access Journals (Sweden)

    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

  9. Is it necessary to repeat cervical cytology at the tie of a colposcopy? É necessário repetir a citologia cervical no momento da colposcopia?

    Directory of Open Access Journals (Sweden)

    Leticia Maria Correia Katz

    2012-09-01

    Full Text Available OBJECTIVES: to evaluate whether repeating Papanicolaou smear testing at the time of colposcopy improves agreement between cytology and histopathology in the diagnosis of cervical cancer. METHODS: this cross-sectional study included 397 women referred for colposcopic evaluation following an abnormal cervical smear test. The cytology was repeated at the time of the colposcopy using a conventional medium. The two cytology tests were compared with each other and with the histopathological findings obtained by colposcopy-directed biopsy. The 2001 Bethesda system and the WHO 1994 classification were used for reporting cytology and histology results. The kappa coefficient was used to determine the agreement between methods. RESULTS: the comparison between the initial cytology findings and cytology performed at the time of colposcopy revealed a kappa of 0.297 (95%CI: 0.235-0.359, indicating a fair degree of agreement. When the results of the initial cytology were compared with histopathology, a kappa of 0.261, considered to represent a fair degree of agreement, was obtained (95%CI: 0.181-0.340. A kappa of 0.408, considered to represent moderate agreement, was found when the second cytology findings were compared with the histopathology (95%CI: 0.332-0.485. CONCLUSIONS: the agreement between cytology and histology improved when cytology was repeated at the time of colposcopy, following an initial abnormal test.OBJETIVOS: avaliar se a repetição do Papanicolaou no momento da colposcopia melhora a concordância entre os métodos diagnósticos (citologia e histopatologia do câncer do colo do útero. MÉTODOS: o estudo foi realizado no Laboratório Central de Saúde Pública do Estado de Pernambuco (LACEN/PE, de janeiro a julho de 2008, em 397 mulheres com exame citopatológico alterado encaminhadas para avaliação colposcópica. No momento da colposcopia, repetiu-se a citologia, em meio convencional. As duas citologias foram comparadas entre si e com o

  10. Diagnostic value of liquid-based cytology with fine needle aspiration specimens for cervical lymphadenopathy.

    Science.gov (United States)

    Bandoh, Nobuyuki; Goto, Takashi; Akahane, Toshiaki; Ohnuki, Natsumi; Yamaguchi, Tomomi; Kamada, Hajime; Harabuchi, Yasuaki; Tanaka, Shinya; Nishihara, Hiroshi

    2016-03-01

    Cervical lymphadenopathy is a symptom that is frequently seen among outpatients, and it is important to differentiate malignant lesions from reactive lymphoid hyperplasia. Fine needle aspiration (FNA) cytology has been widely used for the diagnosis of cervical lymphadenopathy. However, some limitations of the diagnostic accuracy using conventional smear (CS) cytology have been pointed out. The diagnostic value of liquid-based cytology (LBC) with FNA specimens has not yet been fully proven. Forty-two patients with cervical lymphadenopathy who underwent FNA with CS cytology from 2007 to 2011 and 123 patients who underwent FNA with LBC utilizing LBCPREP2™ from 2011 to 2015 were studied. Diagnostic values were compared between the CS and the LBC groups. Of the total 165 patients representing the combined CS and LBC groups, 81 (49.1%) were diagnosed as benign lymph node and 84 (50.9%) were malignant diseases including 37 (22.4%) of metastatic carcinoma except for thyroid carcinoma, 30 (18.2%) of metastatic thyroid carcinoma, and 17 (10.3%) of malignant lymphoma. The overall statistical values including sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the CS were 75%, 100%, 100%, 78.9%, and 87.1%, respectively, whereas those values for LBC were 91.2%, 100%, 100%, 90.7%, and 95.3%, respectively. The sensitivity of LBC for malignant diseases tended to be higher than that of CS cytology (p = 0.081). LBC with FNA specimens from cervical lymphadenopathy is a useful and reliable method for the diagnosis of malignant diseases, especially of metastatic carcinomas, due to its increased sensitivity compared with CS cytology. © 2016 The Authors Diagnostic Cytopathology Published by Wiley Periodicals, Inc.

  11. Diagnostic value of liquid‐based cytology with fine needle aspiration specimens for cervical lymphadenopathy

    Science.gov (United States)

    Goto, Takashi; Akahane, Toshiaki; Ohnuki, Natsumi; Yamaguchi, Tomomi; Kamada, Hajime; Harabuchi, Yasuaki; Tanaka, Shinya; Nishihara, Hiroshi

    2016-01-01

    Background Cervical lymphadenopathy is a symptom that is frequently seen among outpatients, and it is important to differentiate malignant lesions from reactive lymphoid hyperplasia. Fine needle aspiration (FNA) cytology has been widely used for the diagnosis of cervical lymphadenopathy. However, some limitations of the diagnostic accuracy using conventional smear (CS) cytology have been pointed out. The diagnostic value of liquid‐based cytology (LBC) with FNA specimens has not yet been fully proven. Methods Forty‐two patients with cervical lymphadenopathy who underwent FNA with CS cytology from 2007 to 2011 and 123 patients who underwent FNA with LBC utilizing LBCPREP2™ from 2011 to 2015 were studied. Diagnostic values were compared between the CS and the LBC groups. Results Of the total 165 patients representing the combined CS and LBC groups, 81 (49.1%) were diagnosed as benign lymph node and 84 (50.9%) were malignant diseases including 37 (22.4%) of metastatic carcinoma except for thyroid carcinoma, 30 (18.2%) of metastatic thyroid carcinoma, and 17 (10.3%) of malignant lymphoma. The overall statistical values including sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the CS were 75%, 100%, 100%, 78.9%, and 87.1%, respectively, whereas those values for LBC were 91.2%, 100%, 100%, 90.7%, and 95.3%, respectively. The sensitivity of LBC for malignant diseases tended to be higher than that of CS cytology (p = 0.081). Conclusion LBC with FNA specimens from cervical lymphadenopathy is a useful and reliable method for the diagnosis of malignant diseases, especially of metastatic carcinomas, due to its increased sensitivity compared with CS cytology. Diagn. Cytopathol. 2016;44:169–176. © 2016 Wiley Periodicals, Inc. PMID:26748563

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

    Directory of Open Access Journals (Sweden)

    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

  13. [Accuracy of liquid-based cytology in diagnosis of high-grade squamous cervical intraepithelial neoplasia].

    Science.gov (United States)

    Li, Min; Mei, Ping; Luo, Dong-lan; Wang, Xiao-bing; Liu, Yan-hui

    2012-04-01

    To investigate factors affecting the diagnostic accuracy of cervical liquid-based cytology for high-grade squamous intraepithelial lesion (HSIL). A retrospective evaluation of cytological and histological slides was performed in 415 patients who had cytological HSIL between 2007 and 2010. Among 42 209 cases screened by ThinPrep liquid-based cytology, 415 cases (1.0%) of HSIL were eventually identified. The mean age of HSIL patients was 41.6 years, and 30-49 years were the most common age group. Among 415 cases, 325 patients had available histological diagnosis as follows: 23 (7.1%) negative, 22 (6.8%) CIN1/HPV, 223 (68.6%) CIN2/CIN3, and 57 (17.5%) squamous cell carcinoma (SCC). The positive predictive values of HSIL to predict CIN2 (or higher grade of dysplasia) and CIN1 were 86.2% (280/325) and 92.9% (302/325), respectively. Inadequate biopsy, reactive glandular cells, islet atrophy, chemo/radiotherapy and others were responsible for the cytologically false-positive diagnosis. Fifty-seven (17.5%) cases of HSIL had a histological diagnosis of SCC. The possible causes of misdiagnosis were social factors, under-recognized cytological features of poorly-differentiated SCC and absence of typical diagnostic features in cytology slides. Cytology of HSIL has a high positive predictive value for the presence of CIN2/CIN3 and SCC. Cytologists and gynecologists should be aware of the diagnostic pitfalls that may lead to the discrepancy between cytology and histology.

  14. Automation-assisted cervical cancer screening in manual liquid-based cytology with hematoxylin and eosin staining.

    Science.gov (United States)

    Zhang, Ling; Kong, Hui; Ting Chin, Chien; Liu, Shaoxiong; Fan, Xinmin; Wang, Tianfu; Chen, Siping

    2014-03-01

    Current automation-assisted technologies for screening cervical cancer mainly rely on automated liquid-based cytology slides with proprietary stain. This is not a cost-efficient approach to be utilized in developing countries. In this article, we propose the first automation-assisted system to screen cervical cancer in manual liquid-based cytology (MLBC) slides with hematoxylin and eosin (H&E) stain, which is inexpensive and more applicable in developing countries. This system consists of three main modules: image acquisition, cell segmentation, and cell classification. First, an autofocusing scheme is proposed to find the global maximum of the focus curve by iteratively comparing image qualities of specific locations. On the autofocused images, the multiway graph cut (GC) is performed globally on the a* channel enhanced image to obtain cytoplasm segmentation. The nuclei, especially abnormal nuclei, are robustly segmented by using GC adaptively and locally. Two concave-based approaches are integrated to split the touching nuclei. To classify the segmented cells, features are selected and preprocessed to improve the sensitivity, and contextual and cytoplasm information are introduced to improve the specificity. Experiments on 26 consecutive image stacks demonstrated that the dynamic autofocusing accuracy was 2.06 μm. On 21 cervical cell images with nonideal imaging condition and pathology, our segmentation method achieved a 93% accuracy for cytoplasm, and a 87.3% F-measure for nuclei, both outperformed state of the art works in terms of accuracy. Additional clinical trials showed that both the sensitivity (88.1%) and the specificity (100%) of our system are satisfyingly high. These results proved the feasibility of automation-assisted cervical cancer screening in MLBC slides with H&E stain, which is highly desirable in community health centers and small hospitals.

  15. DNA methylation analysis in liquid-based cytology for cervical cancer screening.

    Science.gov (United States)

    Apostolidou, Sophia; Hadwin, Richard; Burnell, Matthew; Jones, Allison; Baff, Donna; Pyndiah, Nitisha; Mould, Tim; Jacobs, Ian J; Beddows, Simon; Kocjan, Gabrijela; Widschwendter, Martin

    2009-12-15

    Cervical cancer is the second most common type of cancer in women worldwide. Preinvasive disease can be detected by cervical cytology. All currently available cytology technologies rely on the visual analysis of exfoliated cells from the uterine cervix. Improvement of conventional cytological screening has been proposed by the introduction of molecular-based markers applied to liquid-based cytology (LBC), the suspension of cells collected from the cervix. DNA methylation changes occur very early in carcinogenesis and identification of appropriate DNA methylation markers in such samples should be able to distinguish high-grade squamous intraepithelial lesions (HSIL) from nonspecific cytology changes and the normal cervix. To address this potential, we have undertaken a proof-of-principle study of methylation status of LBC samples from HSIL cytology cases compared against matched normal controls. Using quantitative methylation-specific PCR on 28 genes, we found SOX1, HOXA11 and CADM1 to significantly discriminate between the groups analyzed (p<0.01). Area under the receiver operating characteristic (ROC) curve (AUC) demonstrated that methylation of SOX1, HOXA11 and CADM1 could discriminate between HSIL cases and controls with high sensitivity and specificity (AUC 0.910, 0.844 and 0.760, respectively). The results were further validated in an independent set. This proof-of-principle study is the first to validate the results in an independent case/control set and presents HOXA11, a gene that is important for cervical development, as a potentially useful DNA marker in LBC samples. Further assessment of these preliminary estimates will need to be performed in a larger cohort to confirm clinical utility.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Comparison of Hybrid capture 2 testing at different thresholds with cytology as primary cervical screening test

    OpenAIRE

    Rijkaart, D. C.; Coupé, V M H; Kemenade, van, PM Patricia; Heideman, D A M; Hesselink, A. T.; Verweij, W.; Rozendaal, L; Verheijen, R H; Snijders, P. J. F.; Berkhof, J; Meijer, C J L M

    2010-01-01

    Background: We evaluated the performance of primary high-risk human papillomavirus (hrHPV) testing by hybrid capture 2 (HC2) with different thresholds for positivity, in comparison with conventional cytology. Methods: We used data of 25 871 women (aged 30–60 years) from the intervention group of the VUSA-Screen study (VU University Medical Center and Saltro laboratory population-based cervical screening study), who were screened by cytology and hrHPV. Primary outcome measure was the number of...

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

    Institute of Scientific and Technical Information of China (English)

    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.

  19. Comparison of FFPE histological versus LBP cytological samples for HPV detection and typing in cervical cancer.

    Science.gov (United States)

    Kim, Geehyuk; Cho, Hyemi; Lee, Dongsup; Park, Sunyoung; Lee, Jiyoung; Wang, Hye-Young; Kim, Sunghyun; Park, Kwang Hwa; Lee, Hyeyoung

    2017-02-27

    Human papillomavirus (HPV) infection is closely associated with cervical cancer. This study analyzed HPV genotype prevalence in 75 cases of formalin-fixed paraffin embedded (FFPE) tissue samples from patients diagnosed with cervical cancer. Genotype prevalence was assessed using Reverse Blot Assay (REBA) and quantitative polymerase chain reaction (qPCR), which target the HPV L1 and HPV E6/E7 genes, respectively. HPV DNA chip tests were also performed using liquid based preparation (LBP) cytological samples from the same patients who provided the FFPE histological samples. We observed a slight difference in HPV genotype distribution as assessed by DNA chip versus REBA. One possible explanation for this difference is that normal regions could be mixed with lesion regions when cytological samples are extracted from each patient with cancer. For the detection of moderate dysplasia, the main target of diagnosis, this difference is anticipated to be greater. We also made several unexpected observations. For example, HPV multi-infection was not detected. Moreover, the rate of HPV positivity varied radically depending on the cancer origin, e.g. squamous cell carcinoma versus adenocarcinoma. Our results imply that it is important to determine whether cytological specimens are suitable for HPV genotyping analysis and cervical cancer diagnosis. Future research on the mechanisms underlying cervical cancer pathogenesis is also necessary.

  20. Chlamydia trachomatis among women with normal and abnormal cervical smears in Lagos, Nigeria

    Directory of Open Access Journals (Sweden)

    Maymunah Adeshola Adegbesan-Omilabu

    2014-06-01

    Results: The overall prevalence of C. trachomatis was 27.7% with a decreasing trend noted with age (P <0.05. The majority of women with C. trachomatis were in the reproductive age group of 25-45 years. 50% of women with abnormal smears were positive for C. trachomatis, compared to only 16.7% of the controls (X2 = 10.95; P = 0.001. There was no statistically significant association between prevalence of C. trachomatis and cervical cytological types (X2 = 1.892; P = 0.595 Conclusions: The study revealed an association between Chlamydia trachomatis and precancerous lesions of the cervix. Routine screening and treatment of sexually active adolescents and women in the reproductive age group is recommended as an indirect measure to reducing the incidence of cervical cancer in Nigeria. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 501-506

  1. Screening for cervical cancer precursors with p16/Ki-67 dual-stained cytology: results of the PALMS study

    National Research Council Canada - National Science Library

    Ikenberg, Hans; Bergeron, Christine; Schmidt, Dietmar; Griesser, Henrik; Alameda, Francisco; Angeloni, Claudio; Bogers, Johannes; Dachez, Roger; Denton, Karin; Hariri, Jalil; Keller, Thomas; von Knebel Doeberitz, Magnus; Neumann, Heinrich H; Puig-Tintore, Luis M; Sideri, Mario; Rehm, Susanne; Ridder, Ruediger

    2013-01-01

    ...) 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, can provide high sensitivity for CIN2...

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

    DEFF Research Database (Denmark)

    Rask, J; Lynge, E; Franzmann, M

    2014-01-01

    in a third laboratory using manually read conventional cytology continually. Data were collected from the Danish National Health Care Registers. For each laboratory, we compared proportions of abnormal cytology defined as atypical squamous cells of undetermined significance or worse (ASCUS+) by age......: 0.78-1.02) and in women aged 45-59 years from 3.4 to 1.0%, RP: 0.30 (95% CI: 0.24-0.37). With implementation of imaging-assisted reading, regardless of the brand of technology, the proportion of abnormality increased by around 30% in all age groups (range from 19 to 41%). In the laboratory...

  3. European guidelines for quality assurance in cervical cancer screening: recommendations for collecting samples for conventional and liquid-based cytology.

    NARCIS (Netherlands)

    Arbyn, M.; Herbert, A.; Schenck, U.; Nieminen, P.; Jordan, J.; Mcgoogan, E.; Patnick, J.; Bergeron, C.; Baldauf, J.J.; Klinkhamer, P.; Bulten, J.; Martin-Hirsch, P.

    2007-01-01

    The current paper presents an annex in the second edition of the European Guidelines for Quality Assurance in Cervical Cancer Screening. It provides guidance on how to make a satisfactory conventional Pap smear or a liquid-based cytology (LBC) sample. Practitioners taking samples for cytology should

  4. European guidelines for quality assurance in cervical cancer screening: recommendations for collecting samples for conventional and liquid-based cytology.

    NARCIS (Netherlands)

    Arbyn, M.; Herbert, A.; Schenck, U.; Nieminen, P.; Jordan, J.; Mcgoogan, E.; Patnick, J.; Bergeron, C.; Baldauf, J.J.; Klinkhamer, P.; Bulten, J.; Martin-Hirsch, P.

    2007-01-01

    The current paper presents an annex in the second edition of the European Guidelines for Quality Assurance in Cervical Cancer Screening. It provides guidance on how to make a satisfactory conventional Pap smear or a liquid-based cytology (LBC) sample. Practitioners taking samples for cytology should

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

    Directory of Open Access Journals (Sweden)

    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

  6. Human papillomavirus genotypes in women with cervical cytological abnormalities from an area with high incidence of cervical cancer Genotipos de virus papiloma humano en mujeres con alteraciones citológicas cervicales de un área con alta incidencia de cáncer cervical

    Directory of Open Access Journals (Sweden)

    Gerardo Daniel Deluca

    2004-02-01

    Full Text Available It has been well demonstrated the relationship between the infection with high-risk human papillomavirus (HPVs genotypes and cervical cancer. In Northeastern Argentina a high incidence of this pathology has been described and therefore a high prevalence of HPV infection is expected. In order to identify HPV genotypes associated with malignant and pre-malignant cervical lesions present in the area, 53 ecto-endo cervical cell specimens obtained from women with cytohistological alterations were studied by a PCR-RFLP technique. Out of 53 patients, 34 (64.2% were positive for HPV infection, being HPV-16 (32.3% the most frequently found genotype, followed by HPV-58 (14.7%, -6, -18 and -45 (5.9%, -33, -52, -53, -54, -56, -66, -MM4 and -LVX100 (2.9%. Also 5 cases of infection caused by multiple genotypes were found, which corresponded to 14.7% of the positive cases. Results indicate that besides HPV-16 and -18, the most prevalent high-risk HPV genotypes worldwide, others like -45 and -58 as well as co-infection cases are frequent between women of Northeastern Argentina, and a particular attention should be paid to this circumstance because it could be an epidemiological feature of regional importance and a useful information for a future vaccination program.La relación entre la infección por los virus papiloma humanos (HPVs de alto riesgo y el cáncer de cuello de útero ha sido bien demostrada. En el Nordeste de Argentina se observa una alta incidencia de esta patología y en consecuencia se estima una alta prevalencia de infección por HPV. A fin de identificar los genotipos de HPV presentes en el área, asociados a casos de lesiones malignas y premalignas de cuello de útero, se estudiaron 53 muestras ecto-endo cervicales de mujeres con alteraciones citohistológicas residentes permanentes de las ciudades de Resistencia y Corrientes. De las 53 pacientes estudiadas, 34 resultaron positivas para HPV (64.2%, correspondiendo la mayor frecuencia a HPV

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

    Directory of Open Access Journals (Sweden)

    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

  8. Detection Rate of High-Grade Cervical Neoplasia and Cost-Effectiveness of High-Risk Human Papillomavirus Genotyping with Reflex Liquid-based Cytology in Cervical Cancer Screening.

    Science.gov (United States)

    Tay, Sun Kuie; Lin, Lynette Eo; Goh, Ronald Ch

    2017-07-01

    This study aimed to determine the prevalence of cervical intraepithelial neoplasia grade 3 or worse (≥CIN3) and cost-effectiveness of human papillomavirus (HPV) genotyping with reflex liquid-based cytology (LBC) for cervical cancer screening in Singapore. Women who were ≥25 years old and undertook co-testing with LBC and HPV-genotyping (Cobas-4800, Roche, USA) for HPV-16, HPV-18 and 12 high-risk HPV types in a single institution were studied retrospectively. A single cervical smear in ThinPrep® PreservCyt® solution (Hologic, USA) was separated for tests in independent cytology and molecular pathology laboratories. The results were reviewed by a designated gynaecologist according to institutional clinical management protocols. Those who tested positive for HPV-16 and/or HPV-18 (regardless of cytology results), cytology showing low-grade squamous intraepithelial lesions (LSIL) or high-grade SIL (HSIL), or atypical squamous cells of undetermined significance (ASCUS) with positive 12 high-risk HPV types were referred for colposcopy. Colposcopy was performed by experienced colposcopists. Cervical biopsy, either directed punch biopsies or excisional biopsy, was determined by a colposcopist. The diagnosis of ≥CIN3 was reviewed by a gynaecologic pathologist. Cost-effectiveness of HPV-based screening in terms of disease and financial burden was analysed using epidemiological, clinical and financial input data from Singapore. Of 1866 women studied, 167 (8.9%) had abnormal cytology (≥ASCUS) and 171 (9.2%) tested positive for high-risk HPV. Twenty-three CIN were detected. Three of the 10 ≥CIN3 cases had negative cytology but positive HPV-16. Compared to cytology, HPV genotyping detected more ≥CIN3 (OR: 1.43). HPV+16/18 genotyping with reflex LBC was superior in terms of cost-effectiveness to LBC with reflex HPV, both for disease detection rate and cost per case of ≥CIN2 detected. Compared to cytology, HPV+16/18 genotyping with reflex LBC detected more ≥CIN3

  9. Isthmic-vaginal smear cytology in the follow-up after radical vaginal trachelectomy for early stage cervical cancer: is it safe?

    Science.gov (United States)

    Lanowska, Malgorzata; Mangler, Mandy; Grittner, Ulrike; Akbar, Gerta Rose; Speiser, Dorothee; von Tucher, Elisabeth; Köhler, Christhardt; Schneider, Achim; Kühn, Wolfgang

    2014-05-01

    Isthmic-vaginal cytology is a follow-up method in patients who have undergone radical vaginal trachelectomy (RVT) for early cervical cancer. However, to the authors' knowledge, little is known regarding its ability to monitor patients and diagnose disease recurrence. Herein, the authors report their experience with cytology after RVT compared with cytology in patients after cone biopsy and women undergoing screening. A database of 563 specimens from 303 patients was analyzed retrospectively (RVT in 361 specimens, conization in 102 specimens, and screening in 100 specimens). The following criteria were applied: Bethesda system, the presence of endocervical and metaplasia cells, regeneration criteria, vaginal flora, and morphological signs of human papillomavirus. The analysis was performed by 2 cytopathologists. Differences between the groups and correlation between the cytopathologists were analyzed. Smears without endocervical and metaplasia cells were significantly less frequent among the patients who underwent RVT. There was no difference in regeneration signs, vaginal flora, and morphologic signs of human papillomavirus between the groups. After RVT, 26/23 smears (cytopathologist 1/cytopathologist 2) smears were diagnosed as abnormal. Biopsies revealed 7 cases of dysplasia and 1 case of disease recurrence. After conization, 1 patient was diagnosed with a low-grade lesion on cytology; follow-up cytology was normal. In the screening, 10/13 smears were diagnosed with lesions on cytology; biopsy revealed dysplasia in 2 cases. The correlation between both cytopathologists was high. After RVT, histological verification of cytology is frequently needed. The reasons might include alterations of anatomy, regeneration, and inflammation process after RVT. Cytopathologists should become familiar with the spectrum of changes in post-RVT cytology and communication between cytopathologists and clinicians should be improved. This might reduce false-positive results. © 2014

  10. Cytological patterns of cervical pap smears with histopathological correlation

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Manual liquid based cytology in primary screening for cervical cancer--a cost effective preposition for scarce resource settings.

    Science.gov (United States)

    Nandini, N M; Nandish, S M; Pallavi, P; Akshatha, S K; Chandrashekhar, A P; Anjali, S; Dhar, Murali

    2012-01-01

    Conventional pap smear (CPS) examination has been the mainstay for early detection of cervical cancer. However, its widespread use has not been possible due to the inherent limitations, like presence of obscuring blood and inflammation, reducing its sensitivity considerably. Automated methods in use in developed countries may not be affordable in the developing countries due to paucity of resources. On the other hand, manual liquid based cytology (MLBC) is a technique that is cost effective and improves detection of precursor lesions and specimen adequacy. Therefore the aim of the study was to compare the utility of MLBC with that of CPS in cervical cancer screening. A prospective study of 100 cases through MLBC and CPS was conducted from October 2009 to July 2010, in a Medical College in India, by two independent pathologists and correlated with histopathology (22 cases). Morphological features as seen through MLBC and CPS were compared. Subsequently, all the cases were grouped based on cytological diagnosis according to two methods into 10 groups and a subjective comparison was made. In order to compare the validity of MLBC with CPS in case of major diagnoses, sensitivity and specificity of the two methods were estimated considering histological examination as the gold standard. Increased detection rate with MLBC was 150%. The concordance rate by LBC/histopathology v/s CPS/histopathology was also improved (86% vs 77%) The percentage agreement by the two methods was 68%. MLBC was more sensitive in diagnosis of LSIL and more specific in the diagnosis of inflammation. Thus, MLBC was found to be better than CPS in diagnosis of precursor lesions. It provided better morphology with increased detection of abnormalities and preservation of specimen for cell block and ancillary studies like immunocytochemistry and HPV detection. Therefore, it can be used as alternative strategy for cervical cancer prevention in limited resource settings.

  13. Causes and relevance of unsatisfactory and satisfactory but limited smears of liquid-based compared with conventional cervical cytology.

    Science.gov (United States)

    Siebers, Albertus G; Klinkhamer, Paul J J M; Vedder, Judith E M; Arbyn, Marc; Bulten, Johan

    2012-01-01

    Recent randomized controlled trials have shown a significant decrease in unsatisfactory rates for liquid-based cytology (LBC) compared with conventional Papanicolaou test (CP). The underlying causes and relevance of unsatisfactory results for LBC and CP have never been compared within the setting of a randomized controlled trial. To examine differences in causes and relevance of unsatisfactory and satisfactory but limited by (SBLB) results for LBC and CP. Data from the Netherlands ThinPrep Versus Conventional Cytology (NETHCON) trial were used, involving 89 784 women. Causes and relevance of unsatisfactory and SBLB results were analyzed. The primary cause for unsatisfactory results for CP and LBC was scant cellularity. Other causes for unsatisfactory CPs were virtually eliminated with LBC. The same was true for SBLB subcategories, with the exception of SBLB absence of transformation zone component and SBLB scant cellularity. The SBLB absence of transformation zone component showed a statistically significant 22% and SBLB scant cellularity a 12% nonsignificant increase with LBC. The detection rates of abnormalities found during 18 months of follow-up of unsatisfactory test results did not differ significantly between the 2 study arms, nor did they differ from the initial test positivity rates from the NETHCON trial. Liquid-based cytology shows an almost complete elimination of most causes for unsatisfactory CP, with scant cellularity remaining as the sole cause for unsatisfactory LBC. On the other hand, with LBC a significant increase of smears without a transformation zone component was noted. Women with an unsatisfactory test result are not at increased risk for cervical abnormalities either with LBC or with CP. Nederlands Trial Register, NTR1032, www.trialregister.nl .

  14. [Risk factors for uterine cervical cancer according to results of VIA, cytology and cervicography].

    Science.gov (United States)

    dos Anjos, Saiwori de Jesus Silva Bezerra; Vasconcelos, Camila Teixeira Moreira; Franco, Eugênio Santana; de Almeida, Paulo César; Pinheiro, Ana Karina Bezerra

    2010-12-01

    This study aimed to evaluate the association between risk factors for uterine cervical neoplasms and cervical lesions by HPV by comparison of the visual inspection with acetic acid (VIA), cytology and cervicography results. A prevalence research was made with 157 women in a health center of Fortaleza in the period of June to September 2006. The SPSS program was used to codify the data. Inferences were made through statistical tests (chi2 = chi square and LR = likelihood ratio). The VIA, cervicography and cytology obtained 43.3%, 10.19% and 3.2% of altered results. The variables with important association to cervical lesions in the VIA were: aged less than 20 years old (p = 0.0001); one or more partners in the last three months (p = 0.015); use of contraceptives (p = 0.0008); presence of vaginal discharge (p = 0.0001) and moderate or accentuated inflammatory process (p = 0.0001). In the cytology: low instructional level (p = 0.0001) and high pH (p = 0.001). It wasn't found any significant association in the cervicography.

  15. A study of cellular counting to determine minimum thresholds for adequacy for liquid-based cervical cytology using a survey and counting protocol.

    Science.gov (United States)

    Kitchener, Henry C; Gittins, Matthew; Desai, Mina; Smith, John H F; Cook, Gary; Roberts, Chris; Turnbull, Lesley

    2015-03-01

    Liquid-based cytology (LBC) for cervical screening would benefit from laboratory practice guidelines that define specimen adequacy for reporting of slides. The evidence base required to define cell adequacy should incorporate both ThinPrep™ (TP; Hologic, Inc., Bedford, MA, USA) and SurePath™ (SP; BD Diagnostics, Burlington, NC, USA), the two LBC systems used in the UK cervical screening programmes. The objectives of this study were to determine (1) current practice for reporting LBC in England, Wales and Scotland, (2) a reproducible method for cell counting, (3) the cellularity of slides classified as inadequate, negative or abnormal and (4) the impact of varying cellularity on the likelihood of detecting cytological abnormalities. The study involved four separate arms to pursue each of the four objectives. (1) A questionnaire survey of laboratories was conducted. (2) A standard counting protocol was developed and used by three experienced cytopathologists to determine a reliable and reproducible cell counting method. (3) Slide sets which included a range of cytological abnormalities were each sent to three laboratories for cell counting to study the correlation between cell counts and reported cytological outcomes. (4) Dilution of LBC samples by fluid only (unmixed) or by dilution with a sample containing normal cells (mixed) was performed to study the impact on reporting of reducing either the total cell count or the relative proportion of abnormal to normal cells. The study was conducted within the cervical screening programmes in England, Wales and Scotland, using routinely obtained cervical screening samples, and in 56 participating NHS cervical cytology laboratories. The study involved only routinely obtained cervical screening samples. There was no clinical intervention. The main outcome measures were (1) reliability of counting method, (2) correlation of reported cytology grades with cellularity and (3) levels of detection of abnormal cells in

  16. Differences in coverage patterns in cervical cytology screening

    Science.gov (United States)

    Smith, Amy; Gale, Alastair G.; Wooding, David S.; Purdy, Kevin J.

    2003-05-01

    The visual screening of cervical smears is a complex process requiring appropriate slide coverage to detect any unusual appearances without making any omission errors. In examining a smear the observer has both to move the microscope stage appropriately to bring different slide areas into view, plus visually search the information presented within the binocular visual field. This study examined the patterns of slide coverage by different individuals when they inspected liquid based cervical smears. A binocular microscope was first adapted in order to record both the physical movement of the stage by the observer and also to access the microscope"s visual field. An image of the area of the smear under the microscope was displayed on a PC monitor and observers" eye movements were recorded as they searched this. By manually adjusting the microscope controls they also moved the stage and all stage movements and focussing were also recorded. The behaviour was examined of both novices and an expert screener as they searched a number of test cervical smears. It was found that novices adopted a regular examination pattern, which maximized slide coverage, albeit slowly. In contrast, the experienced screener covered the slides faster and more effectively ensuring more overlap between microscope fields.

  17. Central nervous system and cervical spine abnormalities in Apert syndrome.

    Science.gov (United States)

    Breik, Omar; Mahindu, Antony; Moore, Mark H; Molloy, Cindy J; Santoreneos, Stephen; David, David J

    2016-05-01

    Apert syndrome characterized by acrocephalosyndactyly is a rare autosomal dominant congenital malformation with a prevalence of 1/65,000 births. With an extensive range of phenotypic and developmental manifestations, its management requires a multidisciplinary approach. A variety of craniofacial, central nervous system (CNS), and cervical spine abnormalities have been reported in these patients. This study aimed to determine the incidence of these CNS abnormalities in our case series. Retrospective review of Australian Craniofacial Unit (ACFU) database for Apert patients was performed. Data collected that included demographics, place of origin, age at presentation, imaging performed, and images were reviewed and recorded. Where available, developmental data was also recorded. Ninety-four patients seen and managed at the ACFU had their CNS and cervical spine abnormalities documented. The main CNS abnormalities were prominent convolutional markings (67 %), ventriculomegaly (48 %), crowded foramen magnum (36 %), deficient septum pellucidum (13 %), and corpus callosum agenesis in 11 %. Major C-spine findings were present in 50.8 % of patients and included fusion of posterior elements of C5/C6 (50 %) and C3/4 (27 %). Multilevel fusion was seen in 20 %. Other abnormalities were C1 spina bifida occulta (7 %) and atlanto-axial subluxation (7 %). Multiple CNS and cervical spine (c-spine) abnormalities are common in Apert syndrome. The significance of these abnormalities remains largely unknown. Further research is needed to better understand the impact of these findings on growth, development, and treatment outcomes.

  18. Interpretation of p16(INK4a) /Ki-67 dual immunostaining for the triage of human papillomavirus-positive women by experts and nonexperts in cervical cytology.

    Science.gov (United States)

    Allia, Elena; Ronco, Guglielmo; Coccia, Anna; Luparia, Patrizia; Macrì, Luigia; Fiorito, Corinna; Maletta, Francesca; Deambrogio, Cristina; Tunesi, Sara; De Marco, Laura; Gillio-Tos, Anna; Sapino, Anna; Ghiringhello, Bruno

    2015-04-01

    The triage of human papillomavirus (HPV)-positive women is needed to avoid overreferral to colposcopy. p16(INK4a) immunostaining is an efficient triage method. p16(INK4a) /Ki-67 dual staining was introduced mainly to increase reproducibility and specificity compared with stand-alone p16(INK4a) staining. Within a pilot project, HPV-positive women were referred to colposcopy if cytology was abnormal or unsatisfactory or HPV testing was still positive after 1 year. For 500 consecutive women, a slide obtained during colposcopy was immunostained for p16(INK4a) /Ki-67 and independently interpreted by 7 readers without previous experience with dual staining. Four of these readers were experts in cervical pathology and 3 were not. Kappa values for multiple raters, sensitivity, and specificity for cervical intraepithelial neoplasia type 2-positive histology were computed. Because women with normal cytology were underrepresented, estimates for all HPV-positive women were obtained as weighted means of cytology-specific estimates. The overall kappa for HPV-positive women was 0.70 (95% confidence interval [95% CI], 0.60-0.77). Kappa values were not found to be significantly different between expert and nonexpert readers with regard to cervical cytology but were significantly increased (P =. 0066) after consensus discussion. The overall specificity estimate for HPV-positive women was 64.0% (95% CI, 57.4%-70.2%): 66.7% (95% CI, 59.8%-73.0%) for experts and 60.5% (95% CI, 59.8%-73.0%) for nonexperts. Among women with abnormal cytology, the sensitivity was 85.5% (95% CI, 77.9%-90.8%): 85.8% (95% CI, 77.9%-91.2%) for experts and 85.1% (95% CI, 76.6%-90.9%) for nonexperts. p16(INK4a) /Ki-67 immunostaining demonstrated good reproducibility and specificity when triaging HPV-positive women. Dual-staining interpretation can be performed, after short training, even by staff who are not experts in cervical cytology. This allows HPV-based screening with triage to be performed in settings in

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

    Science.gov (United States)

    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

  20. A cohort study of cervical screening using partial HPV typing and cytology triage.

    Science.gov (United States)

    Schiffman, Mark; Hyun, Noorie; Raine-Bennett, Tina R; Katki, Hormuzd; Fetterman, Barbara; Gage, Julia C; Cheung, Li C; Befano, Brian; Poitras, Nancy; Lorey, Thomas; Castle, Philip E; Wentzensen, Nicolas

    2016-12-01

    HPV testing is more sensitive than cytology for cervical screening. However, to incorporate HPV tests into screening, risk-stratification ("triage") of HPV-positive women is needed to avoid excessive colposcopy and overtreatment. We prospectively evaluated combinations of partial HPV typing (Onclarity, BD) and cytology triage, and explored whether management could be simplified, based on grouping combinations yielding similar 3-year or 18-month CIN3+ risks. We typed ∼9,000 archived specimens, taken at enrollment (2007-2011) into the NCI-Kaiser Permanente Northern California (KPNC) HPV Persistence and Progression (PaP) cohort. Stratified sampling, with reweighting in the statistical analysis, permitted risk estimation of HPV/cytology combinations for the 700,000+-woman KPNC screening population. Based on 3-year CIN3+ risks, Onclarity results could be combined into five groups (HPV16, else HPV18/45, else HPV31/33/58/52, else HPV51/35/39/68/56/66/68, else HPV negative); cytology results fell into three risk groups ("high-grade," ASC-US/LSIL, NILM). For the resultant 15 HPV group-cytology combinations, 3-year CIN3+ risks ranged 1,000-fold from 60.6% to 0.06%. To guide management, we compared the risks to established "benchmark" risk/management thresholds in this same population (e.g., LSIL predicted 3-year CIN3+ risk of 5.8% in the screening population, providing the benchmark for colposcopic referral). By benchmarking to 3-year risk thresholds (supplemented by 18-month estimates), the widely varying risk strata could be condensed into four action bands (very high risk of CIN3+ mandating consideration of cone biopsy if colposcopy did not find precancer; moderate risk justifying colposcopy; low risk managed by intensified follow-up to permit HPV "clearance"; and very low risk permitting routine screening.) Overall, the results support primary HPV testing, with management of HPV-positive women using partial HPV typing and cytology.

  1. Makorin Ring Finger Protein 1 as Adjunctive Marker in Liquid-based Cervical Cytology.

    Science.gov (United States)

    Lee, Maria; Chang, Min Young; Shin, Ha-Yeon; Shin, Eunah; Hong, Sun Won; Kim, Kyung-Mi; Chay, Doo Byung; Cho, Hanbyoul; Kim, Jae-Hoon

    2016-01-01

    To assess the utility of makorin ring finger protein 1 (MKRN1) as a marker of cervical pathology.A PROspective specimen collection and retrospective Blinded Evaluation study was conducted. Liquid-based cytology samples were collected from 187 women, embedding all residuals as cell blocks for immunohistochemical staining of MKRN1 and P16 . Results of liquid-based cervical cytology, immunostained cell block sections, and human papillomavirus (HPV) hybrid capture (with real-time polymerase chain reaction) were analyzed. Clinical outcomes were analyzed overall and in subsets of specimens yielding atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesions.Makorin ring finger protein 1 positivity and grades (1-3) of cervical intraepithelial neoplasia (CIN) increased in tandem (CIN1, 32.4%; CIN2, 60.0%; and CIN3, 80.0%), reaching 92.3% in invasive cancer. Sensitivity, specificity, positive predictive value, and negative predictive value in detecting CIN2+ via MKRN1 were 73.8%, 76.8%, 75.6%, and 75.0%, respectively. The performance of liquid-based cytology was poorer by comparison (61.3%, 69.5%, 66.2%, and 64.8%, respectively), and HPV assay (versus MKRN1 immunohistochemical staining) displayed lower specificity (67.7%). Combined HPV + MKRN1 testing proved highest in sensitivity, specificity, positive predictive value, and negative predictive value (71.8%, 85.5%, 82.3%, and 76.5%, respectively), whereas corresponding values for cytology + HPV (60.6%, 81.8%, 75.4%, and 69.2%) and cytology + MKRN1 (58.8%, 84.1%, 78.3%, and 67.7%) were all similar. In instances of atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesions, the HPV + MKRN1 combination performed best by above measures (100%, 72.7%, 73.9%, and 100%), followed by cytology + MKRN1 (100%, 50.0%, 60.7%, and 100%).Makorin ring finger protein 1 displayed greater sensitivity and specificity than liquid-based cytology and

  2. Implementation and evaluation of a National External Quality Control Program for Cervical Cytology in Mexico

    Directory of Open Access Journals (Sweden)

    Flisser Ana

    2002-01-01

    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.

  3. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  4. Association between micronucleus frequency and cervical intraepithelial neoplasia grade in Thinprep cytological test and its significance.

    Science.gov (United States)

    Shi, Yong-Hua; Wang, Bo-Wei; Tuokan, Talaf; Li, Qiao-Zhi; Zhang, Ya-Jing

    2015-01-01

    A micronucleus is an additional small nucleus formed due to chromosomes or chromosomal fragments fail to be incorporated into the nucleus during cell division. In this study, we assessed the utility of micronucleus counting as a screening tool in cervical precancerous lesions in Thinprep cytological test smears under oil immersion. High risk HPV was also detected by hybrid capture-2 in Thinprep cytological test smears. Our results showed that micronucleus counting was significantly higher in high-grade squamous intraepithelial lesion (HSIL) and invasive carcinoma cases compared to low-grade squamous intraepithelial lesion (LSIL) and non-neoplastic cases. Receiver operating characteristic (ROC) curve analysis revealed that micronucleus counting possessed a high degree of sensitivity and specificity for identifying HSIL and invasive carcinoma. Cut-off of 7.5 for MN counting gave a sensitivity of 89.6% and a specificity of 66.7% (P = 0.024 and AUC = 0.892) for detecting HSIL and invasive carcinoma lesions. Multiple linear regression analysis showed that only HSIL and invasive cancer lesions not age, duration of marital life and number of pregnancy are significantly associated with MN counting. The positive rate of high risk HPV was distinctly higher in LSIL, HSIL and invasive cancer than that in non-neoplstic categories. In conclusions, MN evaluation may be viewed as an effective biomarker for cervical cancer screening. The combination of MN count with HPV DNA detection and TCT may serve as an effective means to screen precancerous cervical lesions in most developing nations.

  5. [Significance of the demonstration of Actinomyces in cervical cytological smears].

    Science.gov (United States)

    Dybdahl, H; Baandrup, U

    1988-10-17

    In recent years there has been well documented evidence of a connection between adnexitis and the use of IUDs. It has also been reported that Actinomyces-caused adnexitis is often a serious precursor of tubo-ovarian abscesses which require surgical attention. The investigation included a total of 17,734 routine Pap smears taken in the pathology department over a 4-month period. The smears were screened for the presence of Actinomyces and information on type of IUD and gynecological symptoms was gathered from women testing positive for Actinomyces. Comparable information was gathered from 2 age-matched control groups. 1 group consisted of women with an IUD but without Actinomyces; the other group consisted of women without an IUD and without Actinomyces. Of the 180 patients with Actinomyces, 175 were IUD users and only 5 were nonusers. The incidence of gynecological symptoms among the patients showed increased frequency for women with Actinomyces only with regard to cervical discharge. The Nova-T IUD was found to be significantly less frequently associated with Actinomyces than the other IUDs.

  6. Cervical screening by visual inspection, HPV testing, liquid-based and conventional cytology in Amazonian Peru.

    Science.gov (United States)

    Almonte, Maribel; Ferreccio, Catterina; Winkler, Jennifer L; Cuzick, Jack; Tsu, Vivien; Robles, Sylvia; Takahashi, Rina; Sasieni, Peter

    2007-08-15

    Cervical cancer is an important public health problem in many developing countries, where cytology screening has been ineffective. We compared four tests to identify the most appropriate for screening in countries with limited resources. Nineteen midwives screened 5,435 women with visual inspection (VIA) and collected cervical samples for HPV testing, liquid-based cytology (LBC) and conventional cytology (CC). If VIA was positive, a doctor performed magnified VIA. CC was read locally, LBC was read in Lima and HPV testing was done in London. Women with a positive screening test were offered colposcopy or cryotherapy (with biopsy). Inadequacy rates were 5% and 11% for LBC and CC respectively, and less than 0.1% for VIA and HPV. One thousand eight hundred eighty-one women (84% of 2,236) accepted colposcopy/cryotherapy: 79 had carcinoma in situ or cancer (CIS+), 27 had severe- and 42 moderate-dysplasia on histology. We estimated a further 6.5 cases of CIS+ in women without a biopsy. Sensitivity for CIS+ (specificity for less than moderate dysplasia) was 41.2% (76.7%) for VIA, 95.8% (89.3%) for HPV, 80.3% (83.7%) for LBC, and 42.5% (98.7%) for CC. Sensitivities for moderate dysplasia or worse were better for VIA (54.9%) and less favourable for HPV and cytology. In this setting, VIA and CC missed the majority of high-grade disease. Overall, HPV testing performed best. VIA gives immediate results, but will require investment in regular training and supervision. Further work is needed to determine whether screened-positive women should all be treated or triaged with a more specific test.

  7. [Satisfactory cervical cytology. Circular exocervical cytologic smears against longitudinal exocervical smears].

    Science.gov (United States)

    Ramos-Ortega, Gregorio; Díaz-Hernández, Maritza Consuelo; Rodríguez-Moctezuma, José Raymundo; Domínguez-Gómez, Francisco Guillermo

    2014-01-01

    INTRODUCCIÓN: en el Instituto Mexicano del Seguro Social, la muestra del frotis del cuello uterino se extiende en el portaobjetos mediante movimientos circulares (técnica habitual) desde el año de 1962. En 2006, la Secretaría de Salud estableció que el extendido exocervical se realizara de forma longitudinal (técnica convencional). El objetivo de la investigación que se presenta fue evaluar la eficacia y calidad de la técnica de extendido exocervical habitual, convencional y una nueva que se propone. MÉTODOS: estudio cuasiexperimental en mujeres que solicitaron prueba citológica cervical. Las variables analizadas fueron técnica de extendido, cobertura celular y calidad de la muestra exocervical. Se conformaron grupos según la técnica que se aplicó. Los estudios citológicos fueron procesados con técnica de Papanicolaou y los resultados fueron informados por tres observadores conforme al sistema Bethesda. Se utilizó prueba Z, ?2, Anova y riesgo relativo.

  8. HPV testing for cervical cancer screening appears more cost-effective than Papanicolau cytology in Mexico.

    Science.gov (United States)

    Flores, Yvonne N; Bishai, David M; Lorincz, Attila; Shah, Keerti V; Lazcano-Ponce, Eduardo; Hernández, Mauricio; Granados-García, Víctor; Pérez, Ruth; Salmerón, Jorge

    2011-02-01

    To determine the incremental costs and effects of different HPV testing strategies, when compared to Papanicolau cytology (Pap), for cervical cancer screening in Mexico. A cost-effectiveness analysis (CEA) examined the specific costs and health outcomes associated with (1) no screening; (2) only the Pap test; (3) only self-administered HPV; (4) only clinician administered HPV; and (5) clinician administered HPV plus the Pap test. The costs of self- and clinician-HPV testing, as well as with the Pap test, were identified and quantified. Costs were reported in 2008 US dollars. The health outcome associated with these screening strategies was defined as the number of high-grade cervical intraepithelial neoplasia or cervical cancer cases detected. This CEA was performed using the perspective of the Mexican Institute of Social Security (IMSS) in Morelos, Mexico. Screening women between the ages of 30-80 for cervical cancer using clinical-HPV testing or the combination of clinical-HPV testing, and the Pap is always more cost-effective than using the Pap test alone. This CEA indicates that HPV testing could be a cost-effective screening alternative for a large health delivery organization such as IMSS. These results may help policy-makers implement HPV testing as part of the IMSS cervical cancer screening program.

  9. The advantages of incorporating liquid-based cytology (TACAS™) in mass screening for cervical cancer.

    Science.gov (United States)

    Yokoyama, Yoshihito; Futagami, Masayuki; Watanabe, Jun; Sakuraba, Atsushi; Nagasawa, Kazuma; Maruyama, Hidetoshi; Sato, Shigemi

    2016-04-01

    We incorporated liquid-based cytology (LBC) in population-based screening for cervical cancer. The usefulness of using LBC in mass screening for cervical cancer was examined. From 2009 to 2014, 157,061 individuals underwent mass screening for cervical cancer in Aomori Prefecture. From 2009 to 2011, cells were collected from 82,218 individuals and the specimens were conventionally prepared (CP). From 2012 to 2014, cells were collected from 74,843 individuals and the specimens were prepared using LBC (TACAS™). Cytology results for the 2 sets of specimens were compared and differences in cytologic features were examined. ASC-US and more severe lesions were detected at a rate of 1.13 % by CP and 1.44 % by LBC, so LBC had a 1.3-fold higher rate of detection. LBC had a 1.6-fold higher rate of LSIL detection and a 1.2-fold higher rate of HSIL detection. CP detected cancer in 20 cases at a rate of 0.024 % while LBC detected cancer in 18 cases at a rate of 0.024 %. Cytodiagnosis of the 18 cases of SCC that LBC identified revealed that 7 were SCC, 8 were HSIL, and 3 were ASC-H. Atypical cells tended to be smaller with TACAS™. LBC reduced the time needed for microscopic examination of a single specimen by 42 % in comparison to CP. LBC using TACAS™ allowed the detection of slight lesions and slight changes in cells. LBC can lessen the burden on medical personnel and may lead to improved accuracy.

  10. A STUDY OF HISTOPATHOLOGICAL CORRELATION WITH FINE NEEDLE ASPIRATION CYTOLOGY OF CERVICAL LYMPHADENOPATHY

    Directory of Open Access Journals (Sweden)

    Bobby Duarah

    2016-07-01

    Full Text Available BACKGROUND Cervical lymphadenopathy is a common manifestation in our country where incidence of tuberculosis and oral cancer is fairly high, so the proper and early diagnosis of lymphadenopathy is very important for early and effective treatment. AIM The present study was undertaken in the Department of Pathology, Assam Medical College and Hospital, for a period of one year with a view to correlate the cytological diagnosis with histopathology. MATERIALS AND METHODS A series of 100 cases with clinical presentation of palpable lymph node at any part of the cervical region irrespective of age and sex attending the different OPDs of this institution were taken. FNAC was done as an initial step for diagnosis. The results were confirmed by incisional/excisional biopsy afterwards. RESULT Out of 100 cases, there were 74 cases of benign lesions (74% and 26 cases of malignant lesions (26% proven histopathologically. The peak incidence of age group suffering from the disease was 21-30 years (25% followed by 11-20 years (24%. Majority were Tubercular (40% followed by Inflammatory (34%, Metastasis (16%, and Lymphoma (10%. All the cases (Benign and Malignant presented with neck swelling (100%. It was seen that the Jugulodigastric, Posterior triangle, and the submandibular groups of lymph nodes were the most commonly involved groups with a percentage being 41%, 21%, and 13% respectively. Out of a total of 74 histologically proved benign cases, cytology could diagnose 73 cases (98.7%. The percentage of accuracy was 98.7%. Also, the cytological diagnosis could be obtained in 24 out of 26 cases with malignant lesions when correlated with histopathology. The percentage of accuracy was 92.3%. It was seen that the overall accuracy rate of aspiration cytology in the diagnosis of benign lesions was 98.7% and that of malignant lesions was 92.3% against 100% accuracy with histopathology. The overall accuracy of aspiration cytology is 97%. CONCLUSION Though

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

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    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

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

    Science.gov (United States)

    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.

  13. Improving the Utilization of Human Papillomavirus and Cervical Cytology Co-testing for Cervical Cancer Screening in an Obstetrics and Gynecology Resident Clinic.

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    Yoshino, Kurt; Karimoto, Maxine; Marzo, Christina; Kaneshiro, Bliss; Hiraoka, Mark

    2015-08-01

    Human Papillomavirus (HPV) testing in combination with cervical cytology (HPV co-testing) has been recommended for cervical cancer screening for women 30 to 65 years of age. In several studies, HPV co-testing increased sensitivity for detecting high grade dysplasia and resulted in cost-savings. This retrospective cohort study assessed the prevalence of HPV co-testing in an obstetrics and gynecology resident clinic before and after a brief educational intervention which was designed to reinforce current cervical cancer screening recommendations. The intervention consisted of a short presentation that was given to all residents and medical assistants in October 2011. The proportion of women age 30-65 years of age who had cervical cancer screening with HPV co-testing as compared to cervical cytology alone was compared before and after the intervention using chi-square tests. The goal of the intervention was to increase the percentage of patients receiving co-testing from 0.5% to 7.8%. Each arm (pre- and post-intervention) required 130 subjects to achieve 80% power with a significance of P = .05. No significant differences in demographics including age, insurance type, and cytology were noted. HPV co-testing increased from 0% to 55% (P cervical cancer screening for another 5 years. HPV co-testing represents an underutilized cervical cancer screening modality for women 30 years and older. This brief educational intervention, adaptable to any clinical setting, significatnly increased co-testing at the clinical site.

  14. Detection and Type-Distribution of Human Papillomavirus in Vulva and Vaginal Abnormal Cytology Lesions and Cancer Tissues from Thai Women.

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    Ngamkham, Jarunya; Boonmark, Krittika; Phansri, Thainsang

    2016-01-01

    Vulva and Vaginal cancers are rare among all gynecological cancers worldwide, including Thailand, and typically affect women in later life. Persistent high risk human papillomavirus (HR-HPV) infection is one of several important causes of cancer development. In this study, we focused on HPV investigation and specific type distribution from Thai women with abnormality lesions and cancers of the vulva and Vaginal. A total of ninety paraffin-embedded samples of vulva and Vaginal abnormalities and cancer cells with histologically confirmed were collected from Thai women, who were diagnosed in 2003-2012 at the National Cancer Institute, Thailand. HPV DNA was detected and genotyped using polymerase chain reaction and enzyme immunoassay with GP5+/ bio 6+ consensus specific primers and digoxigenin-labeled specific oligoprobes, respectively. The human β-globin gene was used as an internal control. Overall results represented that HPV frequency was 16/34 (47.1%) and 8/20 (40.0%) samples of vulva with cancer and abnormal cytology lesions, respectively, while, 3/5 (60%) and 16/33 (51.61%) samples of Vaginal cancer and abnormal cytology lesions, respectively, were HPV DNA positive. Single HPV type and multiple HPV type infection could be observed in both type of cancers and abnormal lesion samples in the different histological categorizes. HPV16 was the most frequent type in all cancers and abnormal cytology lesions, whereas HPV 18 was less frequent and could be detected as co-infection with other high risk HPV types. In addition, low risk types such as HPV 6, 11 and 70 could be detected in Vulva cancer and abnormal cytology lesion samples, whereas, all Vaginal cancer samples exhibited only high risk HPV types; HPV 16 and 31. In conclusion, from our results in this study we suggest that women with persistent high risk HPV type infection are at risk of developing vulva and Vaginal cancers and HPV 16 was observed at the highest frequent both of these, similar to the cervical

  15. Morphometric analysis of endometrial cells in liquid-based cervical cytology samples.

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    Gupta, P; Gupta, N; Dey, P

    2017-04-01

    Exfoliated endometrial cells can be seen in cervical smears in association with a wide variety of conditions ranging from normal proliferative endometrium to endometrial malignancies. It is often difficult to differentiate between benign, atypical and malignant endometrial cells using cytomorphology alone. This study was conducted to evaluate if morphometric analysis of endometrial nuclei on liquid-based cervical samples could be of help in differentiating between these endometrial cells. Three groups of cervical samples with histopathological correlation were selected: Group A: showing benign endometrial cells; Group B: showing atypical endometrial cells and Group C: showing malignant endometrial cells. There were 30 cases each in Group A and B and 39 cases in Group C. Image J, NIH, USA was used for selecting the endometrial nuclei and performing the morphometric measurements. MANOVA was used for statistical analysis. The mean nuclear area and nuclear perimeter were significantly different between the three groups of endometrial cells with a P-value liquid-based cervical cytology samples. © 2016 John Wiley & Sons Ltd.

  16. Study of a manual method of liquid-based cervical cytology

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    Kavatkar Anita

    2008-04-01

    Full Text Available We report a study of a manual liquid-based cytology (MLBC method. Slides are prepared by using a polymer solution and allowing it to dry, forming a membrane. The aims of the study were to prepare cervical cytology smears using the manual method, observe morphology, compare with direct scrape smears and correlate with histopathology wherever possible. Out of 105 cases, the membrane was intact, indicating a good MLBC preparation, in 97 cases. Simultaneous conventional smears were taken in 81 patients. There was an 88.8% agreement in the diagnoses of general category in both groups. The diagnosis of negative for intraepithelial lesion or malignancy (NILM in both groups was made in 70 cases. The MLBC preparation was unsatisfactory in two cases which showed high grade squamous intraepithelial lesion and low grade squamous intraepithelial lesion, respectively, on the conventional smear. One MLBC smear diagnosed as atypical squamous cells of undetermined significance was reported as NILM on conventional smear. Cytohistologic correlation was done in nine cases, all of which showed cervicitis on histopathology. The MLBC method was found to be comparable to the conventional scrape smear. Further study of this method as a cost-effective alternative to the mechanized methods would be worthwhile.

  17. A comparison of liquid-based cytology with conventional Papanicolaou smears in cervical dysplasia diagnosis

    Science.gov (United States)

    Haghighi, Fatemeh; Ghanbarzadeh, Nahid; Ataee, Marziee; Sharifzadeh, Gholamreza; Mojarrad, Javid Shahbazi; Najafi-Semnani, Fatemeh

    2016-01-01

    Background: Due to the high number of women affected by cervical cancer and the importance of an early diagnosis, combined with the frequent incidence of false-negative Papanicolaou (Pap) smear screening results for this disease, several studies have been conducted in recent years in order to find better tests. Liquid-based cytology (LBC) tests, including the liquid-based thin layer method, have demonstrated the highest potential for reducing false-negative cases and improved sample quality. This study aimed to compare the strength of the Pap smear test with fluid cytology and conventional tests in detecting cervical dysplasia. Materials and Methods: This descriptive-analytic study was conducted on 366 women who attended private laboratories for a Pap smear. The Pap smear sampling was conducted simultaneously using two methods: conventional Pap (CP) smear and LBC), from the cervix. Results: The mean age of the participants was 32 ± 8.8 years. Diagnostic results of endocervical cells, epithelial cells, vaginitis cells, and metaplastia were consistent with both conventional and liquid cytology smears, and the kappa coefficient was determined to be significant (P < 0.001). In total, 40.5% of diagnostic cases indicated bacterial inflammation 80.3% of the diagnoses in both methods were P1 and 3.9% of cases diagnosed were P2, the overall diagnostic consistency was 83.9% between the two sampling methods. The inflammation diagnosis was 40.5% and this was consistent in both methods of LBC and CP. There was one case of a false-negative diagnosis in the LBC method and 14 cases in the CP method. Conclusion: Results showed that the LBC may improve the sample's quality and reduce the number of unsatisfactory cases more than with the CP method. PMID:27995101

  18. A comparison of liquid-based cytology with conventional Papanicolaou smears in cervical dysplasia diagnosis.

    Science.gov (United States)

    Haghighi, Fatemeh; Ghanbarzadeh, Nahid; Ataee, Marziee; Sharifzadeh, Gholamreza; Mojarrad, Javid Shahbazi; Najafi-Semnani, Fatemeh

    2016-01-01

    Due to the high number of women affected by cervical cancer and the importance of an early diagnosis, combined with the frequent incidence of false-negative Papanicolaou (Pap) smear screening results for this disease, several studies have been conducted in recent years in order to find better tests. Liquid-based cytology (LBC) tests, including the liquid-based thin layer method, have demonstrated the highest potential for reducing false-negative cases and improved sample quality. This study aimed to compare the strength of the Pap smear test with fluid cytology and conventional tests in detecting cervical dysplasia. This descriptive-analytic study was conducted on 366 women who attended private laboratories for a Pap smear. The Pap smear sampling was conducted simultaneously using two methods: conventional Pap (CP) smear and LBC), from the cervix. The mean age of the participants was 32 ± 8.8 years. Diagnostic results of endocervical cells, epithelial cells, vaginitis cells, and metaplastia were consistent with both conventional and liquid cytology smears, and the kappa coefficient was determined to be significant (P < 0.001). In total, 40.5% of diagnostic cases indicated bacterial inflammation 80.3% of the diagnoses in both methods were P1 and 3.9% of cases diagnosed were P2, the overall diagnostic consistency was 83.9% between the two sampling methods. The inflammation diagnosis was 40.5% and this was consistent in both methods of LBC and CP. There was one case of a false-negative diagnosis in the LBC method and 14 cases in the CP method. Results showed that the LBC may improve the sample's quality and reduce the number of unsatisfactory cases more than with the CP method.

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

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    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.

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

    Science.gov (United States)

    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

  1. Meta-analysis of type-specific human papillomavirus prevalence in Iranian women with normal cytology, precancerous cervical lesions and invasive cervical cancer: Implications for screening and vaccination.

    Science.gov (United States)

    Jalilvand, Somayeh; Shoja, Zabihollah; Nourijelyani, Keramat; Tohidi, Hamid Reza; Hamkar, Rasool

    2015-02-01

    To predict the impact of current vaccines on cervical cancer and for the improvement of screening programs, regional data on distribution of human papillomavirus (HPV) types in women with or without cervical cancer is crucial. The present meta-analysis intend to comprehensively evaluate the HPV burden in women with invasive cervical cancer, high-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 2 and 3), low-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 1), atypical squamous cells of undetermined significance and normal cytology, as these data will help decision making in regards with screening programs and HPV vaccination in Iran. To determine the HPV prevalence and type distribution in Iranian women with or without cervical cancer, 20 published studies were included in this meta-analysis. In total, 713, 124, 104, 60, and 2577 women invasive cervical cancer, high-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 2 and 3), low-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 1), atypical squamous cells of undetermined significance and normal were reviewed, respectively. Overall HPV prevalence in women with invasive cervical cancer, high-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 2 and 3), low-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 1), atypical squamous cells of undetermined significance and normal cytology were 77.4%, 71.8%, 65.3%, 61.7%, and 8.4%, respectively. The six most common types were HPV 16, 18, 6/11, 31, and 33; among them HPV 16 was the most frequent type in all five different groups. According to this study, it was estimated that HPV vaccines could have a great impact on prevention of cervical cancer in Iran. In conclusion, this meta-analysis highlights the necessity of introducing vaccination program in Iran.

  2. A spectral phenotype of oncogenic human papillomavirus-infected exfoliative cervical cytology distinguishes women based on age.

    Science.gov (United States)

    Kelly, Jemma G; Cheung, Karen T; Martin, Cara; O'Leary, John J; Prendiville, Walter; Martin-Hirsch, Pierre L; Martin, Francis L

    2010-08-05

    Human papillomavirus (HPV) is a sexually-transmitted infection associated with cervical cancer. Of over 100 HPV types identified, 13 are high-risk oncogenic. In unvaccinated women worldwide, the incidence of cervical cancer from HPV16 and HPV18 will remain. Cervical cytology can be graded from normal (atypia-free) to low-grade to high-grade. Infrared (IR) spectroscopy is a non-destructive technique that allows the acquisition of a biochemical-cell fingerprint based on vibrational states of chemical bonds. Exfoliative cervical cytology specimens (n=147) were retrieved, graded by a cytologist and HPV-tested/genotyped using hybrid capture 2 and the Roche HPV Linear Array. Additionally, the spectral signatures of cervical cell lines C33A, HeLa and SiHa were examined. After washing, cellular material was transferred to low-E glass slides and interrogated using attenuated total reflection Fourier-transform IR (ATR-FTIR) spectroscopy. Given the complex nature of the dataset consisting of thousands of variables (wavenumbers), we used multivariate analysis for data reduction and information retrieval. Principal component analysis coupled with linear discriminant analysis (PCA-LDA) generated a visual representation of the data (scores plot) and, identification of the wavenumbers and consequent biochemical entities responsible for segregation (loadings plot). Immortalised cell lines were readily distinguishable from each other. It was difficult to segregate categories of cytology associated with HPV infection types. However, in low-grade cytology infected with high-risk oncogenic HPV16 or HPV18, it was possible to segregate women based on whether they were aged 20-29years vs. 30-39years. Our findings suggest a spectral phenotype in exfoliative cervical cytology associated with transient vs. persistent HPV infection. Copyright 2010 Elsevier B.V. All rights reserved.

  3. Prevalence of high-risk human papilloma virus types and cervical smear abnormalities in female sex workers in Chandigarh, India

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    M P Singh

    2016-01-01

    Full Text Available Purpose: Cervical cancer is the most common cancer among women in developing nations. Nearly 90% of the cases have been linked to the presence of high-risk human papillomavirus (hrHPV types 16 and 18. The risk of cervical cancer may be high in female sex workers (FSWs due to multiple sexual partners. This study aimed to determine the prevalence of cytological abnormalities and hrHPV types 16 and 18 in FSWs in Chandigarh, North India using the liquid-based cytology (LBC approach. Materials and Methods: The cervical brush samples were collected from 120 FSW and 98 age-matched healthy controls (HCs. These were subjected to pap smear using conventional method, LBC and the detection of hrHPV types 16 and 18 was carried out using polymerase chain reaction. Results: The LBC samples showed better cytological details and also reduced the number of unsatisfactory smears from 11% in Pap to 1.5% in the LBC. A significantly higher number of inflammatory smears were reported in FSWs (51.7% vs. 34.7%, P = 0.01. The hrHPV types 16/18 were detected in 33/120 (27.5% FSW versus 23/98 (23.5% HCs. The risk of acquiring hrHPV was higher in FSWs, who had age at first sex ≤25 years, higher income and the habit of smoking. Conclusion: The high prevalence of hrHPV among FSWs and HCs suggests the need for the implementation of effective National Screening Programme for early detection of hrHPV types to decrease the burden of cervical cancer, especially in high-risk population.

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

    Science.gov (United States)

    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 were collected for examining cytology and HPV genotypes. Results Ninety-five eligible participants with complete questionnaire and laboratory data were included in the analyses. Thirty six of them (37.9%) showed abnormal anal cytology as follows: atypical squamous cells of undetermined significance (ASC-US) in 19 (20.0%), atypical squamous cells but cannot exclude HSIL (ASC-H) in 1 (1.1%), low-grade squamous intraepithelial lesion (LSIL) in 15 (15.8%), and high-grade squamous intraepithelial lesion (HSIL) in 1 (1.1%). HPV6 (20.0%), HPV16 (10.9%), HPV56 (10.9%), HPV52 (9.1%) and HPV39 (9.1%) were observed most frequently among those with normal anal cytology, while different distribution was found in the ones with abnormal anal cytology as HPV6 (19.4%), HPV16 (19.4%), HPV45 (16.7%), HPV52 (16.7%) and HPV18 (11.1%). In addition, HPV16, HPV45, HPV52 and HPV18 were the most frequent high-risk types in patients with abnormal anal cytology. HPV multiplicity was found to be significantly related to the prevalence of abnormal anal cytology (p for trend = 0.04). Conclusions High prevalence of HPV infection and abnormal anal cytology was observed among HIV-infected MSM in China. Infection of multiple HPV types or high-risk types was found to be associated with an increased risk of abnormal anal cytology. PMID:22558293

  5. Comparative accuracy of anal and cervical cytology in screening for moderate to severe dysplasia by magnification guided punch biopsy: a meta-analysis.

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    Wm Christopher Mathews

    Full Text Available BACKGROUND: The accuracy of screening for anal cancer precursors relative to screening for cervical cancer precursors has not been systematically examined. The aim of the current meta-analysis was to compare the relative accuracy of anal cytology to cervical cytology in discriminating between histopathologic high grade and lesser grades of dysplasia when the reference standard biopsy is obtained using colposcope magnification. METHODS AND FINDINGS: The outcome metric of discrimination was the receiver operating characteristic (ROC curve area. Random effects meta-analysis of eligible studies was performed with examination of sources of heterogeneity that included QUADAS criteria and selected covariates, in meta-regression models. Thirty three cervical and eleven anal screening studies were found to be eligible. The primary meta-analytic comparison suggested that anal cytologic screening is somewhat less discriminating than cervical cytologic screening (ROC area [95% confidence interval (C.I.]: 0.834 [0.809-0.859] vs. 0.700 [0.664-0.735] for cervical and anal screening, respectively. This finding was robust when examined in meta-regression models of covariates differentially distributed by screening setting (anal, cervical. CONCLUSIONS: Anal cytologic screening is somewhat less discriminating than cervical cytologic screening. Heterogeneity of estimates within each screening setting suggests that other factors influence estimates of screening accuracy. Among these are sampling and interpretation errors involving both cytology and biopsy as well as operator skill and experience.

  6. Cervical cancer in women under 25 years of age in Queensland, Australia: To what extent is the diagnosis made by screening cytology?

    Science.gov (United States)

    Morgan, Edwina L; Sanday, Karen; Budd, Alison; Hammond, Ian G; Nicklin, James

    2017-08-01

    The current Australian National Cervical Screening Program (NCSP) involves biennial, cytology-based screening of women from the age of 18 years. From December, 2017 this will change to a five-yearly human papilloma virus-based screening commencing at age 25. There is some concern that the new program may delay the opportunistic detection of cervical cancers in women under 25 years. (1) To review all cases of invasive cervical cancer in Queensland women under the age of 25 over the last 28 years. (2) To determine symptoms and screening history prior to diagnosis. A retrospective cohort study was undertaken at the Queensland Centre for Gynaecological Cancer (QCGC) and the Queensland Cancer Registry (QCR) of all women aged between 13 and 25 years diagnosed with cervical cancer in Queensland between 1984 and 2012. Demographic data and symptoms prior to diagnosis were extracted from the QCGC and QCR databases. A total of 56 women aged 13-25, were diagnosed with cervical cancer and treated at the QCGC between 1984 and 2012. The commonest reason for the diagnosis of cancer was investigation of abnormal symptoms (n = 22, 39%) rather than routine Pap smear abnormalities (n = 15, 26%). Consistent with the world literature, there is a very low incidence of cervical cancer in women under 25 years of age, irrespective of the age of commencement of screening, or the screening interval. Our study lends some support to the proposed commencement age of 25 years in the new NCSP. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  7. Utilisation of co-testing 
(human papillomavirus DNA testing and cervical cytology) after treatment of CIN: - a survey of GPs' awareness and knowledge.

    Science.gov (United States)

    Munro, Aime; Codde, Jim; Semmens, James; Leung, Yee; Spilsbury, Katrina; Williams, Vincent; Steel, Nerida; Cohen, Paul; Pavicic, Heidi; Westoby, Vicki; O'Leary, Peter

    2015-01-01

    Patients have an increased risk of persistent/recurrent cervical disease if they received treatment for a high-grade squamous intraepithelial lesion (HSIL). Consequently, understanding whether co-testing (human papillomavirus [HPV] DNA testing and cervical cytology) is fully utilised by general practitioners (GPs) is paramount. After consultation with key stakeholders, an anonymous, self-completion questionnaire was developed and disseminated to GPs who had provided cervical cytology. Responses were received from 745 GPs (30.9% response rate). A significant number (34.3%) of GPs were unaware of the use of co-testing (HPV DNA testing and cervical cytology) for the management of patients after HSIL treatment. Additionally, the majority of GPs reported they did not 'always' receive a clear follow-up plan for patients after treatment of an HSIL. GPs require further support and education to ensure successful adoption of co-testing (HPV DNA testing and cervical cytology), specifically, for patients treated for an HSIL.

  8. 围绝经期宫颈病变所致阴道流血%Perimenopausal abnormal vaginal bleeding caused by cervical lesions

    Institute of Scientific and Technical Information of China (English)

    王登凤; 张国楠

    2012-01-01

    围绝经期妇女中,不规则阴道流血是一个最常见、也是最易被忽视的症状,宫颈病变是其主要原因之一,主要包括了宫颈炎、宫颈炎症相关疾病、宫颈上皮内瘤变、宫颈癌、宫颈肌瘤、宫颈结核、宫颈妊娠等,可以通过妇科查体、宫颈脱落细胞学检查、宫颈活检等简单手段在短时间内得到确诊.%For perimenopausal women, abnormal vaginal bleeding is the most common symptom, which is also the most neglected one. In various causes, cervical lesion is the one which can be diagnosed by some simple methods, e. g. gynecological examination , cervical cytology, and cervical biopsy. Cervical lesions in this review include: cervicitis, cervicitis related disease, cervical intraepithelial neoplasia, cervical cancer, cervical myoma, tuberculosis of cervix, cervical pregnancy, etc.

  9. The psychosocial impact of an abnormal cervical smear result.

    Science.gov (United States)

    Drolet, Mélanie; Brisson, Marc; Maunsell, Elizabeth; Franco, Eduardo L; Coutlée, François; Ferenczy, Alex; Fisher, William; Mansi, James A

    2012-10-01

    Data on the impact of abnormal cervical smear results on health-related quality of life (HrQoL) are scarce. We aimed to (i) prospectively assess the HrQoL of women who were informed of an abnormal smear result; (ii) identify predictors of greater negative psychosocial impact of an abnormal result; and (iii) prospectively estimate the quality-adjusted life-years (QALYs) lost following an abnormal result. Between 08/2006 and 08/2008, 492 women with an abnormal result and 460 women with a normal result, frequency matched for age and clinic, were recruited across Canada. HrQoL was measured at recruitment and 4 and 12 weeks later with the EuroQol, Short Form-12, short Spielberg State-Trait Anxiety Inventory (STAI) and HPV Impact Profile. Three blocks of potential predictors of higher psychosocial impact were tested by hierarchical modeling: (i) socio-demographics; (ii) sexual activity; and (iii) smear result severity, communication, and understanding. Receiving an abnormal result significantly increased anxiety (STAI mean difference between both groups = 8.3). Initial anxiety decreased over time for the majority of women. However, 35% of women had clinically meaningful anxiety at 12 weeks (i.e. STAI scores ≥0.5 standard deviation of the controls). These women reported a lower socio-economic level, did not completely understand the information about their result and perceived themselves at higher risk of cancer. QALY lost following an abnormal result were between 0.007 and 0.009. Receiving an abnormal smear has a statistically significant and clinically meaningful negative impact on mental health. However, this negative impact subsides after 12 weeks for the majority of women. Copyright © 2011 John Wiley & Sons, Ltd.

  10. Synchronous high-grade squamous intraepithelial lesion and adenocarcinoma in situ of cervix in a young woman presenting with hyperchromatic crowded groups in the cervical cytology specimen: report of a case.

    Science.gov (United States)

    Zafar, Nadeem; Balazs, Louisa; Benstein, Barbara D

    2008-11-01

    We report a 29-year-old woman who underwent routine gynecologic evaluation at a community clinic and had a cervical sample drawn for liquid-based cytologic evaluation. At cytology, many hyperchromatic crowded groups (HCG) were present, but a consensus could not be established whether the abnormal cells were primarily glandular or squamous with secondary endocervical glandular involvement. An interpretation of atypical endocervical cells, favor neoplastic, was rendered and biopsy advised if clinically appropriate. At biopsy, the cervix contained synchronous squamous cell carcinoma in situ, secondarily involving endocervical glands, and neighboring adenocarcinoma in situ. Immunohistochemistry for Ki-67 and p16(INK4A) crisply and precisely stained both the lesions, clearly separating them from the adjacent uninvolved mucosa. This case re-emphasizes the challenge associated with accurate evaluation of HCG at cytology, the significance of ancillary testing for surrogate markers of high-risk HPV (HR-HPV) infection, the need for adjunct testing for HPV-DNA in the setting of HCG at cervical cytology, and a recommendation to set up studies to evaluate the role of surrogate markers of HR-HPV infection in cytologic samples with HCG.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  12. 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

    Directory of Open Access Journals (Sweden)

    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

  13. Value of P16 expression in the triage of liquid-based cervical cytology with atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesions

    Institute of Scientific and Technical Information of China (English)

    MA Yuan-ying; CHENG Xiao-dong; ZHOU Cai-yun; QIU Li-qian; CHEN Xiao-duan; L(U) Wei-guo; XIE Xing

    2011-01-01

    Background The management of atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesions (ASCUS/LSIL) is still controversial and it is advisable to make a triage for these two cytological abnormalities. P16INK4 (P16)has been shown to be a potential biomarker for predicting high-grade cervical intraepithelial neoplasia (CIN) and cervical cancer. The aim of the study was to determine the value of P16 expression by immunostaining method compared with high-risk human papillomavirus (HR-HPV) DNA test in the triage of ASCUS/LSIL women.Methods Totally 86 eligible residual liquid-based cytological specimens with ASCUS and 45 with LSIL were obtained.All specimens were submitted to HR-HPV DNA test (HC2) and P16 immunocytochemical staining simultaneously. And all women underwent colposcopy and biopsy after cytology.Results The positive rate of P16 staining was 32.6% in ASCUS and 42.2% in LSIL, which was significantly lower than that of HR-HPV test in both ASCUS (P<0.05) and LSIL (P<0.05). Moreover, the positive rate of P16 staining was 12.7% in normal histology, 61.5% in CIN 1, 87.0% in CIN 2-3, and 100.0% in cancer, in which P16 positive rate was significantly lower than HR-HPV positive rate in normal group. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of P16 staining for predicting ClN 2 or more were 87.5%, 68.6%, 38.9%, 96.0%, and 72.1%, respectively in the ASCUS; while 90.0%, 71.4%, 47.4%, 96.2% and 54.7%, respectively in the LSIL, in which the specificity and accuracy of P16 staining were significantly higher than those of HR-HPV test in both ASCUS and LSIL (P<0.05).Conclusion P16 immunostaining had significantly higher specificity and accuracy than HR-HPV DNA test for predicting for high-grade CIN and cervical cancer in ASCUS and LSlL and can be used for the tdage of women with ASCUS/LSlL cytological abnormality.

  14. Cost is a Barrier to Widespread Use of Liquid-Based Cytology for Cervical Cancer Screening in Korea

    Science.gov (United States)

    Chung, Hyun Hoon; Kang, Soon-Beom

    2006-01-01

    This study aimed to document current cervical cancer screening practices of physicians in Korea. Questionnaires were distributed to 852 Korean obstetricians and gynecologists, who attended the 91st Conference of the Korean Society of Obstetrics and Gynecology held during May, 2005. Questionnaires were returned by 30.6% (260/852) of the recipients and 254 of these were eligible for analysis. Sixty-seven percent started cervical cancer screening women at age 20, and 65% replied that they would continue annual screening in a 35-yr-old woman with three consecutive normal cytologic tests. Over 65% of respondents preferred conventional cytologic screening to liquid-based cytology. The cost was a major determinant for selecting screening method. Fifty-three percent used the human papillomavirus DNA test as a triage for atypical squamous cells of undetermined significance. Our findings suggest that majority of Korean obstetricians and gynecologists in hospital prefer annual conventional cytologic testing to liquid-based cytology for financial reason. PMID:17179686

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    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...

  16. Evaluation of a novel real-time fluorescent polymerase chain reaction assay for high-risk human papilloma virus DNA genotypes in cytological cervical screening.

    Science.gov (United States)

    Cheng, Jiaoying; Bian, Meilu; Cong, Xiao; Sun, Aiping; Li, Min; Ma, Li; Chen, Ying; Liu, Jun

    2013-03-01

    It has been confirmed that detection of high-risk human papillomavirus (HR HPV) DNA is useful in cervical cancer (CC) screening. Recently, a new real-time fluorescent polymerase chain reaction (PCR) assay was developed to detect HR HPV. This assay can synchronize nucleic acid amplification and testing using specific primers for 13 types of HR HPV genomes, combined with specific TaqMan fluorescent marker probe techniques through the fluorescence automatic PCR instrument. Furthermore, it uses TaqGold™ DNA polymerase, which minimizes the amount of non-specific amplification and increases the sensitivity of the assay. The aim of this study was to evaluate the analytical and clinical performance of the real-time fluorescent PCR assay in CC screening, compared to the Qiagen Hybrid Capture(®) II High-Risk HPV DNA test(®) (HC II). In total, 1,252 cervical specimens were collected from women between 19 and 71 years of age. The specimens were examined with three different assays, real-time fluorescent PCR assay and HC II for HR HPV detection combined with liquid-based cytology. Women with cytological abnormalities or HR HPV-positive results underwent colposcopy and cervical biopsy. This study demonstrated good overall agreement between HC II and real-time fluorescent PCR assay (overall agreement, 92.25%; Cohen's κ=0.814). For the detection of high-grade cervical intraepithelial neoplasias (CIN) and CC, the sensitivity of HC II and real-time fluorescent PCR was 94.48 and 92.82%, respectively, and the negative predictive value was 98.85 and 98.54%, respectively. High HR HPV infection rate of the high-grade CIN and CC group was detected (PHPV detection and could be used in CC screening in clinic.

  17. Interobserver reproducibility and accuracy of p16/Ki-67 dual-stain cytology in cervical cancer screening.

    Science.gov (United States)

    Wentzensen, Nicolas; Fetterman, Barbara; Tokugawa, Diane; Schiffman, Mark; Castle, Philip E; Wood, Shannon N; Stiemerling, Eric; Poitras, Nancy; Lorey, Thomas; Kinney, Walter

    2014-12-01

    Dual-stain cytology for p16 and Ki-67 has been proposed as a biomarker in cervical cancer screening. The authors evaluated the reproducibility and accuracy of dual-stain cytology among 10 newly trained evaluators. In total, 480 p16/Ki-67-stained slides from human papillomavirus-positive women were evaluated in masked fashion by 10 evaluators. None of the evaluators had previous experience with p16 or p16/Ki-67 cytology. All participants underwent p16/Ki-67 training and subsequent proficiency testing. Reproducibility of dual-stain cytology was measured using the percentage agreement, individual and aggregate κ values, as well as McNemar statistics. Clinical performance for the detection of cervical intraepithelial neoplasia grade 2 or greater (CIN2+) was evaluated for each individual evaluator and for all evaluators combined compared with the reference evaluation by a cytotechnologist who had extensive experience with dual-stain cytology. The percentage agreement of individual evaluators with the reference evaluation ranged from 83% to 91%, and the κ values ranged from 0.65 to 0.81. The combined κ value was 0.71 for all evaluators and 0.73 for cytotechnologists. The average sensitivity and specificity for the detection of CIN2+ among novice evaluators was 82% and 64%, respectively; whereas the reference evaluation had 84% sensitivity and 63% specificity, respectively. Agreement on dual-stain positivity increased with greater numbers of p16/Ki-67-positive cells on the slides. Good to excellent reproducibility of p16/Ki-67 dual-stain cytology was observed with almost identical clinical performance of novice evaluators compared with reference evaluations. The current findings suggest that p16/Ki-67 dual-stain evaluation can be implemented in routine cytology practice with limited training. © 2014 American Cancer Society.

  18. Diagnostic accuracy of fine needle aspiration cytology in providing a diagnosis of cervical lymphadenopathy among HIV-infected patients.

    Science.gov (United States)

    Muyanja, David; Kalyesubula, Robert; Namukwaya, Elizabeth; Othieno, Emmanuel; Mayanja-Kizza, Harriet

    2015-03-01

    Opportunistic infections and malignancies cause lymphadenopathy in HIV-infected patients. The use and accuracy of fine needle aspiration cytology in diagnosing of cervical lymphadenopathy among HIV-infected patients is not well studied in Uganda. The aim of this study was to determine the diagnostic accuracy of fine needle aspiration cytology in providing a diagnosis of cervical lymphadenopathy among HIV-infected patients in Uganda. We consecutively recruited adult HIV-infected patients with cervical lymphadenopathy admitted to Mulago Hospital medical wards. Clinical examination, fine needle aspiration and lymph node biopsy were performed. We estimated the sensitivity, specificity; negative and positive predictive values using histology as the gold standard. We enrolled 108 patients with a mean age of 33 years (range, 18-60), 59% were men and mean CD4 was 83(range, 22-375) cells/mm(3). The major causes of cervical lymphadenopathy were: tuberculosis (69.4%), Kaposi's sarcoma-KS (10.2%) and reactive adenitis (7.4%). Overall fine needle aspiration cytology accurately predicted the histological findings in 65 out of 73 cases (89%) and missed 7 cases (9.5%). With a sensitivity of 93.1%, specificity of 100%, positive predictive value of 100% and negative predictive value of 78.7% for tuberculosis and 80%; 98.4%;88.9% and 98.9% for KS respectively. No fine needle aspiration complications were noted. Fine needle aspiration cytology is safe and accurate in the diagnosis of tuberculosis and KS cervical lymphadenopathy among HIV-positive patients.

  19. Accuracy of a low priced liquid-based method for cervical cytology in 632 women referred for colposcopy after a positive Pap smear.

    Science.gov (United States)

    van Hemel, B M; Buikema, H J; Groen, H; Suurmeijer, A J H

    2009-08-01

    The aim of this quality controlling study was to determine the accuracy of liquid-based cytology (LBC) with the Turbitec cytocentrifuge technique. Cervical smears of 632 women, who were referred to our CIN outpatient department, after at least two smears with ASCUS or higher were evaluated and compared with the histological outcome. In 592 cases the smears revealed abnormalities of squamous epithelium, and in 40 cases the abnormalities of glandular epithelium. In the group of squamous epithelium abnormalities, the sensitivity for LSIL was 39.7% and the specificity was 89.2%; for the LSIL+ group, these values were 89.4% and 91.4%, respectively. For HSIL the sensitivity was 68.3% and the specificity 92.8%, for the HSIL+ group 82.3% and 92.3%, respectively. The ASCUS rate was low (2.4%). The Turbitec cytocentrifuge method was proved to be a very good LBC method for cervical smears. Because of a comparable accuracy together with a lower price, this LBC method outweighs commercial alternatives.

  20. Prevalence of human papilloma virus in cytological abnormalities: Association of risk factors and cytomorphological findings

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    Christo D Izaaks

    2012-01-01

    Full Text Available Background: Previous studies demonstrated the etiological role of human papilloma virus (HPV in cervical carcinogenesis. Assessing the distribution of HPV may elucidate these observations. Materials and Methods: In total, we examined 3839 specimens, of which 187 abnormally classified cervical smears were immunostained using the p16 INK4A assay. DNA was extracted from 182 specimens, and polymerase chain reaction (PCR was performed. Participants′ socio-demographics, sexual and reproductive history, HIV status, contraceptive use, and Pap smear history were recorded. Results: Subject ages, number of sexual partners, and age at first sexual encounter ranged from 15 to 49 years, from 1 to 37 partners, and from 13 to 34 years, respectively. P16 immunoreactivity was detected in 60.4% of cases. The distribution of epithelial lesions and P16 overexpression (bracketed was: 28 (5 atypical squamous cells of undetermined significance (ASC-US, 96 (50 lower grade squamous intraepithelial lesion (LSIL, 9 (7 atypical squamous cells-cannot exclude HSIL (ASC-H, and 54 (51 higher grade squamous intraepithelial lesion (HSIL. Ninety-four percent of HSIL expressed P16. Fifty-two percent of LSIL expressed P16. P16 expression declined from 61% (25-34 year age group to 5% (45-49 year age group for different age groups. HPV-DNA by PCR was detected in 94.5% of P16-positive samples. Type-specific PCR (HPV 16 and 18 was found in 12.2% and 14.5% of abnormal lesions, respectively. Younger age at first sexual encounter and HIV infection predominated in HPV type(s 16 and/or 18 positive subjects. Conclusion: This study reinforced the value of the p16 INK4A surrogate marker in identifying women with progressive cervical disease.

  1. Decreasing cervical cancer mortality in Mexico: effect of Papanicolaou coverage, birthrate, and the importance of diagnostic validity of cytology.

    Science.gov (United States)

    Lazcano-Ponce, Eduardo; Palacio-Mejia, Lina Sofía; Allen-Leigh, Betania; Yunes-Diaz, Elsa; Alonso, Patricia; Schiavon, Raffaela; Hernandez-Avila, Mauricio

    2008-10-01

    The reduction in cervical cancer mortality in developed countries has been attributed to well-organized, population-based prevention and control programs that incorporate screening with the Papanicolaou (Pap) smear. In Mexico, there has been a decrease in cervical cancer mortality, but it is unclear what factors have prompted this reduction. Using data from national indicators, we determined the correlation between cervical cancer mortality rates and Pap coverage, birthrate, and gross national product, using a linear regression model. We determined relative risk of dying of cervical cancer according to place of residence (rural/urban, region) using a Poisson model. We also estimated Pap smear coverage using national survey data and evaluated the validity and reproducibility of Pap smear diagnosis. An increase in Pap coverage (beta= -0.069) and a decrease in birthrate (beta=0.054) correlate with decreasing cervical cancer mortality in Mexico. Self-reported Pap smear rates in the last 12 months vary from 27.4% to 48.1%. Women who live in the central (relative risk, 1.04) and especially the southern (relative risk, 1.47) parts of Mexico have a greater relative risk of dying of cervical cancer than those who live in the north. There is a high incidence of false negatives in cervical cytology laboratories in Mexico; the percentage of false negatives varies from 3.33% to 53.13%. The decrease in cervical cancer mortality observed in Mexico is proportional to increasing Pap coverage and decreasing birthrate. Accreditation of cervical cytology laboratories is needed to improve diagnostic precision.

  2. The population impact of human papillomavirus/cytology cervical cotesting at 3-year intervals: Reduced cervical cancer risk and decreased yield of precancer per screen.

    Science.gov (United States)

    Silver, Michelle I; Schiffman, Mark; Fetterman, Barbara; Poitras, Nancy E; Gage, Julia C; Wentzensen, Nicolas; Lorey, Thomas; Kinney, Walter K; Castle, Philip E

    2016-12-01

    The objective of cervical screening is to detect and treat precancer to prevent cervical cancer mortality and morbidity while minimizing overtreatment of benign human papillomavirus (HPV) infections and related minor abnormalities. HPV/cytology cotesting at extended 5-year intervals currently is a recommended screening strategy in the United States, but the interval extension is controversial. In the current study, the authors examined the impact of a decade of an alternative, 3-year cotesting, on rates of precancer and cancer at Kaiser Permanente Northern California. The effect on screening efficiency, defined as numbers of cotests/colposcopy visits needed to detect a precancer, also was considered. Two cohorts were defined. The "open cohort" included all women screened at least once during the study period; > 1 million cotests were performed. In a fixed "long-term screening cohort," the authors considered the cumulative impact of repeated screening at 3-year intervals by restricting the cohort to women first cotested in 2003 through 2004 (ie, no women entering screening later were added to this group). Detection of cervical intraepithelial neoplasia 3/adenocarcinoma in situ (CIN3/AIS) increased in the open cohort (2004-2006: 82.0/100,000 women screened; 2007-2009: 140.6/100,000 women screened; and 2010-2012: 126.0/100,000 women screened); cancer diagnoses were unchanged. In the long-term screening cohort, the detection of CIN3/AIS increased and then decreased to the original level (2004-2006: 80.5/100,000 women screened; 2007-2009: 118.6/100,000 women screened; and 2010-2012: 84.9./100,000 women screened). The number of cancer diagnoses was found to decrease. When viewed in terms of screening efficiency, the number of colposcopies performed to detect a single case of CIN3/AIS increased in the cohort with repeat screening. Repeated cotesting at a 3-year interval eventually lowers population rates of precancer and cancer. However, a greater number of

  3. Direct sampling of metastatic ovarian carcinoma masquerading as endocervical adenocarcinoma in liquid-based cytology cervical sample

    Science.gov (United States)

    Gupta, Nalini; Bhar, Vikrant; Dey, Pranab; Rajwanshi, Arvind; Suri, Vanita

    2014-01-01

    Cervical sample is routinely taken to identify squamous dysplastic lesions of the cervix. Glandular lesions are far less commonly reported on cervical samples. The most common glandular lesion reported on cervical smear is endocervical adenocarcinoma, followed by endometrial adenocarcinoma. Direct sampling by Cervex brush is possible even in endometrial adenocarcinoma, if the tumor directly involves lower uterine segment/endocervical canal. Metastases to cervix are rare but have occasionally been reported in previous reports. We wish to highlight in this case, metastatic ovarian carcinoma directly sampled in cervical liquid-based cytology (LBC) sample, which mimicked cytomorphologically a well-differentiated endocervical adenocarcinoma. To the best of our knowledge, a similar case has not been previously published in SurePath LBC sample. PMID:25538388

  4. A systematic review of p16/Ki-67 immuno-testing for triage of low grade cervical cytology.

    Science.gov (United States)

    Kisser, A; Zechmeister-Koss, I

    2015-01-01

    Screening for cervical cancer precursors by Papanicolaou cytology is a public health success story; however, its low sensitivity entails unnecessary referrals to colposcopy of healthy women with equivocal (ASCUS) or mild dysplasia (LSIL) cytology. We assessed the accuracy of p16/Ki-67 immuno-testing for triage of low grade cervical cytology. We systematically searched Medline, Embase, CRD and Cochrane databases, and handsearched key references. Eligible studies included women with ASCUS or LSIL cervical cytology who had undergone p16/Ki-67 testing and subsequent verification by colposcopy-directed biopsies and histologic analysis. We extracted data on patient characteristics and test conduct, diagnostic accuracy measures and assessed the methodological quality of the studies. R software was used to perform a bivariate analysis of test performance data. Five eligible studies were identified. Four of the studies had high risk of bias. In the LSIL subgroup, the sensitivity of p16/Ki-67 testing ranged from 0.86 to 0.98, compared with 0.92-0.96 of high-risk HPV testing (hrHPV); specificity ranged from 0.43 to 0.68 versus 0.19 to 0.37, respectively. In the ASCUS subgroup, sensitivity ranged from 0.64 to 0.92 (p16/Ki67 test) versus 0.91 to 0.97 (hrHPV); specificity ranged from 0.53 to 0.81 versus 0.26 to 0.44, respectively. p16/Ki-67 testing cannot be recommended for triage women with ASCUS or LSIL cytology due to insufficient high-quality evidence. Further studies on test performance and the impact of p16/Ki-67-based triage on health outcomes are needed for a definitive evaluation of its clinical utility. © 2014 Royal College of Obstetricians and Gynaecologists.

  5. Accuracy of reading liquid based cytology slides using the ThinPrep Imager compared with conventional cytology: prospective study

    Science.gov (United States)

    d'Assuncao, Jefferson; Irwig, Les; Macaskill, Petra; Chan, Siew F; Richards, Adele; Farnsworth, Annabelle

    2007-01-01

    Objective To compare the accuracy of liquid based cytology using the computerised ThinPrep Imager with that of manually read conventional cytology. Design Prospective study. Setting Pathology laboratory in Sydney, Australia. Participants 55 164 split sample pairs (liquid based sample collected after conventional sample from one collection) from consecutive samples of women choosing both types of cytology and whose specimens were examined between August 2004 and June 2005. Main outcome measures Primary outcome was accuracy of slides for detecting squamous lesions. Secondary outcomes were rate of unsatisfactory slides, distribution of squamous cytological classifications, and accuracy of detecting glandular lesions. Results Fewer unsatisfactory slides were found for imager read cytology than for conventional cytology (1.8% v 3.1%; Pcytology (7.4% v 6.0% overall and 2.8% v 2.2% for cervical intraepithelial neoplasia of grade 1 or higher). Among 550 patients in whom imager read cytology was cervical intraepithelial neoplasia grade 1 or higher and conventional cytology was less severe than grade 1, 133 of 380 biopsy samples taken were high grade histology. Among 294 patients in whom imager read cytology was less severe than cervical intraepithelial neoplasia grade 1 and conventional cytology was grade 1 or higher, 62 of 210 biopsy samples taken were high grade histology. Imager read cytology therefore detected 71 more cases of high grade histology than did conventional cytology, resulting from 170 more biopsies. Similar results were found when one pathologist reread the slides, masked to cytology results. Conclusion The ThinPrep Imager detects 1.29 more cases of histological high grade squamous disease per 1000 women screened than conventional cytology, with cervical intraepithelial neoplasia grade 1 as the threshold for referral to colposcopy. More imager read slides than conventional slides were satisfactory for examination and more contained low grade cytological

  6. p16/Ki-67 Dual Stain Cytology for Detection of Cervical Precancer in HPV-Positive Women

    Science.gov (United States)

    Fetterman, Barbara; Castle, Philip E.; Schiffman, Mark; Wood, Shannon N.; Stiemerling, Eric; Tokugawa, Diane; Bodelon, Clara; Poitras, Nancy; Lorey, Thomas; Kinney, Walter

    2015-01-01

    Background: Human papillomavirus (HPV)–based cervical cancer screening requires triage markers to decide who should be referred to colposcopy. p16/Ki-67 dual stain cytology has been proposed as a biomarker for cervical precancers. We evaluated the dual stain in a large population of HPV-positive women. Methods: One thousand five hundred and nine HPV-positive women screened with HPV/cytology cotesting at Kaiser Permanente California were enrolled into a prospective observational study in 2012. Dual stain cytology was performed on residual Surepath material, and slides were evaluated for dual stain–positive cells. Disease endpoints were ascertained from the clinical database at KPNC. We evaluated the clinical performance of the assay among all HPV-positive women and among HPV-positive, cytology-negative women. We used internal benchmarks for clinical management to evaluate the clinical relevance of the dual stain assay. We evaluated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the dual stain compared with Pap cytology. All statistical tests were two-sided. Results: The dual stain had lower positivity (45.9%) compared with cytology at an ASC-US threshold (53.4%). For detection of CIN2+, the dual stain had similar sensitivity (83.4% vs 76.6%, P = .1), and statistically higher specificity (58.9% vs 49.6%, P < .001), PPV (21.0% vs 16.6%, P < .001), and NPV (96.4% vs 94.2%, P = .01) compared with cytology. Similar patterns were observed for CIN3+. Women with a positive test had high enough risk for referral to colposcopy, while the risk for women with negative tests was below a one-year return threshold based on current US management guidelines. Conclusion: Dual stain cytology showed good risk stratification for all HPV-positive women and for HPV-positive women with normal cytology. Additional follow-up is needed to determine how long dual stain negative women remain at low risk of precancer. PMID:26376685

  7. Second edition of 'The Bethesda System for reporting cervical cytology' – atlas, website, and Bethesda interobserver reproducibility project

    Directory of Open Access Journals (Sweden)

    Nayar Ritu

    2004-10-01

    Full Text Available Abstract A joint task force of the American Society of Cytopathology (ASC and the National Cancer Institute (NCI recently completed a 2-year effort to revise the Bethesda System "blue book" atlas and develop a complementary web-based collection of cervical cytology images. The web-based collection of images is housed on the ASC website, which went live on November 5th, 2003; it can be directly accessed at http://www.cytopathology.org/NIH/.

  8. Liquid based cytology improves the positive predictive value of glandular smears compared to conventional cytology.

    Science.gov (United States)

    Edmondson, R J; Errington, C A; Mansour, D J A

    2010-01-01

    To investigate whether the introduction of liquid-based cytology (LBC) in an urban setting decreases the diagnosis of glandular neoplasia (grade 6) and improves the positive predictive value (PPV) of cervical cytological screening. A retrospective database review was conducted identifying women with cervical cytological abnormalities including glandular neoplasia (grade 6) before and after the introduction of LBC. Following the introduction of LBC the rate of glandular neoplasia (grade 6) referrals fell from 1.08% to 0.69% of all cervical cytological abnormalities. There was a significant reduction in 'abnormal' cytological samples subsequently found to be associated with no invasive or preinvasive disease but no decrease in the number showing preinvasive or invasive disease. A significant decrease in number of patients having a final diagnosis of normal/inflammatory or wart changes was seen in those patients referred during the LBC period (p cytological glandular neoplasia referrals but not at the expense of missing preinvasive and invasive cancers. It has also increased the PPV of cervical sampling to detect preinvasive and invasive cancer from 59.6% to 76.0%.

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

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    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

  10. HPV triage for low grade (L-SIL) cytology is appropriate for women over 35 in mass cervical cancer screening using liquid based cytology.

    Science.gov (United States)

    Ronco, Guglielmo; Cuzick, Jack; Segnan, Nereo; Brezzi, Silvia; Carozzi, Francesca; Folicaldi, Stefania; Dalla Palma, Paolo; Del Mistro, Annarosa; Gillio-Tos, Anna; Giubilato, Pamela; Naldoni, Carlo; Polla, Enzo; Iossa, Anna; Zorzi, Manuel; Confortini, Massimo; Giorgi-Rossi, Paolo

    2007-02-01

    In the experimental arm of a randomised trial, women were tested both for liquid-based cytology and human papillomavirus (HPV) DNA and referred for colposcopy if cytology was ASCUS (atypical cells of undetermined significance) or more severe. We considered those with ASCUS (757) or LSIL (low-grade squamous intraepithelial lesions) (485) and a valid HPV test who received colposcopy. We computed sensitivity, specificity and ROC curves with different values of relative light units (RLU, that are related to viral load) as cut off, using cervical intraepithelial neoplasia grade 2 or more severe (CIN2+) at blind histology review as the endpoint. The area under the receiver operating characteristic (ROC) curve was significantly less among women aged 25-34 years than in those older, both considering ASCUS/AGUS (atypical glandular cells of undetermined significance) (p=0.0355) and LSIL (p=0.0009). At age 35-60 the curves for ASCUS and LSIL were similar, while at age 25-34 the area under the curve for LSIL was significantly less than for ASCUS (p=0.0084). With LSIL cytology, specificity of Hybrid Capture 2 with 2 RLU cut-off was 35.0% (95%CI 28.4-42.1) at age 25-34 and 64.5% (95%CI 58.3-70.3) at age 35-60. In conclusion, triaging by HPV testing performed better in women aged over 35 years than those younger. For older women, HPV triaging should also be considered for managing those with LSIL cytology.

  11. Pooled Analysis of Performance of Liquid Based Cytology in Population-Based Cervical Cancer Screening Studies in China

    Science.gov (United States)

    Pan, Qin-Jing; Hu, Shang-ying; Zhang, Xun; Ci, Pu-wa; Zhang, Wen-hua; Guo, Hui-qin; Cao, Jian; Zhao, Fang-hui; Lytwyn, Alice; Qiao, You-lin

    2013-01-01

    Background Liquid based cytology (LBC) has been widely used for cervical cancer screening. Despite numerous studies and systematic reviews, few large studies have focused on biopsy-confirmed cervical lesions and controversy remains about its diagnostic accuracy. The aim of our study was to assess LBC for detecting biopsy-confirmed cervical intraepithelial neoplasia (CIN) and cancer. Methods We performed a pooled analysis of LBC using data from 13 population-based, cross-sectional, cervical-cancer screening studies performed in China from 1999 to 2008. Participants (n = 26782) received LBC and HPV testing. Screen-positive women were referred for colposcopy and biopsy. We analyzed the accuracy of LBC for detecting biopsy-confirmed CIN2 or worse lesion (CIN2+) as well as CIN3 or worse lesion (CIN3+). Results Of 25830 women included in the analysis, CIN2+ was found in 107/2612(4.1%) with ASC, 142/923 (15.4%) with LSIL, 512/784 (65.3%) with HSIL, 29/30 (96.7%) with SCC, 4/27(14.8%) with AGC, and 0.4% (85/21454) with normal cytology results. No invasive cancers had ASC, AGC or cytological normal slides. The overall sensitivity, specificity, PPV, NPV and accuracy of LBC for detecting CIN2+ were 81.0%, 95.4%, 38.3%, 99.3 % and 94.9% respectively. Although HC2 was more sensitive than LBC, the specificity, PPV and overall accuracy of LBC were higher than those of HC2, at 85.2%, 18.6% and 85.5%, respectively. Conclusions The results indicate that performance of LBC can effectively predict a risk of existing CIN2+ and may be a good screening tool for cervical cancer prevention in a developing country. PMID:23907807

  12. Comparative analysis of diagnostic adequacy rate between aspiration and nonaspiration techniques of fine-needle cytology in patients with thyroid cancer and ultrasonographically suspicious cervical lymph nodes.

    Science.gov (United States)

    Aydin, Cevdet; Dellal, Fatma Dilek; Tam, Abbas Ali; Ogmen, Berna; Kilicarslan, Aydan; Topaloglu, Oya; Ersoy, Reyhan; Cakir, Bekir

    2017-08-18

    We aimed to compare nonaspiration (NAS) and aspiration (AS) techniques in the evaluation of fine-needle cytology of lymph node (FNC-LN) in terms of diagnostic adequacy of cytologic material. One hundred and twenty-three superficial cervical LNs in 75 patients who underwent NAS and AS-FNC-LN in the same visit were evaluated. Cytological results were categorized as diagnostic and nondiagnostic. The rates of malignancy were 13.8% in AS versus 16.3% in NAS technique, whereas nondiagnostic cytology was detected in 43.1% and 25.2%, respectively (P = .549 and P < .01). The diagnostic adequacy rate in NAS-FNC-LN was significantly higher than AS-FNC-LN. However, NAS technique seems to be more simple and comfortable. We suggest both NAS and AS-FNC-LN in cytologic evaluation of suspicious cervical LNs until the diagnostic accuracy is determined with prospective studies. © 2017 Wiley Periodicals, Inc.

  13. Follow-up of high-risk HPV positive women by combined cytology and bi-marker CADM1/MAL methylation analysis on cervical scrapes

    NARCIS (Netherlands)

    Verhoef, V.M.; Kemenade, F.J. van; Rozendaal, L.; Heideman, D.A.; Bosgraaf, R.P.; Hesselink, A.T.; Melchers, W.J.G.; Massuger, L.F.A.G.; Bekkers, R.L.M.; Steenbergen, R.D.; Berkhof, J.; Snijders, P.J.; Meijer, C.J.W.

    2015-01-01

    OBJECTIVES: Triage of HPV screen-positive women is needed to identify those with underlying cervical intraepithelial neoplasia grade 2/3 or worse (CIN2/3+). Presently, cytology on a physician-taken cervical scrape is mostly accepted as triage test, but needs follow-up testing in order not to miss

  14. Interobserver Reproducibility of Dna-Image-Cytometry in Ascus or Higher Cervical Cytology

    Directory of Open Access Journals (Sweden)

    Vu Quoc Huy Nguyen

    2004-01-01

    Full Text Available In the present study, the aim has been to investigate the interobserver reproducibility of DNA‐image‐cytometry (DNA‐ICM applied to routine Pap smears classified as Atypical Squamous Cells of Undetermined Significance (ASCUS or higher lesions (ASCUS+. 202 Pap smears diagnosed as ASCUS or higher were included in the study. After cytological assessment, smears underwent restaining according to Feulgen. First measurements were performed as routine workup. The second measurements were blinded to the result of the first and consecutively performed. DNA‐ICM met the consensus statements of the European Society of Analytical Cellular Pathology (ESACP. Interobserver agreement was assessed by calculating Kappa statistics. The diagnosis of DNA‐aneuploidy in the first measurements was confirmed in all cases. Second measurement detected 12 additional cases with aneuploidy. Nine out of these cases were classified as aneuploidy by detection of 9c Exceeding Events (9cEE. In three cases stemline‐aneuploidy was disclosed. The overall proportion of observed agreement was 94.1%, κ=0.87, 95% CI=0.74–0.99. Our study shows a good interobserver reproducibility of DNA‐ICM performed on cervical smears with ASCUS or higher lesions. DNA‐ICM thus represents a highly reproducible diagnostic procedure.

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

    Directory of Open Access Journals (Sweden)

    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

  16. Triage of Women with Low-Grade Cervical Lesions - HPV mRNA Testing versus Repeat Cytology

    Science.gov (United States)

    Sørbye, Sveinung Wergeland; Arbyn, Marc; Fismen, Silje; Gutteberg, Tore Jarl; Mortensen, Elin Synnøve

    2011-01-01

    Background In Norway, women with low-grade squamous intraepithelial lesions (LSIL) are followed up after six months in order to decide whether they should undergo further follow-up or be referred back to the screening interval of three years. A high specificity and positive predictive value (PPV) of the triage test is important to avoid unnecessary diagnostic and therapeutic procedures. Materials and Methods At the University Hospital of North Norway, repeat cytology and the HPV mRNA test PreTect HPV-Proofer, detecting E6/E7 mRNA from HPV types 16, 18, 31, 33 and 45, are used in triage of women with ASC-US and LSIL. In this study, women with LSIL cytology in the period 2005–2008 were included (n = 522). Two triage methods were evaluated in two separate groups: repeat cytology only (n = 225) and HPV mRNA testing in addition to repeat cytology (n = 297). Histologically confirmed cervical intraepithelial neoplasia of grade 2 or worse (CIN2+) was used as the study endpoint. Results Of 522 women with LSIL, 207 had biopsies and 125 of them had CIN2+. The sensitivity and specificity of repeat cytology (ASC-US or worse) were 85.7% (95% confidence interval (CI): 72.1, 92.2) and 54.4 % (95% CI: 46.9, 61.9), respectively. The sensitivity and specificity of the HPV mRNA test were 94.2% (95% CI: 88.7, 99.7) and 86.0% (95% CI: 81.5, 90.5), respectively. The PPV of repeat cytology was 38.4% (95% CI: 29.9, 46.9) compared to 67.0% (95% CI: 57.7, 76.4) of the HPV mRNA test. Conclusion HPV mRNA testing was more sensitive and specific than repeat cytology in triage of women with LSIL cytology. In addition, the HPV mRNA test showed higher PPV. These data indicate that the HPV mRNA test is a better triage test for women with LSIL than repeat cytology. PMID:21918682

  17. Analytical performance of RNA isolated from BD SurePath™ cervical cytology specimens by the PreTect™ HPV-Proofer assay.

    Science.gov (United States)

    Dixon, Eric P; Grønn, Petter; King, Lorraine M; Passineau, Heather; Doobay, Hema; Skomedal, Hanne; Hariri, Jalil; Hay, Shauna N; Brown, Charlotte A; Fischer, Timothy J; Malinowski, Douglas P

    2012-11-01

    Several commercial HPV ancillary tests are available for detection of E6/E7 RNA. It is not clear how storage of a cervical Pap affects the analytical and clinical performance of the PreTect™ HPV-Proofer assay. To investigate the qualitative performance of RNA extracted from BD SurePath™ liquid-based cytology (LBC) specimens for the detection of human papillomavirus (HPV) E6/E7 mRNA using the PreTect™ HPV-Proofer assay, studies including stability, reproducibility, residual specimen analysis, and storage medium comparison assays were performed. Cervical cytology specimens were collected and stored in BD SurePath™ LBC preservative fluid and/or PreTect™ Transport Media. RNA was isolated using the RecoverAll™ Total Nucleic Acid Isolation kit and RNA integrity was evaluated in the PreTect™ HPV-Proofer assay. The performance of RNA isolated from cervical cells collected and stored in BD SurePath™ LBC preservative fluid or PreTect™ Transport Media was also evaluated through a storage medium comparison study. The RNA was found to be stable for a minimum of 21 days when stored at ambient temperature and displayed high reproducibility with the mean percentage reproducibility ranging from 90.5% to 100% for the HPV types detected by the PreTect™ HPV-Proofer assay. The prevalence rate of HPV types in this study cohort was consistent with published reports. A 93.7% first pass acceptance rate was demonstrated across all cytology grades. The positive human U1 snRNP specific A protein (U1A) and HPV rate for BD SurePath™ LBC and PreTect™ Transport Media specimens was statistically equivalent for both normal and abnormal specimens. This data support the use of RNA isolated from BD SurePath™ LBC for ancillary HPV testing and demonstrates the feasibility of using BD SurePath™ preservative fluid as a specimen type with the PreTect™ HPV-Proofer assay.

  18. Analysis on results of cervical liquid-based cytology in 11030 cases%11030例宫颈液基细胞学检查结果分析

    Institute of Scientific and Technical Information of China (English)

    江海燕

    2011-01-01

    Objective: To explore the value of thin layer cytology test (TLT) plus cervical liquid -based cytology in gyrecological screening. Methods: The results of cervical liquid - based cytology in 11 030 patients from December 2006 to June 2009 were analyzed, all the patients were given TBS reports; 711 positive patients received histological biopsy, the results of cervical liquid -based cytology and histological biopsy were compared. Results: Among 1 1 030 patients receiving cervical liquid -based cytology, 757 patients were diagnosed as above-ASCUS pathological changes, the positive detection rate was 6. 86%. Among 711 positive patients, 165 patients were found with LSIL, 96 patients were diagnosed as condyloma and cervical intraepithelial neoplasia (CIN), the accordance rate was 58. 18%; 43 patients were found with excessive diagnosis ( inflammation), accounting for 26. 06%; 26 patients were found with under - diagnosis (CtN Ⅱ and CIN Ⅲ ) ( 15. 76% ) . Among 49 patients with HSIL, 25 patients were diagnosed as CIN Ⅱ and CIN Ⅲ, the accordance rate was 51.02%; 23 patients were found with excessive diagnosis, accounting for 45. 10% (3 patients with inflammation, 2 patients with condyloma and 18 patients with CIN Ⅰ ), one patient was found with under- diagnosis (squamous cell carcinoma); among 497 patients with ASC -US, ASC -H .and ACC- NOS, 114 patients were diagnosed as condyloma and CIN, the detection rate was 22. 94%. Conclusion: TLT plus cervical liquid -based cytology is an effective screening method of cervical precancerous lesion, but it has false negative and positive results, the cases with abnormal results of cervical liquid - based cytology should be confirmed furtherly by biopsy.%目的:探讨TLT - plus 液基细胞学检测系统在妇科普查中的价值.方法:分析该院2006年12月~2009年6月11 030例宫颈液基细胞学检查结果,所有病例均采用宁波美生医疗器材有限公司的液基细胞学产品(TLT-plus

  19. 8781例宫颈液基细胞学分析%Liquid-based cytology test analysis of 8 781 cervical cases

    Institute of Scientific and Technical Information of China (English)

    王红群

    2014-01-01

    Objective To investigate the characteristics of cervical intraepithelial lesions through analyzing the liquid -based cytology test results of 8 781 cases.Methods We used liquid-based cytology test,and the criteria of the Bethesda system (TBS) were adopted. The abnormal cytological examination results of 199 cases were compared with those of histopathological results .Results Four hundred and ten cases(4.7%) had squamous epithelial lesions which were positively correlative with patients ’age(r=0.105,P=0.036). Three cases(0.03%) had glandular epithelium lesions .Liquid-based cytology test had high positive accuracy with histopathological re-sult of biopsy .Conclusions Adult women should be regularly examined by liquid-based cytology test in order to find precancerous le-sions as early as possible and have early treatment .%目的:分析8781例宫颈液基细胞学检查结果及其与组织学检测的相关性。方法采用宫颈液基细胞学检查,细胞学诊断采用TBS进行分析,199例异常细胞学检查与活检组织学进行对比分析。结果410例(4.7%)标准有鳞状上皮病变,3例(0.03%)有腺上皮病变,细胞的鳞状上皮病变与年龄大小呈正相关(r=0.105,P=0.036)。活检与细胞学检查阳性符合率高。结论成年女性应常规做宫颈液基细胞学检查,以便早期发现癌前病变,及时治疗。

  20. Analysis on the results of cervical cytological screening among the population undergoing physical examination from 2006 to 2009%2006~2009年健康体检人群宫颈细胞学筛查结果分析

    Institute of Scientific and Technical Information of China (English)

    魏清柱; 赵彤; 刘江欢; 张志雄; 阳巧

    2012-01-01

    Objective; To explore the significance and problems of cervical cytological screening among the population undergoing physical examination. Methods; The results of cervical cytological screening among the population undergoing physical examination from 2006 to 2009 were analyzed retrospectively. Results; A total of 33 605 women underwent cervical cytological screening from 2006 to 2009, including 2 970 women (8. 8% ) undergoing liquid - based cytological test, 280 women (0. 83% ) were found with epithelial cell abnormalities, 841 women (2. 50% ) were found with positive organisms; 20 086 women underwent cervical cytological screening for more than consecutive two years, 33 case - times (21. 57% ) were found with epithelial cell abnormalities for more than consecutive two years, 98 case -times (21.40% ) were found with positive organisms, and 15 case - times (62.50% ) were found with positive trichomonad. Conclusion; Cervical cytological screening among the population undergoing physical examination can find the cases with epithelial cell abnormalities early , which is helpful to prevent the occurrence of cervical cancer; conventional Papanicolaou smear is still a main screening method for cervical cancer, the training of the technique and quality control should be enhanced; persistent epithelial cell abnormalities and microbial infection account for a large proportion of the population undergoing physical examination, so follow - up should be strengthened.%目的:探讨健康体检人群宫颈细胞学筛查的意义及存在问题.方法:回顾性分析2006~2009年健康体检人群宫颈细胞学筛查结果.结果:2006~2009年共33 605例宫颈细胞学检查,其中液基细胞学2 970例(8.8%),上皮细胞异常280例(0.83%),微生物阳性841例(2.50%);连续两年以上行宫颈细胞学筛查20 086例,连续两年以上上皮细胞异常33例次(21.57%)、念珠菌阳性98例次(21.40%)、滴虫阳性15例次(62.50%).结论:健康体检人

  1. Interlaboratory variation in the performance of liquid-based cytology: insights from the ATHENA trial.

    Science.gov (United States)

    Wright, Thomas C; Stoler, Mark H; Behrens, Catherine M; Sharma, Abha; Sharma, Keerti; Apple, Raymond

    2014-04-15

    Although it is recognized that cervical cytology is highly subjective, and that there is considerable interlaboratory variation in how slides are evaluated, little is known as to how this impacts the performance of cytology. In the ATHENA trial, liquid-based cytology specimens from 46,887 eligible women ≥21 years of age were evaluated at four large regional US laboratories, providing a unique opportunity to evaluate the impact of interlaboratory variations on the performance of cervical cytology. All women with abnormal cytology (atypical squamous cells of undetermined significance or higher) were referred to colposcopy, as were all high-risk human papillomavirus (hrHPV)-positive women ≥25 years of age and a random subset of those ≥25 years of age who were negative by both hrHPV testing and cytology. Sociodemographics, risk factors for cervical disease, and prevalence of cervical intraepithelial neoplasia (CIN) were similar across the laboratories. There were considerable differences among the laboratories both in overall cytological abnormal rates, ranging from 3.8 to 9.9%, and in sensitivity of cytology to detect CIN grade 2 or worse (CIN2+), from 42.0 to 73.0%. In contrast, the hrHPV positivity rate varied only from 10.9 to 13.4%, and the sensitivity of hrHPV testing from 88.2 to 90.1%. These observations suggest that hrHPV testing without cytology should be considered as the initial method for cervical cancer screening. © 2013 UICC.

  2. Comparison of Unsatisfactory Samples from Conventional Smear versus Liquid-Based Cytology in Uterine Cervical Cancer Screening Test.

    Science.gov (United States)

    Jeong, Hoiseon; Hong, Sung Ran; Chae, Seoung-Wan; Jin, So-Young; Yoon, Hye Kyoung; Lee, Juhie; Kim, Eun Kyung; Ha, Sook Tai; Kim, Sung Nam; Park, Eun-Jung; Jung, Jong Jae; Sung, Sun Hee; Lim, Sung-Chul

    2017-05-01

    Cervical cytology for uterine cervical cancer screening has transitioned from conventional smear (CS) to liquid-based cytology (LBC), which has many advantages. The aim of this study was to compare the proportion of unsatisfactory specimens from CS versus LBC at multiple institutions including general hospitals and commercial laboratories. Each participating institution provided a minimum of 500 Papanicolaou (Pap) test results for analysis. Pap tests were classified according to the participating institution (commercial laboratory or general hospital) and the processing method (CS, ThinPrep, SurePath, or CellPrep). The causes of unsatisfactory results were classified as technical problems, scant cellularity, or complete obscuring factors. A total of 38,956 Pap test results from eight general hospitals and three commercial laboratories were analyzed. The mean unsatisfactory rate of LBC was significantly lower than that of CS (1.26% and 3.31%, p = .018). In the LBC method, samples from general hospitals had lower unsatisfactory rates than those from commercial laboratories (0.65% vs 2.89%, p = .006). The reasons for unsatisfactory results were heterogeneous in CS. On the other hand, 66.2% of unsatisfactory results in LBC were due to the scant cellularity. Unsatisfactory rate of cervical cancer screening test results varies according to the institution and the processing method. LBC has a significantly lower unsatisfactory rate than CS.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Performance of the linear array HPV genotyping test on paired cytological and formalin-fixed, paraffin-embedded cervical samples.

    Science.gov (United States)

    Donà, Maria Gabriella; Ronchetti, Livia; Giuliani, Massimo; Carosi, Mariantonia; Rollo, Francesca; Congiu, Mario; Mazza, Domenica; Pescarmona, Edoardo; Vocaturo, Amina; Benevolo, Maria

    2013-05-01

    Detection and genotyping of human papillomavirus (HPV) from formalin-fixed, paraffin-embedded (FFPE) samples may be difficult when using assays based on amplification of large fragments. The objective of the present study was to investigate the performance of the Linear Array HPV Genotyping Test (Linear Array) on FFPE cervical cone biopsy specimens using paired cytologic samples obtained immediately before the conization as a criterion standard. Thirty-nine samples of grade 2 or higher cervical intraepithelial neoplasia were selected; all of the corresponding cytological samples were positive by the Linear Array and had a report of atypical squamous cells of undetermined significance or worse. A valid Linear Array test result was obtained for 38 FFPE specimens (97.4%, 95% CI 88.0 to 99.9). Specifically, 34 were HPV-positive (89.5%, 95% CI 76.5 to 96.9) and 4 were HPV-negative (10.5%, 95% CI 3.4 to 23.5). The overall agreement of the results obtained for the cytologic and histologic paired samples was good (Cohen's κ = 0.85, SE = 0.082, P = 0.000). Further analysis of samples with negative or invalid Linear Array test results, both modifying the nucleic acids extraction protocol and using the INNO-LiPA assay, suggested that failure of the Linear Array test in HPV detection from tissues was probably due to DNA fragmentation. Parallel analysis of paired FFPE and cytologic samples is extremely useful for evaluation of the efficiency of PCR-based assays in HPV detection and genotyping from tissue samples. In the present study, false-negative results were obtained in a limited percentage of cases, our data depicting the successful performance of the Linear Array test on FFPE samples.

  5. Histology verification demonstrates that biospectroscopy analysis of cervical cytology identifies underlying disease more accurately than conventional screening: removing the confounder of discordance.

    Directory of Open Access Journals (Sweden)

    Ketan Gajjar

    Full Text Available BACKGROUND: Subjective visual assessment of cervical cytology is flawed, and this can manifest itself by inter- and intra-observer variability resulting ultimately in the degree of discordance in the grading categorisation of samples in screening vs. representative histology. Biospectroscopy methods have been suggested as sensor-based tools that can deliver objective assessments of cytology. However, studies to date have been apparently flawed by a corresponding lack of diagnostic efficiency when samples have previously been classed using cytology screening. This raises the question as to whether categorisation of cervical cytology based on imperfect conventional screening reduces the diagnostic accuracy of biospectroscopy approaches; are these latter methods more accurate and diagnose underlying disease? The purpose of this study was to compare the objective accuracy of infrared (IR spectroscopy of cervical cytology samples using conventional cytology vs. histology-based categorisation. METHODS: Within a typical clinical setting, a total of n = 322 liquid-based cytology samples were collected immediately before biopsy. Of these, it was possible to acquire subsequent histology for n = 154. Cytology samples were categorised according to conventional screening methods and subsequently interrogated employing attenuated total reflection Fourier-transform IR (ATR-FTIR spectroscopy. IR spectra were pre-processed and analysed using linear discriminant analysis. Dunn's test was applied to identify the differences in spectra. Within the diagnostic categories, histology allowed us to determine the comparative efficiency of conventional screening vs. biospectroscopy to correctly identify either true atypia or underlying disease. RESULTS: Conventional cytology-based screening results in poor sensitivity and specificity. IR spectra derived from cervical cytology do not appear to discriminate in a diagnostic fashion when categories were based on

  6. Histology Verification Demonstrates That Biospectroscopy Analysis of Cervical Cytology Identifies Underlying Disease More Accurately than Conventional Screening: Removing the Confounder of Discordance

    Science.gov (United States)

    Gajjar, Ketan; Ahmadzai, Abdullah A.; Valasoulis, George; Trevisan, Júlio; Founta, Christina; Nasioutziki, Maria; Loufopoulos, Aristotelis; Kyrgiou, Maria; Stasinou, Sofia Melina; Karakitsos, Petros; Paraskevaidis, Evangelos; Da Gama-Rose, Bianca; Martin-Hirsch, Pierre L.; Martin, Francis L.

    2014-01-01

    Background Subjective visual assessment of cervical cytology is flawed, and this can manifest itself by inter- and intra-observer variability resulting ultimately in the degree of discordance in the grading categorisation of samples in screening vs. representative histology. Biospectroscopy methods have been suggested as sensor-based tools that can deliver objective assessments of cytology. However, studies to date have been apparently flawed by a corresponding lack of diagnostic efficiency when samples have previously been classed using cytology screening. This raises the question as to whether categorisation of cervical cytology based on imperfect conventional screening reduces the diagnostic accuracy of biospectroscopy approaches; are these latter methods more accurate and diagnose underlying disease? The purpose of this study was to compare the objective accuracy of infrared (IR) spectroscopy of cervical cytology samples using conventional cytology vs. histology-based categorisation. Methods Within a typical clinical setting, a total of n = 322 liquid-based cytology samples were collected immediately before biopsy. Of these, it was possible to acquire subsequent histology for n = 154. Cytology samples were categorised according to conventional screening methods and subsequently interrogated employing attenuated total reflection Fourier-transform IR (ATR-FTIR) spectroscopy. IR spectra were pre-processed and analysed using linear discriminant analysis. Dunn’s test was applied to identify the differences in spectra. Within the diagnostic categories, histology allowed us to determine the comparative efficiency of conventional screening vs. biospectroscopy to correctly identify either true atypia or underlying disease. Results Conventional cytology-based screening results in poor sensitivity and specificity. IR spectra derived from cervical cytology do not appear to discriminate in a diagnostic fashion when categories were based on conventional screening

  7. Cervical neuro-muscular syndrome: discovery of a new disease group caused by abnormalities in the cervical muscles.

    Science.gov (United States)

    Matsui, Takayoshi; Ii, Kunio; Hojo, Shuntaro; Sano, Keiji

    2012-01-01

    Our previous study of whiplash injury found that abnormalities in the cervical muscles cause autonomic dystonia. Further research has found that abnormalities in the cervical muscles cause headache, chronic fatigue syndrome, vertigo, and dizziness. We named this group of diseases cervical neuro-muscular syndrome. Patients treated within a 2-year period from April 1, 2002 to March 31, 2004 reported good outcomes in 83.8% for headache, 88.4% for vertigo and dizziness, 84.5% for chronic fatigue syndrome, 88.0% for autonomic dystonia, and 83.7% for whiplash-associated disorder. A large number of outpatients present with general malaise, including many general physical complaints without identifiable cause. We propose that treatment of the cervical muscle is effective for general malaise.

  8. Comparative study of the results from conventional cervico-vaginal oncotic cytology and liquid-based cytology.

    Science.gov (United States)

    Stabile, Sueli Aparecida Batista; Evangelista, Dilson Henrique Ramos; Talamonte, Valdely Helena; Lippi, Umberto Gazi; Lopes, Reginaldo Guedes Coelho

    2012-01-01

    To compare two oncotic cervical cytology techniques, the conventional and the liquid-based cytology, in low risk patients for uterine cervical cancer. Comparative prospective study with 100 patients who came to their annual gynecological exam, and were submitted simultaneously to both techniques. We used the McNemar test, with a significance level of p cytology and in 84% of the liquid-based cytology had statistical significance. As for the diagnosis of atypical cells they were detected in 3% of conventional cytology and in 10% of liquid-based cytology (p = 0.06). Atypical squamous cells of undetermined significance were the most prevalent abnormality. The liquid-based cytology performance was better when compared with colposcopy (guided biopsy), presenting sensitivity of 66.7% and specificity of 100%. There was no cytological and histological concordance for the conventional cytology. Liquid-based cytology had a better performance to diagnose atypical cells and the cytohistological concordance was higher than in the conventional cytology.

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

    Science.gov (United States)

    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

  10. A Review on the Impact of IUD in Cervical Cytology: Mardin Region Data

    Directory of Open Access Journals (Sweden)

    Işık İkbal BARIŞ1

    2013-01-01

    Full Text Available Objective: The aim of the study was to provide an overview to infectious and reactive cytological effects of intrauterine devices, which are one of the most widely used methods of contraception, with the results we obtained in the Mardin region.Material and Method: We evaluated together the pap smears of the 300 intrauterine device (+ and 300 intrauterine device (- patients sent to the pathology department in the period of 2010-2011. Genital infection rates and frequency of reactive-dysplastic cellular changes were statistically compared between the groups together with the literature data.Results: In the intrauterine device (+ group, 2 (+ and more severe inflammation was observed in 66.3% of cases. Bacterial vaginosis (26%, candida (12% and trichomonas vaginalis (8% were recorded as the most common infectious agents, followed by actinomyces (4%. Between the groups of intrauterine device (+ and (-, no significant difference was observed in terms of the incidence of squamous cell abnormalities, except ASC-US (p=0.02. In the intrauterine device (+ group, the presence of atypical glandular cells and reactive findings was significantly higher than the control group. After the removal of the intrauterine device, 61 cases that had control smears showed regression, with a rate of %75.4 (n=46.Conclusion: The local irritative and inflammatory effect of intrauterine devices basically causes reactive and regenerative changes mostly in glandular cells. Intrauterine devices disrupt the genital flora and significantly increase the frequency of genital infection by creating a foreign body reaction.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    BACKGROUND: We compared the sensitivity and specificity of liquid-based cytology (LBC) and computer-assisted reading for SurePath/FocalPoint and ThinPrep with those of manually read conventional cytology in routine cervical screening in four Danish laboratories. METHODS: Using data from five...... 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 indicator of relative specificity. RESULTS: At 23-29 years, SurePath/FocalPoint statistically significantly increased the detection of ⩾CIN3 by 85% compared with manually read conventional cytology. The 11% increase with ThinPrep was not significant. At 30-44 years, the increase with Sure...

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

    DEFF Research Database (Denmark)

    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 ...-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...

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

    DEFF Research Database (Denmark)

    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 ... 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...

  14. Results of an Australian trial using SurePath liquid-based cervical cytology with FocalPoint computer-assisted screening technology.

    Science.gov (United States)

    Bowditch, Ron C; Clarke, Joanne M; Baird, Phillip J; Greenberg, Merle L

    2012-12-01

    BD FocalPoint GS™ computer-assisted screening of BD SurePath® liquid-based cervical cytology slides (SP + FP) was compared with screening an accompanying conventional cervical Papanicolaou (Pap) smear (CON) in a split sample trial of 2,198 routine specimens. The rate of unsatisfactory specimens in the SP + FP arm was 0.2% compared with 4.1% in the conventional Pap smear, a significant reduction. There was no statistically significant difference between SP + FP and CON for the detection of histologically confirmed high-grade (HG) lesions in the routine split sample specimens (n = 9). To further test the sensitivity of SP + FP for HG lesions, 38 SurePath slides from confirmed HG cases, without an accompanying CON, were interpolated among the routine smears. In every one of the 47 confirmed HG cases, either HG cells were present in the microscope fields selected by FocalPointGS™ for review by the screening cytologist (46 of 47), or full screening of the slide was indicated by the FocalPointGS™ (1 of 47), confirming the effectiveness of SP + FP technology for primary screening. In a small number of cases, the screening cytologist did not recognize the abnormality even though on review HG cells were present in fields selected by FocalPointGS™. The overall detection rate was 93% for HG squamous lesions; 89% for known HG endocervical glandular lesions; and 91% for known endometrial carcinoma. In conclusion, the SP + FP detected 100% of HG abnormalities in the trial set; significantly reduced the rate of unsatisfactory specimens; and improved the overall screening rate of detection of HG abnormalities particularly of glandular lesions when compared with other screening technologies.

  15. Cytology and Human Papillomavirus Testing 6 to 12 Months after ASCUS or LSIL Cytology in Organized Screening To Predict High-Grade Cervical Neoplasia between Screening Rounds

    Science.gov (United States)

    Sjøborg, Katrine D.; Nygård, Mari; Røysland, Kjetil; Campbell, Suzanne; Alfsen, G. Cecilie; Jonassen, Christine M.

    2012-01-01

    We carried out a prospective study comparing the performance of human papillomavirus (HPV) E6/E7 mRNA (PreTect HPV-Proofer; NorChip, Klokkarstua, Norway) and DNA (Amplicor HPV test; Roche Diagnostics, Basel, Switzerland) triage testing of women 6 to 12 months after atypical-squamous-cells-of-undetermined-significance (ASCUS) or low-grade-squamous-intraepithelial-lesion (LSIL) cytology in organized screening to predict high-grade cervical intraepithelial neoplasia of grade 2 or worse (CIN2+) between screening rounds. Between January 2005 and April 2008, 692 study women with screening-detected ASCUS/LSIL cytology 6 to 12 months earlier returned for HPV mRNA and DNA testing and repeat cytology. The median follow-up time was 3 years, using existing health care facilities. Follow-up test results were available for 625 women. Of the 145 CIN2+ cases detected during the study period, 95 (65.5%) were HPV mRNA positive 6 to 12 months after screening-detected ASCUS/LSIL, 44 (30.4%) were HPV mRNA negative, and 6 (4.1%) were invalid. The corresponding HPV DNA results were 139 (95.9%), 5 (3.4%), and 1 (0.7%), respectively. The cumulative incidences of CIN2+ 3 years after a negative HPV mRNA and DNA test were 10.3% (95% confidence interval [CI], 7.2 to 13.3%) and 1.8% (95% CI, 0.0 to 3.6%), respectively. The cumulative incidences of CIN2+ 3 years after positive HPV mRNA and DNA tests were 52.8% (95% CI, 40.1 to 60.1%) and 41.3% (95% CI, 35.5 to 46.6%), respectively. In conclusion, both positive HPV mRNA and DNA test results have a high enough long-term prediction of CIN2+ risk to consider referral to colposcopy as good practice when performed in delayed triage of women with ASCUS/LSIL cytology. In addition, the low CIN2+ risk among women with a negative Amplicor HPV test in our study confirms its safe use in a clinical setting. PMID:22518869

  16. Effect of the treatment with β-glucan in women with cervical cytologic report of atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesions (L-SIL).

    Science.gov (United States)

    Laccetta, G; Carrone, A; Burratti, M; Mancino, P

    2015-04-01

    The aim of this study was to evaluate the effect of β-glucan in women with ASCUS or L-SIL, as detected by cervical cytologic screening. A total of 356 women with ASCUS or L-SIL were enrolled and divided into two groups: 1) 176 patients, treated with topical β-glucan; and 2) 180 patients who were only followed-up. The treatment consisted of two cycles of topical β-glucan applied once a day for 20 consecutive days and treatment separated by ten days. The effect of β-glucan was evaluated comparing Pap cytology results and colposcopic findings between treated patients and controls after 6 and 12 months of follow-up. After 6 months from enrollment, 63.1% (111/176) of patients treated with β-glucan had a negative Pap smear versus 45% (81/180) of controls (Plesions (P=0.001). At the end of the 12-month follow up, 83.5% (147/176) of treated patients versus 60% (108/180) of controls had a negative Pap smear (Plesions (P<0.001). No side effects were observed in treated patients. β-glucan increases the spontaneous regression rate of low-grade cytologic abnormalities as well as cervical findings.

  17. Prevalence of anal infection due to high-risk human papillomavirus and analysis of E2 gene integrity among women with cervical abnormalities.

    Science.gov (United States)

    Gonzalez-Losa, María Del Refugio; Puerto-Solís, Marylin; Ayora-Talavera, Guadalupe; Gómez-Carvallo, Jesús; Euán-López, Alejandra; Cisneros-Cutz, José I; Rosado-López, Ariel; Echeverría Salazar, Jesúa; Conde-Ferráez, Laura

    2017-01-06

    High-risk human papillomaviruses (HR-HPV) infection has been associated with 90% of anal cancer cases. Women with abnormal cytology are a high-risk group to develop anal neoplasia. The aim of this study is to describe the prevalence and epidemiology of HR-HPV 16, 18, 45, and 58 anal infections in women with cervical abnormalities, as well as to assess E2 gene integrity. A cross-sectional study was performed on 311 cervical and 311 anal samples from patients with abnormal cytology in two colposcopy clinics in Yucatan, Mexico. A specific PCR for oncogenes was performed in order to identify HVP 16, 18, 45 and 58. Real time PCR was used to amplify the whole HPV 16, 18, and 58 E2 gene to verify its integrity in anal samples. High risk HPV 16, 18, 58, and/or 45 were found in 41.47% (129/311) of cervical samples, and in 30.8% (96/331) of anal samples, with 18% (57/311) of the patients being positive in both samples. The same genotypes in both anatomical sites were observed in 11.25% (35/311). The E2 gene was disrupted in 82% of all tested samples. The frequency of genome disruption viral integration in anal samples by genotype was: HPV 58 (97.2%); HPV 16 (72.4%), and HPV 18 (0%). Women with cervical disease have HR-HPV anal infections, and most of them have the E2 gene disrupted, which represents a risk to develop anal cancer. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  18. 宫颈液基细胞学检查与高危型HPV检测早期筛查宫颈癌前病变的对比分析%Comparative study of liquid-based cervical cytology and high-risk HPV testing on ear-ly screening for cervical precancerous lesions

    Institute of Scientific and Technical Information of China (English)

    刘志红; 邹艳芬

    2016-01-01

    Objective:To study the effect of cervical cytology liquid-based and high-risk HPV screening for early detection of cervical lesions before. Methods:From March 2013 to March 2014 to select cervical screening 700 cases as subjects. Using high-risk HPV testing and liquid-based cervical cytology screening to test early cervical lesions. Results:In 700 cases with high-risk HPV-positive in 47 cases. HPV16 type was the most,accounting for 48. 94 percent,followed by HPV18,accounting for 21. 28%. Liquid-based cytology in cervical smear abnormalities in patients with 40 cases. LSIL accounted for 2. 71%,HSIL accounted for 0. 57%. TCT method combined high-risk HPV,LSIL and HSIL were 2. 32% and 0. 54%,and TCT was 0. 45% and 0. 19%. Conclusion:High-risk HPV tes-ting can improve the accuracy of cervical cancer screening,combined with liquid-based cervical cytology high-risk HPV testing can improve the success rate of screening for cervical precancerous lesions.%目的:对比研究宫颈液基细胞学检查与高危型HPV检测早期筛查宫颈癌前病变.方法:选取2013年3月到2014年3月接受宫颈病理变化筛选检查的700例患者作为研究对象.采用高危型HPV检查和宫颈液基细胞检查进行早期宫颈癌前病变筛查.结果:在700例患者中,高危型HPV检查结果阳性有47例.其中HPV16型最多,占48.94%,其次是HPV18型,占21.28%.在宫颈液基细胞学检查中涂片异常病人有40例.其中LSIL占2.71%,HSIL占0.57%.高危HPV联合TCT方法,LSIL和HSIL分别是2.32%和0.54%;而TCT则是0.45%和0.19%.结论:高危型HPV检查能够提高宫颈癌前筛查的准确率,宫颈液基细胞检查联合高危HPV检查能够提高宫颈癌前病变筛查成功率.

  19. Teenage cervical screening in a high risk American population

    OpenAIRE

    Songlin Zhang; Jaiyeola Thomas; Joel Thibodeaux; Ami Bhalodia; Fleurette Abreo

    2011-01-01

    Background: The new 2009 ACOG guideline for cervical cytology screening changed the starting age to 21 years regardless of the age of onset of sexual intercourse. However, many recent studies have shown a dramatic increase in the incidence of cervical epithelial abnormalities among adolescents within the past two decades. Materials and Methods: For this study, the reports of 156,342 cervical cytology were available of which 12,226 (7.8%) were from teenagers. A total of 192 teenagers with high...

  20. Pooled analysis of the performance of liquid-based cytology in population-based cervical cancer screening studies in China.

    Science.gov (United States)

    Pan, Qin-Jing; Hu, Shang-ying; Zhang, Xun; Ci, Pu-wa; Zhang, Wen-hua; Guo, Hui-qin; Cao, Jian; Zhao, Fang-hui; Lytwyn, Alice; Qiao, You-lin

    2013-09-01

    Liquid-based cytology (LBC) has been widely used for cervical cancer screening. Despite numerous studies and systematic reviews, to the authors' knowledge few large studies to date have focused on biopsy-confirmed cervical lesions and controversy remains concerning its diagnostic accuracy. The objective of the current study was to assess LBC for detecting biopsy-confirmed cervical intraepithelial neoplasia (CIN) and cancer. A pooled analysis of LBC using data from 13 population-based, cross-sectional, cervical cancer screening studies performed in China from 1999 to 2008 was performed. Participants (n = 26,782) received LBC and human papillomavirus testing. Women found to be positive on screening were referred for colposcopy and biopsy. The accuracy of LBC for detecting biopsy-confirmed CIN of type 2 or worse (CIN2+) as well as CIN type 3 or worse (CIN3+) lesions was analyzed. Of 25,830 women included in the analysis, CIN2+ was found in 107 of 2612 with atypical squamous cells (4.1%), 142 of 923 with low-grade squamous intraepithelial neoplasia (15.4%), 512 of 784 with high-grade squamous intraepithelial neoplasia (65.3%), 29 of 30 with squamous cell carcinoma (96.7%), 4 of 27 with atypical glandular cells (14.8%), and 85 of 21,454 with normal cytology results (0.4%). No invasive cancers were found to have atypical squamous cells, atypical glandular cells, or cytologically normal slides. The overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of LBC for detecting CIN2+ were 81.0%, 95.4%, 38.3%, 99.3 %, and 94.9%, respectively. Although Hybrid Capture 2 was more sensitive than LBC, the specificity, positive predictive value, and overall accuracy of LBC were higher than those of Hybrid Capture2 at 85.2%, 18.6%, and 85.5%, respectively. The results of the current study indicate that the performance of LBC can effectively predict the risk of existing CIN2+ and may be a good screening tool for cervical cancer prevention

  1. p16 INK4a immunocytochemistry on cell blocks as an adjunct to cervical cytology: Potential reflex testing on specially prepared cell blocks from residual liquid-based cytology specimens

    Directory of Open Access Journals (Sweden)

    Vinod B Shidham

    2011-01-01

    Full Text Available Background: p16 INK4a (p16 is a well-recognized surrogate molecular marker for human papilloma virus (HPV related squamous dysplasia. Our hypothesis is that the invasive interventions and related morbidities could be avoided by objective stratification of positive cytologic interpretations by p16 immunostaining of cell block sections of cytology specimens. Materials and Methods: Nuclear immunoreactivity for p16 was evaluated in cell block sections in 133 adequate cases [20 negative for intraepithelial lesion or malignancy, 28 high-grade squamous intraepithelial lesion (HSIL, 50 low-grade squamous intraepithelial lesion (LSIL, 21 atypical squamous cells, cannot exclude HSIL (ASC-H, and 14 atypical squamous cells of undetermined significance (ASCUS] and analyzed with cervical biopsy results. Results: (a HSIL cytology (28: 21 (75% were p16 positive (11 biopsies available - 92% were positive for cervical intraepithelial neoplasia (CIN 1 and above and 7 (25% were p16 negative (3 biopsies available - all showed only HPV with small atypical parakeratotic cells. (b LSIL cytology (50: 13 (26% cases were p16 positive (12 biopsies available - all were CIN1 or above and 37 (74% were p16 negative (12 biopsies available - all negative for dysplasia. However, 9 (75% of these biopsies showed HPV. (c ASC-H cytology (21: 14 (67% were p16 positive (6 biopsies available - 5 showed CIN 3/Carcinoma in situ/Ca and 1 showed CIN 1 with possibility of under-sampling. Cytomorphologic re-review favored HSIL and 7 (33% were p16 negative (5 biopsies available - 3 negative for dysplasia. Remaining 2 cases - 1 positive for CIN 3 and 1 showed CIN 1 with scant ASC-H cells on cytomorphologic re-review with possibility under-sampling in cytology specimen. (d ASCUS cytology (14: All (100% were p16 negative on cell block sections of cervical cytology specimen. HPV testing performed in last 6 months in 7 cases was positive in 3 (43% cases. Conclusion: p16 immunostaining on cell block

  2. 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.

    Institute of Scientific and Technical Information of China (English)

    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

  3. Comparison of cervical cell morphology using two different cytology techniques for early detection of pre-cancerous lesions.

    Science.gov (United States)

    Moosa, Najla Yussuf; Khattak, Nuzhat; Alam, Muhammad Irfan; Sher, Alam; Shah, Walayat; Mobashar, Shumaila; Alam, Muhammad Imran; Javid, Asima

    2014-01-01

    Cervical cancer is an issue of foremost importance globally, specifically affecting the developing nations. Significant advances have taken place with regard to diagnosis of cervical cancer, especially with screening. Appropriate screening measures can thus reduce the incidence of cervical cancer. The most desirable screening technique should be less invasive, easy to perform, cost-effective and cover a wide range of diagnostic icons. Manual liquid based cytology (MLBC) can be considered as one of the suitable technique for screening with the above-mentioned benefits. The aim of the current study was to compare two cervical screening techniques on the basis of different morphological parameters and staining parameters by using modified acetic acid Pap staining to see the possibility of reducing time economy involved in conventional Pap staining (CPS). The study was conducted on a total 88 cases and all were analyzed with both MLBC and CPS. Forty eight cases that were regarded as satisfactory on the basis of Bethesda system by both methods were further recruited for investigation. Their morphological parameters and staining quality were compared and scored according to a scoring system defined in the study. Quality indices was calculated for both staining procedures and smear techniques.

  4. The vaginal stump cytology role in follow-up after treatment of cervical cancer%阴道残端超薄细胞学检查在宫颈癌治疗后随访中的作用

    Institute of Scientific and Technical Information of China (English)

    刘春红; 殷超

    2015-01-01

    Objective To assess the clinical role of vaginal stump cytology in follow-up of cervical cancer patients who had surgery treatment. Method A retrospective analysis of these patients underwent cervical cancer surgery in our hospital between January 1, 2002 and December 31, 2005, and the data of the vaginal stump ultra-thin cytology about these patients were intact during postoperative follow-up. Result Totally, 1244 cases of cervical vaginal exam-inations from 300 female patients were involved in our research. Abnormalities in the vaginal cytology stump exami-nation was showed by 187 cases from 93 patients, which including 83 cases of atypical squamous cells without defi-nitely diagnostic significance, 58 cases of low-grade squamous intraepithelial lesions, 34 cases of highly squamous intraepithelial lesion , 6 cases of atypical glandular cell lesions,6 patients of tumor tendency. 25 patients had CINⅡ or worse lesions were showed in colposcopy examination of these abnormal cases. No recurrence or CINⅢof col-poscopy biopsy was not found in these patients which was also better vaginal stump cytological results than HSIL. Conclusion During follow-up, 1/3 cervical cancer survivors may have abnormal cytology; cytological results for HSIL patients should accept the colposcopy. If there is no visible lesions, ASC-US or LSIL patients cannot to col-poscopy in follow up, unless the abnormalities persist.%目的:评估阴道残端细胞学在宫颈癌随访中的作用。方法回顾分析2002年1月至2005年12月在本院因宫颈癌行手术治疗的患者,对300例患者的1244个阴道残端细胞学结果进行分析。结果93例患者的187个细胞学结果异常,包括83个诊断意义尚不明确的非典型鳞状上皮改变( atypical squamous cell of undetermined significance,ASC-US),58个低度鳞状上皮内病变(low grade squamous intraepithelial le-sion,LSIL),34个高度鳞状上皮内病变( high grade squamous intraepithelial lesion,HSIL),6

  5. 阴道镜联合液基薄层细胞学检测对宫颈癌前病变的诊断价值%Diagnostic value of colposcopy combined new thinprep pap test in cervical cytology precancerous lesions

    Institute of Scientific and Technical Information of China (English)

    王继红

    2011-01-01

    目的 探讨阴道镜联合液基薄层细胞学检测(TCT)在宫颈病变筛查中的诊断价值.方法 选取行宫颈细胞学检查患者1 266例,行阴道镜和液基薄层细胞学联合检查.结果 本组所检1 266例中异常者169例,宫颈病变检出率13.35%,异常者中宫颈上皮内病变及鳞癌共126例,占9.99%.宫颈上皮内病变发病率检测各年龄组之间差异无统计学意义(P>0.05).结论 阴道镜联合液基薄层细胞学检测是宫颈癌前病变可靠的早期临床诊断方法.%Objective To evaluate the new colposcopy combined cytology thinprep pap test(TCT) in cervical screening in the diagnosis of disease. Methods 1 266 patients detected by gynecologic cervical cytology were conducted on colposcopy and liquid-based thin-layer cytology of the Joint Inspection. Results 1 266 cases in which seized 169 cases of abnormal cervical lesion detection rate of 13. 35%,abnormalities in cervical squamous intraepithelial lesions and 126 cases,accounting for 9.99%. The incidence of cervical intraepithelial lesions detected no difference between age groups was statistically significant(P>0.05). Conclusion Thinprep cytology combined colposcopy cervical precancerous lesions was a reliable method for early diagnosis.

  6. Prevalence of human papillomavirus genotypes in cytologic abnormalities from unvaccinated women living in north-western Spain.

    Science.gov (United States)

    Otero-Motta, Ana Pastora; Ordóñez, José Luis; González-Celador, Rafael; Rivas, Belen; Macías, María Del Carmen García; Bullón, Agustín; Abad, María Del Mar

    2011-03-01

    Cervical cancer and its precursors low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) are associated with infection by human papillomavirus (HPV), in particular HPV 16 and 18. The distribution of the HPV genotype varies with the severity of cervical disease, age and the geographic location of the patients. We report the results of a population study carried out in a region of north-western (NW) Spain aimed at determining the prevalence of single and multiple infections by 35 types of HPV using low-density microarrays for 113 cases with negative for intraepithelial lesions or malignancies; 588 with atypical squamous cells of undetermined significance (ASCUS)/LSIL; 183 with HSIL; and seven cases of squamous cell carcinomas. Of the 891 patients analysed, 50.2% had single infections and 49.8% had multiple HPV infections. In women aged below 30 years, there was a predominance of multiple infections (p = 0.027). ASCUS/LSIL was associated with multiple and HSIL with single infections (p = 0.025). We observed significant increases in the percentage of infections due to a high-risk (HR) type of HPV when the severity of the cytological lesion increased (p = 0.001). No relationship was found between greater aggressiveness in the cytological diagnosis and a higher number of HPV types involved in multiple infections. The five most frequent genotypes were HPV 16 (26.3%), 53 (18.2%), 51 (17.3%), 6 (14.8%) and 66 (13.1%). The prevalence of HPV 16, 33 and 58 increased significantly from ACUS/LSIL to HSIL and the prevalence of HPV 51, 53 and 66 decreased. HPV 16 was the only genotype that showed a significant increase in prevalence when the severity of the cytological disease increased in single infections (p = 0.0001). The implementation of bivalent prophylactic vaccination could potentially lead to prevention in 32% of the population included in the study - in at least a quarter of patients with ACUS/LSIL (26.7%), and in half

  7. Comparison of human papillomavirus infection and cervical cytology in women using copper-containing and levonorgestrel-containing intrauterine devices.

    Science.gov (United States)

    Lekovich, Jovana P; Amrane, Selma; Pangasa, Misha; Pereira, Nigel; Frey, Melissa K; Varrey, Aneesha; Holcomb, Kevin

    2015-05-01

    To investigate whether there is a difference in cervical cytology and high-risk human papillomavirus (HPV) infection clearance between levonorgestrel- and copper-containing intrauterine device (IUD) users. The electronic medical record system was searched by the appropriate procedural code for IUD insertion for all patients undergoing IUD placement during the study period (January 31, 2005 to January 31, 2012). Patients who received treatment for cervical dysplasia, had their IUDs removed, or conceived during the study period were excluded. High-risk HPV and cervical cytology results immediately preceding and after IUD placement were obtained. One hundred fifty patients had a copper-containing and 152 patients a levonorgestrel-containing IUD placed. The groups were comparable in terms of age, body mass index, duration of follow-up, and percentage of smokers. Sixty-six patients were high-risk HPV-positive before IUD insertion (30 in copper compared with 36 in the levonorgestrel IUD group, P=.4), and the groups had similar follow-up times (364.1±26.3 compared with 357.2±29.7 days, respectively, between the IUD placement and a repeat Pap test with high-risk HPV cotesting, P=.2). Of those, 21 (70%; 95% confidence interval [CI] 53.6-86.4%) cleared the infection after copper-containing IUD placement compared with 15 (42%; 95% CI 25.6-57.8%) in the levonorgestrel group (P=.04). There were only two (1.7%) new high-risk HPV infections in the copper compared with eight (6.9%) in the levonorgestrel group (P=.056). Our data suggest that levonorgestrel-containing IUD could be associated with decreased high-risk HPV infection clearance and possibly increased acquisition compared with the copper-containing IUD. II.

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

    NARCIS (Netherlands)

    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

  9. Accuracy of a Low Priced Liquid-Based Method for Cervical Cytology in 632 Women Referred for Colposcopy After a Positive Pap Smear

    NARCIS (Netherlands)

    van Hemel, B. M.; Buikema, H. J.; Groen, H.; Suurmeijer, A. J. H.

    2009-01-01

    The aim of this quality controlling study was to determine the accuracy of liquid-based cytology (LBC) with the Turbitec (R) cytocentrifuge technique. Cervical smears of 632 Women, Who were referred to our CIN outpatient department, after at least two smears with ASCUS or higher were evaluated and c

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

    DEFF Research Database (Denmark)

    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...

  11. Accuracy of a Low Priced Liquid-Based Method for Cervical Cytology in 632 Women Referred for Colposcopy After a Positive Pap Smear

    NARCIS (Netherlands)

    van Hemel, B. M.; Buikema, H. J.; Groen, H.; Suurmeijer, A. J. H.

    2009-01-01

    The aim of this quality controlling study was to determine the accuracy of liquid-based cytology (LBC) with the Turbitec (R) cytocentrifuge technique. Cervical smears of 632 Women, Who were referred to our CIN outpatient department, after at least two smears with ASCUS or higher were evaluated and c

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

    NARCIS (Netherlands)

    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

  13. Selective filtration of abnormal spermatozoa by the cervical mucus.

    Science.gov (United States)

    Freundl, G; Grimm, H J; Hofmann, N

    1988-04-01

    The Düsseldorf classification of spermatozoal morphology in semen is based on the spermatogenesis in the testis. So it is possible in some cases to relate a pathological finding in semen to a special disorder in the testis. We have tested the filtering effect of the cervical mucus on the various spermatozoal forms by performing a post-coital test from the upper cervical region after artificial insemination from the husband (AIH). It was found that in addition to the motility of spermatozoa their outer shape is very important for their transport through the cervical canal. Pathological spermatozoa with a rather normal-shaped head like AI and AII forms will pass the cervix almost like normal spermatozoa. In a superficial post-coital test they can be classified as 'normal'. Still, they are not able to fertilize an egg.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  15. Risk assessment of cervical disease by hrHPV testing and cytology

    OpenAIRE

    Kocken, Mariëlle

    2012-01-01

    textabstractAs cervical cancer is an important health problem worldwide with over a half million patients a year and as it is the fourth most common cause of cancer-related death in women, improving the prevention of this disease is a continuing and important process. A major reduction of cancer incidence and mortality has occurred in countries with cervical cancer screening. Because cervical cancer develops through different premalignant stages it can be detected in a premalignant stage, all...

  16. 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

    DEFF Research Database (Denmark)

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

    2014-01-01

    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. During...... 2002-2005, residual liquid-based cervical cytology samples were collected from women screened for cervical cancer in Copenhagen, Denmark. Samples were HPV-tested with Hybrid Capture 2 (HC2) and genotyped with INNO-LiPA. Semi-quantitative viral load was measured by HC2 relative light units in women......HPV genotyping during cervical cancer screening may help identify women at highest risk of CIN3+....

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

    Science.gov (United States)

    Wang, Lina; Wang, Pengyan; Ren, Yan; 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

  18. How will transitioning from cytology to HPV testing change the balance between the benefits and harms of cervical cancer screening? Estimates of the impact on cervical cancer, treatment rates and adverse obstetric outcomes in Australia, a high vaccination coverage country.

    Science.gov (United States)

    Velentzis, Louiza S; Caruana, Michael; Simms, Kate T; Lew, Jie-Bin; Shi, Ju-Fang; Saville, Marion; Smith, Megan A; Lord, Sarah J; Tan, Jeffrey; Bateson, Deborah; Quinn, Michael; Canfell, Karen

    2017-08-12

    Primary HPV screening enables earlier diagnosis of cervical lesions compared to cytology, however, its effect on the risk of treatment has not been investigated. We estimated the cumulative lifetime risk (CLR) of cervical cancer and excisional treatment; and change in adverse obstetric outcomes in HPV unvaccinated women and cohorts offered vaccination (>70% coverage in 12-13 years) for the Australian cervical screening program. 2-yearly cytology screening (ages 18-69 years) was compared to 5-yearly primary HPV screening with partial genotyping for HPV16/18 (ages 25-74 years). A dynamic model of HPV transmission, vaccination, cervical screening and treatment for precancerous lesions was coupled with an individual-based simulation of obstetric complications. For cytology screening, the CLR of cervical cancer diagnosis, death and treatment would be 0.65%, 0.20% and 13% without vaccination and 0.18%, 0.06% and 7%, in vaccinated cohorts, respectively. For HPV screening, relative reductions of 33% and 22% in cancer risk for unvaccinated and vaccinated cohorts are predicted, respectively, compared to cytology. Without vaccination, a 4% increase in treatment risk for HPV versus cytology screening is predicted, implying a possible increase in pre-term delivery (PTD) and low birthweight (LBW) events of 19-35 and 14-37, respectively, per 100,000 unvaccinated women. However, in vaccinated cohorts treatment risk will decrease by 13%, potentially leading to 4-41 fewer PTD events and from 2 more to 52 fewer LBW events per 100,000 vaccinated women. HPV screening starting at age 25 in populations with high vaccination coverage, is therefore expected to decrease the risks of cervical cancer and excisional treatment. This article is protected by copyright. All rights reserved. © 2017 UICC.

  19. 液基薄层细胞学检查用于宫颈疾病筛查的临床应用%ThinPrep Cervical Cytology in Clinical Applications for Disease Screening

    Institute of Scientific and Technical Information of China (English)

    崔泳

    2014-01-01

    Objective To discuss the clinical ThinPrep cytology in cervical disease screening.Methods A randomized extracted from January 2012 to December 2012 in our hospital gynecology clinic and hospital treatment of patients with cervical lesions, combined Bethesda 2001 reporting classification standards, using technology TCT producer, randomized patients with cervical lesions in these 60 cases of cervical cells School screening. And more cases of atypical squamous cervical histopathological examination.Results 60 patients were satisfied with the drawn smear:abnormal results detected atypical squamous eight cases,not excluding the height of five cases of atypical squamous lesions,low-grade squamous intraepithelial lesions in 2 cases, high-grade squamous intraepithelial lesions in one case,Histopathological results for intraepithelial lesion (≥LSIL)14 cases of pathological 87.5%.Conclusion ThinPrep cytology, early detection of precancerous cervical lesions and cervical cancer even change that clinical application in cervical disease screening.%目的:讨论液基薄层细胞学检查在宫颈疾病筛查中的临床应用。方法随机提取2012年1~12月在我院妇科门诊及住院就诊的宫颈病变患者,结合Bethesda2001报告分类标准,采用TCT制片技术,随机对这60例宫颈病变患者进行宫颈细胞学筛查。并对非典型鳞状上皮以上病例进行宫颈组织病理学检查。结果60例患者取材均为满意涂片:检出异常结果非典型鳞状上皮8例,不除外高度病变的非典型鳞状上皮5例,低度鳞状上皮内病变2例,高度鳞状上皮内病变1例。病理组织学结果为上皮内病变(≥LSIL)14例,病理符合率为87.5%。结论在宫颈疾病筛查中应用液基薄层细胞学检查,可早期发现宫颈病变和癌前病变甚至宫颈癌变,可临床推广应用。

  20. 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

    Institute of Scientific and Technical Information of China (English)

    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

  1. HPV testing in combination with liquid-based cytology in primary cervical screening (ARTISTIC): a randomised controlled trial.

    Science.gov (United States)

    Kitchener, Henry C; Almonte, Maribel; Thomson, Claire; Wheeler, Paula; Sargent, Alexandra; Stoykova, Boyka; Gilham, Clare; Baysson, Helene; Roberts, Christopher; Dowie, Robin; Desai, Mina; Mather, Jean; Bailey, Andrew; Turner, Andrew; Moss, Sue; Peto, Julian

    2009-07-01

    Testing for human papillomavirus (HPV) DNA is reportedly more sensitive than cytology for the detection of high-grade cervical intraepithelial neoplasia (CIN). The effectiveness of HPV testing in primary cervical screening was assessed in the ARTISTIC trial, which was done over two screening rounds approximately 3 years apart (2001-03 and 2004-07) by comparing liquid-based cytology (LBC) combined with HPV testing against LBC alone. Women aged 20-64 years who were undergoing routine screening as part of the English National Health Service Cervical Screening Programme in Greater Manchester were randomly assigned (between July, 2001, and September, 2003) in a ratio of 3:1 to either combined LBC and HPV testing in which the results were revealed and acted on, or to combined LBC and HPV testing where the HPV result was concealed from the patient and investigator. The primary outcome was the detection rate of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) in the second screening round, analysed by intention to treat. This trial is registered with the International Standard Randomised Controlled Trial Number ISRCTN25417821. There were 24 510 eligible women at entry (18 386 in the revealed group, 6124 in the concealed group). In the first round of screening 233 women (1.27%) in the revealed group had CIN3+, compared with 80 (1.31%) women in the concealed group (odds ratio [OR] 0.97, 95% CI 0.75-1.25; p>0.2). There was an unexpectedly large drop in the proportion of women with CIN3+ between the first and second rounds of screening in both groups, at 0.25% (29 of 11 676) in the revealed group and 0.47% (18 of 3866 women) in the concealed group (OR 0.53, 95% CI 0.30-0.96; p=0.042). For both rounds combined, the proportion of women with CIN3+ were 1.51% (revealed) and 1.77% (concealed) (OR 0.85, 95% CI 0.67-1.08; p>0.2). LBC combined with HPV testing resulted in a significantly lower detection rate of CIN3+ in the second round of screening compared with LBC

  2. Comparison of Hybrid capture 2 testing at different thresholds with cytology as primary cervical screening test

    NARCIS (Netherlands)

    Rijkaart, D. C.; Coupe, V. M. H.; van Kemenade, F. J.; Heideman, D. A. M.; Hesselink, A. T.; Verweij, W.; Rozendaal, L.; Verheijen, R. H.; Snijders, P. J.; Berkhof, J.; Meijer, C. J. L. M.

    2010-01-01

    BACKGROUND: We evaluated the performance of primary high-risk human papillomavirus (hrHPV) testing by hybrid capture 2 (HC2) with different thresholds for positivity, in comparison with conventional cytology. METHODS: We used data of 25 871 women (aged 30-60 years) from the intervention group of the

  3. Comparison of Hybrid capture 2 testing at different thresholds with cytology as primary cervical screening test

    NARCIS (Netherlands)

    Rijkaart, D. C.; Coupe, V. M. H.; van Kemenade, F. J.; Heideman, D. A. M.; Hesselink, A. T.; Verweij, W.; Rozendaal, L.; Verheijen, R. H.; Snijders, P. J.; Berkhof, J.; Meijer, C. J. L. M.

    2010-01-01

    BACKGROUND: We evaluated the performance of primary high-risk human papillomavirus (hrHPV) testing by hybrid capture 2 (HC2) with different thresholds for positivity, in comparison with conventional cytology. METHODS: We used data of 25 871 women (aged 30-60 years) from the intervention group of the

  4. Quantitative assessment of DNA methylation for the detection of cervical and endometrial adenocarcinomas in liquid-based cytology specimens.

    Science.gov (United States)

    Kim, Ga-Eon; Kweon, Sun-Seog; Lee, Ji Shin; Lee, Jae Hyuk; Nam, Jong Hee; Choi, Chan

    2012-08-01

    To investigate the aberrant promoter hypermethylation as a screening tool for cervical adenocarcinomas (CAs) and endometrial adenocarcinomas (EAs) in cervical scrapings. A quantitative multiplex methylation-specific polymerase chain reaction approach was used to examine promoter methylation of 5 genes (APC, HIN-1, RAR-beta, RASSF1A and Twist) in biopsy-confirmed CA (n = 31) and EA (n = 27) residual, liquid-based cytology samples. The data of negative for intraepithelial lesions or malignancy and low-grade squamous intraepithelial lesions were used as controls. Methylation levels of APC, RAR-beta, RASSF1A and Twist were significantly higher in CA than in control cervical samples. For EA, only the methylation levels of RASSF1A differed significantly from those of control. Receiver-operating characteristic analysis demonstrated that APC, RAR-beta and RASSF1A had the ability to distinguish CA/EA, CA and EA from control samples. In CA/EA and CA samples, the best 3-gene combination was RASSF1A/RAR-beta/APC. This 3-gene panel had a sensitivity of 87.0% for CA/EA and of 80.6% for CA and a specificity of 79.3% for both CA/EA and CA. In EA samples, RASSF1A showed the best performance in distinguishing EA from control. The estimated sensitivity of RASSF1A for detecting EA was 63.0%, and its specificity was 96.3%. This feasibility study demonstrates that quantitative detection of aberrant DNA methylation in cervical scrapings may be a promising new diagnostic tool for the detection of CA and EA.

  5. First trial of cervical cytology in healthy women of urban Laos using by self-sampling instrument.

    Science.gov (United States)

    Nabandith, Viengvansay; Pholsena, Vatsana; Mounthisone, Phouthasone; Shimoe, Kyoko; Kato, Saiko; Aoki, Kunio; Noda, Sadamu; Takamatsu, Reika; Saio, Masanao; Yoshimi, Naoki

    2012-01-01

    Cervical cancer is the most common cancer in Laos women and a screening programme, even with the PAP smear test (PAP test), has yet to be established for routine use. The Pap test is accepted as the most appropriate for cervical cancer screening in some settings but it is not commonly available in Laos hospitals, because there are few cytopathologists and gynecologists have little experience. As a pilot program, seminars for the PAP test were given in 2007 and 2008, and then PAP tests were carried out using self-sampling instrument (Kato's device) with 200 healthy volunteers in Setthathirath hospital, Laos, in 2008. The actual examination number was 196, divided into class I 104 (53.1%), class II 85 (43.3%), class IIIa 4 (2.0%), class IIIb 1 (0.5%), and class V 1 (0.5%) by modified Papanicolau classification. Four cases had menstruation. There were 6 cases with epithelial cell abnormalities including malignancy. There were 7 cases with fungus and 2 cases with trichomonas in Class II. More than 70% volunteers felt comfortable with the Kato's device and wanted to use it next time, because of the avoidance of the embarrassment and a low cost as compared with pelvic examination by gynecologists. This first trial for PAP test for healthy Laos women related to a hospital found three percent to have abnormal cervical epithelial cells. Therefore, this appraoch using a self-sampling device suggests that it should be planned for cervical cancer prevention in Laos.

  6. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  7. Referral compliance, outcome and predictors of CIN after repeated borderline cervical smears in the Netherlands.

    NARCIS (Netherlands)

    Siebers, A.G.; Massuger, L.F.A.G.; Bulten, J.

    2007-01-01

    BACKGROUND: Borderline cytological abnormalities are diagnosed very frequently but have limited predictive value for high-grade cervical lesions, resulting in high costs, patient anxiety and over treatment. A conservative management strategy for the Dutch diagnostic equivalent of borderline nuclear

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

    Science.gov (United States)

    Rebolj, Matejka; Rask, Johanne; van Ballegooijen, Marjolein; Kirschner, Benny; Rozemeijer, Kirsten; Bonde, Jesper; Rygaard, Carsten; Lynge, Elsebeth

    2015-01-01

    Background: We compared the sensitivity and specificity of liquid-based cytology (LBC) and computer-assisted reading for SurePath/FocalPoint and ThinPrep with those of manually read conventional cytology in routine cervical screening in four Danish laboratories. Methods: Using data from five 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 indicator of relative specificity. Results: At 23–29 years, SurePath/FocalPoint statistically significantly increased the detection of ⩾CIN3 by 85% compared with manually read conventional cytology. The 11% increase with ThinPrep was not significant. At 30–44 years, the increase with SurePath/FocalPoint was 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. PMID:26448176

  9. Triage of HR-HPV positive women with minor cytological abnormalities: a comparison of mRNA testing, HPV DNA testing, and repeat cytology using a 4-year follow-up of a population-based study.

    Directory of Open Access Journals (Sweden)

    Maria Persson

    Full Text Available OBJECTIVE: Expression of the viral E6/E7 oncogenes of high-risk human papillomaviruses (HR-HPV is necessary for malignant conversion and maintenance in cervical tissue. In order to determine whether HR-HPV E6/E7 mRNA testing more effectively predicts precancerous lesions and invasive cervical cancer than HR-HPV DNA testing, we aimed to compare triage using HR-HPV E6/E7 mRNA testing by APTIMA HPV Assay (APTIMA to HPV16 DNA testing, HPV16/18 DNA testing, and repeat cytology. METHODS: Liquid-based (PreservCyt cell samples were obtained from HR-HPV-positive women diagnosed with atypical squamous cells of undetermined significance (ASCUS and low-grade squamous intraepithelial lesions (LSIL within the framework of the population-based cervical cancer screening program in Stockholm, Sweden. Samples were tested for HR-HPV E6/E7 mRNA by APTIMA (Gene-Probe Inc., San Diego, CA, USA. Women were followed up for 4 years after the index cytology via medical and laboratory records, and the Stockholm Oncology Center. RESULTS: Nine of 25 (36% women in the ASCUS group, and 64 of 180 (36% women in the LSIL group developed cervical intraepithelial neoplasia (CIN grade 2 or worse during 4 years of follow-up. 162 (74% women were APTIMA-positive, and APTIMA had the highest sensitivity to predict CIN2 or worse and CIN3 or worse in the ASCUS (77.8% and 100% and LSIL (78.1 and 75.8% groups, although specificity was insufficient (<50%. HPV16 DNA testing and repeat cytology were more specific than APTIMA. CONCLUSION: The results of this population-based study with comprehensive follow-up support the use of APTIMA as a triage test for women with ASCUS. More focused investigation is required for women with LSIL.

  10. Triage of HR-HPV Positive Women with Minor Cytological Abnormalities: A Comparison of mRNA Testing, HPV DNA Testing, and Repeat Cytology Using a 4-Year Follow-Up of a Population-Based Study

    Science.gov (United States)

    Persson, Maria; Elfström, K. Miriam; Brismar Wendel, Sophia; Weiderpass, Elisabete; Andersson, Sonia

    2014-01-01

    Objective Expression of the viral E6/E7 oncogenes of high-risk human papillomaviruses (HR-HPV) is necessary for malignant conversion and maintenance in cervical tissue. In order to determine whether HR-HPV E6/E7 mRNA testing more effectively predicts precancerous lesions and invasive cervical cancer than HR-HPV DNA testing, we aimed to compare triage using HR-HPV E6/E7 mRNA testing by APTIMA HPV Assay (APTIMA) to HPV16 DNA testing, HPV16/18 DNA testing, and repeat cytology. Methods Liquid-based (PreservCyt) cell samples were obtained from HR-HPV-positive women diagnosed with atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesions (LSIL) within the framework of the population-based cervical cancer screening program in Stockholm, Sweden. Samples were tested for HR-HPV E6/E7 mRNA by APTIMA (Gene-Probe Inc., San Diego, CA, USA). Women were followed up for 4 years after the index cytology via medical and laboratory records, and the Stockholm Oncology Center. Results Nine of 25 (36%) women in the ASCUS group, and 64 of 180 (36%) women in the LSIL group developed cervical intraepithelial neoplasia (CIN) grade 2 or worse during 4 years of follow-up. 162 (74%) women were APTIMA-positive, and APTIMA had the highest sensitivity to predict CIN2 or worse and CIN3 or worse in the ASCUS (77.8% and 100%) and LSIL (78.1 and 75.8%) groups, although specificity was insufficient (cytology were more specific than APTIMA. Conclusion The results of this population-based study with comprehensive follow-up support the use of APTIMA as a triage test for women with ASCUS. More focused investigation is required for women with LSIL. PMID:24587193

  11. Triage of HR-HPV positive women with minor cytological abnormalities: a comparison of mRNA testing, HPV DNA testing, and repeat cytology using a 4-year follow-up of a population-based study.

    Science.gov (United States)

    Persson, Maria; Elfström, K Miriam; Brismar Wendel, Sophia; Weiderpass, Elisabete; Andersson, Sonia

    2014-01-01

    Expression of the viral E6/E7 oncogenes of high-risk human papillomaviruses (HR-HPV) is necessary for malignant conversion and maintenance in cervical tissue. In order to determine whether HR-HPV E6/E7 mRNA testing more effectively predicts precancerous lesions and invasive cervical cancer than HR-HPV DNA testing, we aimed to compare triage using HR-HPV E6/E7 mRNA testing by APTIMA HPV Assay (APTIMA) to HPV16 DNA testing, HPV16/18 DNA testing, and repeat cytology. Liquid-based (PreservCyt) cell samples were obtained from HR-HPV-positive women diagnosed with atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesions (LSIL) within the framework of the population-based cervical cancer screening program in Stockholm, Sweden. Samples were tested for HR-HPV E6/E7 mRNA by APTIMA (Gene-Probe Inc., San Diego, CA, USA). Women were followed up for 4 years after the index cytology via medical and laboratory records, and the Stockholm Oncology Center. Nine of 25 (36%) women in the ASCUS group, and 64 of 180 (36%) women in the LSIL group developed cervical intraepithelial neoplasia (CIN) grade 2 or worse during 4 years of follow-up. 162 (74%) women were APTIMA-positive, and APTIMA had the highest sensitivity to predict CIN2 or worse and CIN3 or worse in the ASCUS (77.8% and 100%) and LSIL (78.1 and 75.8%) groups, although specificity was insufficient (cytology were more specific than APTIMA. The results of this population-based study with comprehensive follow-up support the use of APTIMA as a triage test for women with ASCUS. More focused investigation is required for women with LSIL.

  12. [Prevalence of epithelial squamous cell abnormalities and associated factors in women of a rural town of Colombia].

    Science.gov (United States)

    Grisales, Hugo; Vanegas, Angela Patricia; Gaviria, Angela M; Castaño, Jorge; Mora, Martín Alonso; Borrero, Mauricio; Rojas, Carlos; Arbeláez, María Patricia; Sánchez, Gloria I

    2008-06-01

    In spite of implementation of cytology-based cervical cancer screening in Colombia, mortality rates remain stable. The description of factors associated to cervical pre-neoplasic lesions is needed to establish strategies for mortality prevention. The prevalence of epithelial squamous cell abnormalities was determined to explore the association of cytology abnormalities with described risk factors. This population-based, cross-sectional study included 739 women randomly selected by age. A validated face-to-face questionnaire and conventional cervical cytology were used to collect the information. To establish the association between cervical abnormalities and some qualitative variables, the independent chi squared test was used. We also calculated prevalence ratio with their 95% confidence intervals. A logistic regression model was used to explore variables that potentially explain cytology abnormalities. The prevalence of squamous cell abnormality was 15.8%. Among women with abnormal cytology, 10% presented atypical squamous cells of undetermined significance, 3.9% low grade squamous intra-epithelial lesion and 1.9% high grade squamous intra-epithelial lesion. The adjusted logistical regression analysis showed that history of sexual transmitted disease, two or more sexual partners during entire life and previous abnormal cytology were associated with cytology abnormalities. The relation of epithelial squamous cell abnormalities with sexual behavior history reflexes the link between human papiloma virus infection and cervical cancer pre-neoplasic lesions. The frequency of use and knowledge about the purpose of cytology were factors that suggested other diagnostic limitations such as quality of cervical cytology or barriers to access health care. These latter factors may be the underlying basis for the high cervical cancer mortality rates.

  13. Prevalence of cervical intraepithelial neoplasia grades II/III and cervical cancer in patients with cytological diagnosis of atypical squamous cells when high-grade intraepithelial lesions (ASC-H cannot be ruled out

    Directory of Open Access Journals (Sweden)

    Andréa Cytryn

    Full Text Available CONTEXT AND OBJECTIVE: The latest update of the Bethesda System divided the category of atypical squamous cells of undetermined significance (ASCUS into ASC-US (undetermined significance and ASC-H (high-grade intraepithelial lesion cannot be ruled out. The aims here were to measure the prevalence of pre-invasive lesions (cervical intraepithelial neoplasia, CIN II/III and cervical cancer among patients referred to Instituto Fernandes Figueira (IFF with ASC-H cytology, and compare them with ASC-US cases. DESIGN AND SETTING: Cross-sectional study with retrospective data collection, at the IFF Cervical Pathology outpatient clinic. METHODS: ASCUS cases referred to IFF from November 1997 to September 2007 were reviewed according to the 2001 Bethesda System to reach cytological consensus. The resulting ASC-H and ASC-US cases, along with new cases, were analyzed relative to the outcome of interest. The histological diagnosis (or cytocolposcopic follow-up in cases without such diagnosis was taken as the gold standard. RESULTS: The prevalence of CIN II/III in cases with ASC-H cytology was 19.29% (95% confidence interval, CI, 9.05-29.55% and the risk of these lesions was greater among patients with ASC-H than with ASC-US cytology (prevalence ratio, PR, 10.42; 95% CI, 2.39-45.47; P = 0.0000764. Pre-invasive lesions were more frequently found in patients under 50 years of age with ASC-H cytology (PR, 2.67; 95% CI, 0.38-18.83; P = 0.2786998. There were no uterine cervical cancer cases. CONCLUSION: The prevalence of CIN II/III in patients with ASC-H cytology was significantly higher than with ASC-US, and division into ASC diagnostic subcategories had good capacity for discriminating the presence of pre-invasive lesions.

  14. Cervical leukocytosis and abnormal post-coital test: a diagnostic and therapeutic approach.

    Science.gov (United States)

    Matilsky, M; Ben-Ami, M; Geslevich, Y; Eyali, V; Shalev, E

    1993-02-01

    Inflammatory processes and cell-mediated immunological reactions in the cervix and vagina have been implicated as causal factors in some cases of infertility. This investigation examined whether cervical Papanicolaou (PAP) smears in combination with post-coital tests could reveal infertile patients with asymptomatic cervical leukocytosis. Women (n = 56) attending a hospital-based community infertility clinic were subjected to post-coital tests and simultaneous preparation of cervical PAP smears. Those women (n = 18) with both abnormal post-coital tests and asymptomatic cervical leukocytosis, based on abnormally high numbers of leukocytes in the PAP smear, were randomly divided into two groups. One group (n = 10) received antibiotic therapy and the other (n = 8) received no therapy. In the treated group six women became pregnant within 3 months after treatment; none of the eight untreated patients became pregnant within the same period. These results suggest that cervical PAP smears, in cases with abnormal post-coital tests, are useful in detecting couples whose infertility may be due to simple, undetected, asymptomatic bacterial infections.

  15. 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

    Institute of Scientific and Technical Information of China (English)

    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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Abnormal surface EMG during clinically normal wrist movement in cervical dystonia

    NARCIS (Netherlands)

    de Vries, P. M.; Leenders, K. L.; van der Hoeven, J. H.; de Jong, B. M.; Kuiper, A. J.; Maurits, N. M.

    2007-01-01

    We investigated whether patients with cervical dystonia (CD) have abnormal muscle activation in non-dystonic body parts. Eight healthy controls and eight CD patients performed a flexion-extension movement of the right wrist. Movement execution was recorded by surface electromyography (EMG) from fore

  19. Qualification of ASCUS. A comparison of equivocal LSIL and equivocal HSIL cervical cytology in the ASCUS LSIL Triage Study.

    Science.gov (United States)

    Sherman, M E; Solomon, D; Schiffman, M

    2001-09-01

    Cytologic detection of high-grade squamous intraepithelial lesions (HSILs) is critical to cervical cancer prevention. Therefore, identifying "equivocal HSIL" (ASCUS [atypical squamous cells of undetermined significance]-H) may be useful. Accordingly, we compared findings associated with "equivocal low-grade SIL" (ASCUS-L), ASCUS-H, and HSIL using data from the ASCUS LSIL (low-grade squamous intraepithelial lesion) Triage Study. The frequency of oncogenic human papillomavirus (HPV) DNA detection and underlying lesions cervical intraepithelial neoplasia (CIN) 2 or worse or CIN 3 or worse in women with ASCUS-H was intermediate between that of ASCUS-L and HSIL. Oncogenic HPV DNA was associated with 85.6% of ASCUS-H ThinPreps and 69.8% of ASCUS-H smears. Histopathologic lesions CIN 2 or worse were associated with 40.5% of ASCUS-H ThinPreps and 27.2% of ASCUS-H smears (mostly CIN 3). Nevertheless, numerically more lesions CIN 2 or worse were preceded by ASCUS-L than by ASCUS-H because ASCUS-L was more common. ASCUS-H is an uncommon interpretation that derives clinical usefulness from its high positive predictive value for lesions CIN 2 or worse.

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

    DEFF Research Database (Denmark)

    Kristiansen, Bettina Kjær

    2014-01-01

    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......-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...... will be of great importance to the future organisation of cervical and colorectal cancer screening programmes in Denmark, but will also have international interest because of their similar challenges....

  1. Cervical spinal cord injury without radiological abnormality in adults.

    Directory of Open Access Journals (Sweden)

    Bhatoe H

    2000-07-01

    Full Text Available Spinal cord injury occurring without concomitant radiologically demonstrable trauma to the skeletal elements of the spinal canal rim, or compromise of the spinal canal rim without fracture, is a rare event. Though documented in children, the injury is not very well reported in adults. We present seventeen adult patients with spinal cord injury without accompanying fracture of the spinal canal rim, or vertebral dislocation, seen over seven years. None had preexisting spinal canal stenosis or cervical spondylosis. Following trauma, these patients had weakness of all four limbs. They were evaluated by MRI (CT scan in one patient, which showed hypo / isointense lesion in the cord on T1 weighted images, and hyperintensity on T2 weighted images, suggesting cord contusion or oedema. MRI was normal in two patients. With conservative management, fifteen patients showed neurological improvement, one remained quadriplegic and one died. With increasing use of MRI in the evaluation of traumatic myelopathy, such injuries will be diagnosed more often. The mechanism of injury is probably acute stretching of the cord as in flexion and torsional strain. Management is essentially conservative and prognosis is better than that seen in patients with fracture or dislocation of cervical spine.

  2. Atypical cervical cytology. Colposcopic follow-up using the Bethesda System.

    Science.gov (United States)

    Taylor, R R; Guerrieri, J P; Nash, J D; Henry, M R; O'Connor, D M

    1993-06-01

    Patients with a cytologic diagnosis of either atypical squamous cells of undetermined significance (squamous ACUS) (191), atypical squamous cells suggestive of papillomavirus (ACPV) (79), low grade squamous intraepithelial lesion (LSIL) (184) or atypical glandular cells of undetermined significance (glandular ACUS) (30) obtained over an 18-month period were evaluated colposcopically at the National Naval Medical Center. The diagnosis of squamous atypia rendered using the Bethesda System was reduced when compared to the diagnosis of atypia rendered using traditional cytologic terms (1.9% versus 7.2%). Results from colposcopic evaluations of patients with squamous ACUS demonstrated similar rates of underlying dysplasia as in studies using older terminology (low grade dysplasia in 14% and high grade in 6% of the referrals). Colposcopic evaluation of patients with a referral diagnosis of squamous ACPV demonstrated rates of underlying low grade dysplasia double that of the diagnosis of squamous ACUS but half that of a diagnosis of LSIL (25% versus 14%, and 48%, respectively). Colposcopic evaluation of glandular ACUS rendered a diagnosis of high grade dysplasia more than three times (20%) as often as of squamous ACUS (6%). While the Bethesda System reduces inconsistencies in the diagnosis of atypical cytologic changes, a separate category (ACUS) appears to be useful in identifying underlying, unsuspected low grade dysplasias in our laboratory. In addition, glandular atypias herald a significant rate of underlying high grade dysplasias and warrant immediate colposcopic investigation.

  3. Cytological profile of Pap smears in a tertiary care hospital of West Bengal, India

    Directory of Open Access Journals (Sweden)

    Nandini Bhaduri Bhattacharyya

    2016-12-01

    Conclusions: Majority of the cases cervical cytology were reported to be without any epithelial cell abnormality followed by LSIL. Age and religion were significantly associated with the abnormality of smears. [Int J Reprod Contracept Obstet Gynecol 2016; 5(12.000: 4397-4400

  4. Segmentation and abnormality detection of cervical cancer cells using fast elm with particle swarm optimization

    Directory of Open Access Journals (Sweden)

    Sukumar P.

    2015-01-01

    Full Text Available Cervical cancer arises when the anomalous cells on the cervix mature unmanageable obviously in the renovation sector. The most probably used methods to detect abnormal cervical cells are the routine and there is no difference between the abnormal and normal nuclei. So that the abnormal nuclei found are brown in color while normal nuclei are blue in color. The spread or cells are examined and the image denoising is performed based on the Iterative Decision Based Algorithm. Image Segmentation is the method of paneling a digital image into compound sections. The major utilize of segmentation is to abridge or modify the demonstration of an image. The images are segmented by applying anisotropic diffusion on the Denoised image. Image can be enhanced using dark stretching to increase the quality of the image. It separates the cells into all nuclei region and abnormal nuclei region. The abnormal nuclei regions are further classified into touching and non-touching regions and touching regions undergoes feature selection process. The existing Support Vector Machines (SVM is classified few nuclei regions but the time to taken for execution is high. The abnormality detected from the image is calculated as 45% from the total abnormal nuclei. Thus the proposed method of Fast Particle Swarm Optimization with Extreme Learning Machines (Fast PSO-ELM to classify all nuclei regions further into touching region and separated region. The iterative method for to training the ELM and make it more efficient than the SVM method. In experimental result, the proposed method of Fast PSO-ELM may shows the accuracy as above 90% and execution time is calculated based on the abnormality (ratio of abnormal nuclei regions to all nuclei regions image. Therefore, Fast PSO-ELM helps to detect the cervical cancer cells with maximum accuracy.

  5. Unique LCR variations among lineages of HPV16, 18 and 45 isolates from women with normal cervical cytology in Ghana.

    Science.gov (United States)

    Awua, Adolf K; Adanu, Richard M K; Wiredu, Edwin K; Afari, Edwin A; Zubuch, Vanessa A; Asmah, Richard H; Severini, Alberto

    2017-04-21

    In addition to being useful for classification, sequence variations of human Papillomavirus (HPV) genotypes have been implicated in differential oncogenic potential and a differential association with the different histological forms of invasive cervical cancer. These associations have also been indicated for HPV genotype lineages and sub-lineages. In order to better understand the potential implications of lineage variation in the occurrence of cervical cancers in Ghana, we studied the lineages of the three most prevalent HPV genotypes among women with normal cytology as baseline to further studies. Of previously collected self- and health personnel-collected cervical specimen, 54, which were positive for HPV16, 18 and 45, were selected and the long control region (LCR) of each HPV genotype was separately amplified by a nested PCR. DNA sequences of 41 isolates obtained with the forward and reverse primers by Sanger sequencing were analysed. Nucleotide sequence variations of the HPV16 genotypes were observed at 30 positions within the LCR (7460 - 7840). Of these, 19 were the known variations for the lineages B and C (African lineages), while the other 11 positions had variations unique to the HPV16 isolates of this study. For the HPV18 isolates, the variations were at 35 positions, 22 of which were known variations of Africa lineages and the other 13 were unique variations observed for the isolates obtained in this study (at positions 7799 and 7813). HPV45 isolates had variations at 35 positions and 2 (positions 7114 and 97) were unique to the isolates of this study. This study provides the first data on the lineages of HPV 16, 18 and 45 isolates from Ghana. Although the study did not obtain full genome sequence data for a comprehensive comparison with known lineages, these genotypes were predominately of the Africa lineages and had some unique sequence variations at positions that suggest potential oncogenic implications. These data will be useful for comparison

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

    Directory of Open Access Journals (Sweden)

    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.

  7. High-Risk Human Papillomavirus (hrHPV) E6/E7 mRNA Testing by PreTect HPV-Proofer for Detection of Cervical High-Grade Intraepithelial Neoplasia and Cancer among hrHPV DNA-Positive Women with Normal Cytology

    Science.gov (United States)

    Rijkaart, D. C.; Heideman, D. A. M.; Coupe, V. M. H.; Brink, A. A. T. P.; Verheijen, R. H. M.; Skomedal, H.; Karlsen, F.; Morland, E.; Snijders, P. J. F.

    2012-01-01

    Our aim was to investigate whether high-risk HPV (hrHPV) mRNA detection by PreTect HPV-Proofer can be used to stratify hrHPV DNA-positive women of different cytology classes for risk of high-grade cervical intraepithelial neoplasia or worse (cervical precancer or cancer, i.e., cervical intraepithelial neoplasia grade 2 or higher [≥CIN2]). A total of 375 women participating in population-based screening, with a GP5+/6+-PCR hrHPV DNA-positive cervical scrape with normal cytology (n = 202), borderline or mild dyskaryosis (BMD) (n = 88), or moderate dyskaryosis or worse (>BMD) (n = 85), were enrolled. Cervical scrapes were additionally subjected to HPV16/18/31/33/45 E6/E7 mRNA analysis by PreTect HPV-Proofer (mRNA test). Referral and follow-up policies were based on cytology, hrHPV DNA, and mRNA testing. The primary study endpoint was the number of ≥CIN2 detected within 3 years of follow-up. The mRNA positivity increased with the severity of cytological abnormality, ranging from 32% (64/202) in hrHPV DNA-positive women with normal cytology to 47% (41/88) in BMD and 68% (58/85) in >BMD groups (P cytology, i.e., 0.55 (95% confidence interval [95% CI], 0.34 to 0.76) in mRNA-positive versus 0.20 (95% CI, 0.07 to 0.33) in mRNA-negative women. In hrHPV DNA-positive women with BMD or >BMD, the result of the mRNA test did not influence the ≥CIN2 risk. In conclusion, mRNA testing by PreTect HPV-Proofer might be of value to select hrHPV DNA-positive women with normal cytology in need of immediate referral for colposcopy. PMID:22553244

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

    Science.gov (United States)

    Walsh, Michael J; Singh, Maneesh N; Stringfellow, Helen F; Pollock, Hubert M; Hammiche, Azzedine; Grude, Olaug; Fullwood, Nigel J; Pitt, Mark A; Martin-Hirsch, Pierre L; Martin, Francis L

    2008-03-25

    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 mum) 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 (nu(as)) PO(2) (-) (1,225 cm(-1)) and carbohydrates (1,155 cm(-1)). In contrast, symmetric (nu(s)) PO(2) (-) (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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

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

    Directory of Open Access Journals (Sweden)

    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

  12. Tracheobronchial cytologic changes and abnormal serum heme pigments in hemorrhagic shock.

    Science.gov (United States)

    Friedman-Mor, Z; Chalon, J; Turndorf, H; Orkin, L R

    1977-11-01

    Significantly elevated numbers of iron laden histiocytes have been shown to appear in the tracheobronchial secretions of subjects in hemorrhagic shock and in patients undergoing open heart-surgery during cardiopulmonary bypass (3,4). Abnormal heme pigments have also been demonstrated in the serum of dogs bled to hemorrhagic shock (6) and have been felt to be toxic. Because the ingestion of abnormal heme pigments by histiocytes may be part of a defense mechanism, we have attempted to correlate the percentage of iron laden histiocytes found in the tracheobronchial secretions of patients in hemorrhagic shock (Prussian blue method) with the presence of degradation of products of hemoglobin found in their serum by scanning spectrophotometry. There were, generally speaking, few iron laden histiocytes when hemoglobin degradation was advanced, and always numerous iron laden histiocytes when abnormal heme pigments were absent or spectrophotometric findings revealed minor degrees of degradation. Our findings probably reflect the process in the reticuloendothelial systems which eliminates toxic products accumulating in the circulation in low-flow states.

  13. Clinical role of p16INK4a expression in liquid-based cervical cytology: correlation with HPV testing and histologic diagnosis.

    Science.gov (United States)

    Benevolo, Maria; Vocaturo, Amina; Mottolese, Marcella; Mariani, Luciano; Vocaturo, Giuseppe; Marandino, Ferdinando; Sperduti, Isabella; Rollo, Francesca; Antoniani, Barbara; Donnorso, Raffaele Perrone

    2008-04-01

    p16INK4a is overexpressed in high-risk human papillomavirus (HR-HPV)-infected preneoplastic and neoplastic lesions of the uterine cervix. Our aim was to verify whether p16 is a diagnostic marker also in cervical liquid-based cytology. We performed p16 immunocytochemical analysis and the Hybrid Capture 2 (HC2) test (Digene, Gaithersburg, MD) for HR-HPV infection in 471 ThinPrep-processed (Cytyc, Boxborough, MA) cervicovaginal samples and correlated the results with histologic findings. A total of 32.3% of the specimens showed p16 immunoreactivity, whereas the HC2 test was positive in 41.2% of the cases (65.2% concordance rate). Correlating the cytologic, p16, and HPV results with histologic findings revealed HC2 as the most sensitive test for a diagnosis of cervical intraepithelial neoplasia 2 or worse, whereas cytologic examination was the most specific. The positive predictive value was significantly higher for cytologic examination than for p16 and HR-HPV testing. These data suggest that p16 evaluation in ThinPrep samples does not have better clinical effectiveness for identifying high-grade lesions than conventional morphologic examination and HPV testing.

  14. Cost-effectiveness of cervical cancer screening: Cytology versus human papillomavirus DNA testing

    NARCIS (Netherlands)

    J.M. van Rosmalen (Joost); I.M.C.M. de Kok (Inge); M. van Ballegooijen (Marjolein)

    2012-01-01

    textabstractObjective To determine the most cost-effective screening programme for cervical cancer. Design Cost-effectiveness analysis from a societal perspective. Setting The Netherlands. Population Dutch women who have not been invited for human papillomavirus (HPV) vaccination. Methods We calibra

  15. Diagnostic parameters in liquid-based cervical cytology using a coagulant suspension fixative

    NARCIS (Netherlands)

    Boon, ME; Ouwerkerk-Noordam, E; Suurmeijer, AH; Kok, LP

    2005-01-01

    Objective To evaluate in detail the morphology of cervical cell samples suspended in the coagulant fixative BoonFix (R) (Finetec, Tokyo, Japan) in liquid-based Papspin (R) slides (Thermo Shandon, Pittsburgh, Pennsylvania, U.S.A) to detect shifts in diagnostic parameters for infections and neoplasia.

  16. Cost-effectiveness of cervical cancer screening: Cytology versus human papillomavirus DNA testing

    NARCIS (Netherlands)

    J.M. van Rosmalen (Joost); I.M.C.M. de Kok (Inge); M. van Ballegooijen (Marjolein)

    2012-01-01

    textabstractObjective To determine the most cost-effective screening programme for cervical cancer. Design Cost-effectiveness analysis from a societal perspective. Setting The Netherlands. Population Dutch women who have not been invited for human papillomavirus (HPV) vaccination. Methods We calibra

  17. Diagnostic parameters in liquid-based cervical cytology using a coagulant suspension fixative

    NARCIS (Netherlands)

    Boon, ME; Ouwerkerk-Noordam, E; Suurmeijer, AH; Kok, LP

    2005-01-01

    Objective To evaluate in detail the morphology of cervical cell samples suspended in the coagulant fixative BoonFix (R) (Finetec, Tokyo, Japan) in liquid-based Papspin (R) slides (Thermo Shandon, Pittsburgh, Pennsylvania, U.S.A) to detect shifts in diagnostic parameters for infections and neoplasia.

  18. Clinical analysis on results of cervical cytology screening: report of 6 498 cases%6498例宫颈液基细胞学检查结果分析

    Institute of Scientific and Technical Information of China (English)

    李茜; 郭德玉; 黄玉胜; 陈艳

    2013-01-01

    Objective To investigate the diagnose accordance rate of liquid-based cytology test ( LCT) and tissue biopsy for cervix, and to investigate the clinical application value of LCT combined with tissue biopsy in early screening for cervical epithelial lesions. Methods The results of 6 498 cases undergoing cervical LCT inspection during January to December 2011 were retrospectively analyzed. Patients with atypical squamous cells of undetermined significance (ASC-US) or severe than ASC-US were defined as abnormal cytology according to Bethesda system for cytology classifications. Among 377 cases of abnormal cytology, 148 cases received biopsy inspection. The cytology and histology results were compared, and the relationship of lesion and ages were analyzed. Results In 6 498 cases receiving cervical LCT, the abnormal cytology ratio was 5. 80%. Among them, ASC-US were 215 cases (57.03% ), atypical squamous cell cannot exclude high grade squamous intraepithelial lesion (ASC-H) were 36 cases (9.55%), low grade squamous intraepithelial lesion (LSIL) were 82 cases (21. 75% ) , high grade squamous intraepithelial lesion ( HSIL) were 39 cases ( 10. 34% ) , atypical glandular cells of undetermined significance not otherwise specified ( AGC-NOS) were 4 cases (1. 06% ), and squamous cell carcinoma (SCC) were 1 cases (0.27% ). Among the 148 cases of biopsy, cases of inflammation reaction were 39 cases (26. 35% ) , koilocytotic cells 16 cases (10. 81% ) , cervical intraepithelial neoplasia (CIN Ⅰ ) 32 cases (21.62% ), CINⅡ35 cases (23.65% ), CINⅢ 17 cases (11.49% ), squamous carcinoma 8 cases (5.41%), and adenocarcinoma 1 cases (0. 68% ) , which revealing that the cytology results had a high conformity rate with biopsy results. And the onset age of cervical lesions ranged from 30 to 50. Conclusion LCT is an important approach of screening for cervical epithelial lesions with its high accuracy. Combination of LCT and tissue biopsy can greatly improve early diagnosis of CIN and

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

    Institute of Scientific and Technical Information of China (English)

    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.

  20. Economic evaluation of DNA ploidy analysis vs liquid-based cytology for cervical screening.

    Science.gov (United States)

    Nghiem, V T; Davies, K R; Beck, J R; Follen, M; MacAulay, C; Guillaud, M; Cantor, S B

    2015-06-09

    DNA ploidy analysis involves automated quantification of chromosomal aneuploidy, a potential marker of progression toward cervical carcinoma. We evaluated the cost-effectiveness of this method for cervical screening, comparing five ploidy strategies (using different numbers of aneuploid cells as cut points) with liquid-based Papanicolaou smear and no screening. A state-transition Markov model simulated the natural history of HPV infection and possible progression into cervical neoplasia in a cohort of 12-year-old females. The analysis evaluated cost in 2012 US$ and effectiveness in quality-adjusted life-years (QALYs) from a health-system perspective throughout a lifetime horizon in the US setting. We calculated incremental cost-effectiveness ratios (ICERs) to determine the best strategy. The robustness of optimal choices was examined in deterministic and probabilistic sensitivity analyses. In the base-case analysis, the ploidy 4 cell strategy was cost-effective, yielding an increase of 0.032 QALY and an ICER of $18 264/QALY compared to no screening. For most scenarios in the deterministic sensitivity analysis, the ploidy 4 cell strategy was the only cost-effective strategy. Cost-effectiveness acceptability curves showed that this strategy was more likely to be cost-effective than the Papanicolaou smear. Compared to the liquid-based Papanicolaou smear, screening with a DNA ploidy strategy appeared less costly and comparably effective.

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

    LENUS (Irish Health Repository)

    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.

  2. Primary cervical cancer screening with HPV testing compared with liquid-based cytology: results of round 1 of a randomised controlled trial -- the HPV FOCAL Study.

    Science.gov (United States)

    Ogilvie, G S; Krajden, M; van Niekerk, D J; Martin, R E; Ehlen, T G; Ceballos, K; Smith, L W; Kan, L; Cook, D A; Peacock, S; Stuart, G C E; Franco, E L; Coldman, A J

    2012-12-04

    Round 1 data of human papillomavirus (HPV) FOCAL, a three-arm, randomised trial, which aims to establish the efficacy of HPV DNA testing as a primary screen for cervical cancer, are presented. The three arms are: Control arm - liquid based cytology with atypical squamous cells of unknown significance (ASC-US) triage with hrHPV testing; Intervention Arm - hrHPV at entry with liquid-based cytology (LBC) triage of hrHPV positives, with exit screen at 4 years; Safety check arm - hrHPV at entry with LBC triage of hrHPV positives with exit screen at 2 years. A total of 6154 women were randomised to the control arm and 12 494 to the HPV arms (intervention and safety check). In the HPV arm, the baseline cervical intraepithelial neoplasia (CIN)2+ and CIN3+ rate was 9.2/1000 (95%CI; 7.4, 10.9) and 4.8/1000 (95%CI; 3.6, 6.1), which increased to 16.1/1000 (95%CI 13.2, 18.9) for CIN2+ and to 8.0/1000 (95%CI; 5.9, 10.0) for CIN3+ after subsequent screening of HPV-DNA-positive/cytology-negative women. Detection rate in the control arm remained unchanged after subsequent screening of ASC-US-positive/hrHPV DNA-negative women at 11.0/1000 for CIN2+ and 5.0/1000 for CIN3+. After subsequent screening of women who were either hrHPV positive/cytology negative or ASC-US positive/HPV negative, women randomised to the HPV arms had increased CIN2+ detection compared with women randomised to the cytology arm.

  3. Primary cervical cancer screening with HPV testing compared with liquid-based cytology: results of round 1 of a randomised controlled trial – the HPV FOCAL Study

    Science.gov (United States)

    Ogilvie, G S; Krajden, M; van Niekerk, D J; Martin, R E; Ehlen, T G; Ceballos, K; Smith, L W; Kan, L; Cook, D A; Peacock, S; Stuart, G C E; Franco, E L; Coldman, A J

    2012-01-01

    Background: Round 1 data of human papillomavirus (HPV) FOCAL, a three-arm, randomised trial, which aims to establish the efficacy of HPV DNA testing as a primary screen for cervical cancer, are presented. Methods: The three arms are: Control arm – liquid based cytology with atypical squamous cells of unknown significance (ASC-US) triage with hrHPV testing; Intervention Arm – hrHPV at entry with liquid-based cytology (LBC) triage of hrHPV positives, with exit screen at 4 years; Safety check arm – hrHPV at entry with LBC triage of hrHPV positives with exit screen at 2 years. Results: A total of 6154 women were randomised to the control arm and 12 494 to the HPV arms (intervention and safety check). In the HPV arm, the baseline cervical intraepithelial neoplasia (CIN)2+ and CIN3+ rate was 9.2/1000 (95%CI; 7.4, 10.9) and 4.8/1000 (95%CI; 3.6, 6.1), which increased to 16.1/1000 (95%CI 13.2, 18.9) for CIN2+ and to 8.0/1000 (95%CI; 5.9, 10.0) for CIN3+ after subsequent screening of HPV-DNA-positive/cytology-negative women. Detection rate in the control arm remained unchanged after subsequent screening of ASC-US-positive/hrHPV DNA-negative women at 11.0/1000 for CIN2+ and 5.0/1000 for CIN3+. Conclusion: After subsequent screening of women who were either hrHPV positive/cytology negative or ASC-US positive/HPV negative, women randomised to the HPV arms had increased CIN2+ detection compared with women randomised to the cytology arm. PMID:23169286

  4. Cervical Abnormalities in South African Women Living With HIV With High Screening and Referral Rates.

    Science.gov (United States)

    Katz, Ingrid T; Butler, Lisa M; Crankshaw, Tamaryn L; Wright, Alexi A; Bramhill, Karen; Leone, Dominick A; Giddy, Janet; Mould, Sean

    2016-12-01

    To determine the prevalence of screening, cervical dysplasia, and malignancy on the basis of histologic diagnoses from colposcopy and large loop excision of the transformation zone among women living with HIV (WLWH) who attended an urban antiretroviral treatment (ART) clinic in KwaZulu-Natal, South Africa. We performed a retrospective cohort study to examine a random sample of 462 WLWH during a 5-year period from 2004 to 2009. Women on ART for Papanicolau test. At baseline, 237 women (54.9%) had an abnormal Papanicolau test, and of these patients, 181 (76.3%) had a Papanicolau test that qualified for further colposcopic evaluation. In addition, 115 women (63.5%) received colposcopy within a median of 39 days from referral. This yielded 74 evaluable histologic samples (64.3%), of which 21.6%, 27.0%, 27.0%, and 1.4% had cervical intraepithelial neoplasia (CIN) 1, CIN2, CIN3, and invasive cervical cancer, respectively. In a large sample of WLWH who received ART in KwaZulu-Natal, South Africa, where Papanicolau test coverage and rates of referral for colposcopy and large loop excision of the transformation zone were high, > 75% of women with evaluable histologic samples had evidence of cervical dysplasia or malignancy. These findings underscore the importance of routine cervical screening upon entry into HIV care to optimize survival.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Normal or abnormal? Demystifying uterine and cervical contrast enhancement at multidetector CT.

    Science.gov (United States)

    Yitta, Silaja; Hecht, Elizabeth M; Mausner, Elizabeth V; Bennett, Genevieve L

    2011-01-01

    Computed tomography (CT) is not generally advocated as the first-line imaging examination for disorders of the female pelvis. However, multidetector CT is often the modality of choice for evaluating nongynecologic pelvic abnormalities, particularly in emergent settings, in which all the pelvic organs are invariably assessed. Incidental findings of uterine and cervical contrast enhancement in such settings may easily be mistaken for abnormalities, given the broad spectrum of anatomic variants and enhancement patterns that may be seen in the normal uterus and cervix. The authors' review of CT and magnetic resonance (MR) imaging enhancement patterns, augmented by case examples from their clinical radiology practice, provides a solid foundation for understanding the spectrum of normal uterine and cervical appearances and avoiding potential pitfalls in the diagnosis of benign cervical lesions, adenomyosis, infection, malignancy, and postpartum effects. This information should help radiologists more confidently differentiate between normal and abnormal CT findings and, when CT findings are not definitive, offer appropriate recommendations for follow-up ultrasonography or MR imaging.

  7. Controle da qualidade em colpocitologia: visão rápida com campo marcado Cervical cytology quality control: rapid pre-screening with marked field

    Directory of Open Access Journals (Sweden)

    Jane Lopes Bonilha

    2006-12-01

    Preto, SP had decided to develop a Quality Control System following the NBR ISO 9001: 2000 guidelines. Some procedures were adopted to verify technical reliability for the exams performed, where quality is defined as the clients' judgement, i.e., the solution for the clients' requests and expectations. In this study we have focused on the quality of the cervical cytology performed in the Department. Although the development of cervical lesions through cervical carcinoma takes place slowly, the treatment will have a better chance of success in case of an early diagnosis. Considering all the possible diagnostic mistakes, the false-negative exam is the most dangerous, as it delays the beginning of the treatment. OBJECTIVE: To test three different methods looking for the one with the smaller number of false-negative results. MATERIAL AND METHODS: For the same team of technicians, and with the same diagnostic criteria the three different techniques were tested. Methodology 1 (M1: in accordance to the Brazilian Ministry of National Health, with a random review of 10% of the false-negative results, in the 3,500 cytologies; Methodology 2 (M2: rapid review (RR, as suggested in literature, consists of a rapid review of 100% of the smears, after their routine evaluation, and was done in 7,373 cytologies; Methodology 3 (M3: rapid prescreening (RP with marked field, was proposed by the researcher and consists of a rapid screening of all cases, pointing out a field were there are abnormal cells, and after that the normal screening, in 8,096 cytologies. RESULTS: The three techniques tested showed the following false-negative rates: M1: 2.4%; M2: 1.7% and M3: 1.2 %. CONCLUSION: The M3 was the best methodology, presenting less false-negative diagnosis.

  8. Human papillomavirus infections in women seeking cervical Papanicolaou cytology of Durango, Mexico: prevalence and genotypes

    Directory of Open Access Journals (Sweden)

    Reyes-Romero Miguel

    2006-02-01

    Full Text Available Abstract Background HPV infection in women from developing countries is an important public health problem. Therefore, we sought to determine the prevalences of HPV infection and HPV genotypes in a female population of Durango City, Mexico. Also to determine whether any socio-demographic characteristic from the women associated with HPV infection exists. Methods Four hundred and ninety eight women seeking cervical Papanicolaou examination in three public Health Centers were examined for HPV infection. All women were tested for HPV DNA PCR by using HPV universal primers. In addition, all positive HPV DNA PCR samples were further analyzed for genotyping of HPV genotype 16, 18 and 33. Socio-demographic characteristics from each participant were also obtained. Results Twenty-four out of four hundred and ninety-eight (4.8% women were found infected by HPV. HPV genotype 16 was found in 18 out of the 24 (75% infected women. Two of them were also coinfected by HPV genotype 18 (8.3%. In the rest 6 PCR positive women, genotyping for HPV genotypes 16, 18 and 33 were negative. Conclusion The prevalence of HPV in women of Durango City is low; however, most infected women have high risk HPV genotype. The women who were studied showed low frequency of risk factors for HPV infection and this may explain the low prevalence of HPV infection. The high frequency of high risk HPV genotypes observed might explain the high rate of mortality for cervical cancer in our region.

  9. Liquid-based cytology and human papillomavirus testing: a pooled analysis using the data from 13 population-based cervical cancer screening studies from China.

    Science.gov (United States)

    Pan, Qin-Jing; Hu, Shang-Ying; Guo, Hui-Qin; Zhang, Wen-Hua; Zhang, Xun; Chen, Wen; Cao, Jian; Jiang, Yong; Zhao, Fang-Hui; Qiao, You-Lin

    2014-05-01

    The objective of this study was to evaluate the impact of introducing HR-HPV testing in cytology regarding cervical cancer screening practice. A pooled analysis of liquid-based cytology (LBC) and HR-HPV testing using data from 13 population-based cervical cancer screening studies conducted in China was performed. Participants (n=25,404) received LBC and HR-HPV testing. Women found to be positive on screening were referred for colposcopy and biopsy. The effectiveness of screening strategies that use: LBC with HR-HPV triage for atypical squamous cells of undetermined significance (ASC-US), HR-HPV testing with cytology triage for HPV positive tests, or LBC and HPV cotesting was compared with that of LBC screening alone. LBC with HR-HPV triage for ASC-US had similar sensitivity compared with LBC alone, but significantly increased specificity for both cervical intraepithelial neoplasia grade 2 or worse (CIN2+) and CIN3 or worse (CIN3+) endpoints, and had the best balance between sensitivity and specificity among the strategies. LBC and HR-HPV cotesting had the highest sensitivity and negative predictive value (NPV) and could permit a safe extension of screening intervals. Through the use of an immediate colposcopy threshold of ASC-US or worse for HR-HPV positive women and the use of a raised threshold of low-grade squamous intraepithelial lesion (LSIL) or worse for HR-HPV negative women, LBC and HR-HPV cotesting could provide the same effectiveness as LBC testing with HR-HPV triage for ASC-US at baseline tests. The results of the current study support the use of the cervical cancer screening guidelines in China. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Teenage cervical screening in a high risk American population

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    Songlin Zhang

    2011-01-01

    Full Text Available Background: The new 2009 ACOG guideline for cervical cytology screening changed the starting age to 21 years regardless of the age of onset of sexual intercourse. However, many recent studies have shown a dramatic increase in the incidence of cervical epithelial abnormalities among adolescents within the past two decades. Materials and Methods: For this study, the reports of 156,342 cervical cytology were available of which 12,226 (7.8% were from teenagers. A total of 192 teenagers with high grade intraepithelial lesion (HSIL cervical cytology were identified. The ages ranged from 13 to 19 years with a mean of 17.7 years and a median of 18 years. Among them, 31.3% were pregnant, 12.0% were postpartum, and 13.5% were on oral contraceptive. Ninety-eight had prior cervical cytology. Results: The teenagers had statistically significant higher detection rates of overall abnormal cervical cytology (23.6% vs. 6.6%, P = 0, with 15.4% vs. 3.2% (P = 0 of low grade intraepithelial lesion (LSIL and 1.8% vs. 1.0% (P = 2.56 Χ 10 -13 of HSIL compared to women ≥20 years. The teenage group had the highest abnormal cytology among all age groups. The LSIL/HSIL ratio was 8.5:1 for teenagers and 3.1:1 for women ≥20 years. A total of 131 teenagers had cervical biopsies within 12 months of the HSIL cytology, with diagnoses of 39 CIN 3, 1 VAIN 3, 15 CIN 2, 62 CIN 1, and 14 had a negative histology (CIN 0. Only in 19 of these 39 women, the CIN 2/3 lesion proved to be persistent. Conclusion: We conclude that cytology screening of high risk teenagers is effective in detecting CIN 2/3 lesions. Moreover, treatment and careful follow-up can be realized.

  11. [Sexual profile of women with cervical cytology in a first level unit].

    Science.gov (United States)

    Cabrera-Gaytán, David Alejandro; Palacios-Rodríguez, Raúl Gabriel; Guzmán-Solorio, José Antonio

    2014-01-01

    INTRODUCCIÓN: el perfil sexual de las mujeres conforma un conjunto de componentes que juega un papel fundamental en la aparición del virus del papiloma humano (VPH) o del cáncer cervicouterino (CACU). Se buscó determinar el perfil sexual de un grupo de mujeres con citología cervical en una unidad de primer nivel del Instituto Mexicano del Seguro Social del Estado de México. MÉTODOS: se estudiaron mujeres que acudieron para detección citológica de tumor maligno del cuello uterino. Se les entrevistó para obtener características sociodemográficas y ginecoobstétricas. El análisis estadístico se hizo con prueba exacta de Fisher, chi cuadrada de Mantel-Haenszel, y correlación de Spearman.

  12. 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

    Institute of Scientific and Technical Information of China (English)

    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

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

    OpenAIRE

    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...

  14. The clinical impact of using p16(INK4a) immunochemistry in cervical histopathology and cytology: an update of recent developments.

    Science.gov (United States)

    Bergeron, Christine; Ronco, Guglielmo; Reuschenbach, Miriam; Wentzensen, Nicolas; Arbyn, Marc; Stoler, Mark; von Knebel Doeberitz, Magnus

    2015-06-15

    Cervical cancer screening test performance has been hampered by either lack of sensitivity of Pap cytology or lack of specificity of Human Papillomavirus (HPV) testing. This uncertainty can lead to unnecessary referral and treatment, which is disturbing for patients and increases costs for health care providers. The identification of p16(INK4a) as a marker for neoplastic transformation of cervical squamous epithelial cells by HPVs allows the identification of HPV-transformed cells in histopathology or cytopathology specimens. Diagnostic studies have demonstrated that the use of p16(INK4a) immunohistochemistry substantially improves the reproducibility and diagnostic accuracy of histopathologic diagnoses. p16(INK4a) cytology has substantially higher sensitivity for detection of cervical precancer in comparison to conventional Pap tests. Compared to HPV DNA tests, immunochemical detection of p16(INK4a) -stained cells demonstrates a significantly improved specificity with remarkably good sensitivity. About 15 years after the initial observation that p16(INK4a) is overexpressed in HPV-transformed cells we review the accumulated clinical evidence suggesting that p16(INK4a) can serve as a useful biomarker in the routine diagnostic work up of patients with HPV infections and associated lesions of the female anogenital tract. © 2014 The Authors. Published by Wiley Periodicals, Inc. on behalf of UICC.

  15. Correlation of abnormal DNMT1 and MeCP2 expression with cell biological characteristics in cervical lesion tissue

    Institute of Scientific and Technical Information of China (English)

    Wei Lin; Sha Ma

    2016-01-01

    Objective:To study the correlation of abnormal DNMT1 and MeCP2 expression with cell biological characteristics in cervical lesion tissue.Methods:Cervical cancer tissue and para-carcinoma tissue were collected from cervical cancer patients who received surgery in our hospital from May 2012 to October 2015, and HPV types as well as the expression levels of DNMTs, MeCP2, PBK, TOPK, Snail, Slug, SALL4 and Cat L were determined.Results:Protein levels of DNMT1, DNMT2, DNMT3a, DNMT3b, DNMT3l and MeCP2 in cervical cancer tissue were significantly higher than those in para-carcinoma tissue, and the rising trend of DNMT1 expression level was the most significant; protein levels of DNMT1, DNMT2, DNMT3a, DNMT3b, DNMT3l and MeCP2 in cervical cancer tissue with high-risk HPV infection were significantly higher than those in cervical cancer tissue with normal HPV infection; in cervical cancer tissue with high expression of DNMT1 and MeCP2, PBK, TOPK, Snail, Slug, SALL4 and Cat L levels were significantly higher than those in cervical cancer tissue with low expression of DNMT1 and MeCP2.Conclusions:Abnormally high expression of DNMT1 and MeCP2 in cervical cancer tissue may up-regulate the expression of a variety of malignant biological molecules by increasing methylation level.

  16. Etiologic factors related to unsatisfactory ThinPrep® cervical cytology: Evaluation and potential solutions to improve

    Directory of Open Access Journals (Sweden)

    Tatyana Kalinicheva

    2015-01-01

    Full Text Available Background: In cervical cytology, the unsatisfactory rates for ThinPrep (TP are slightly higher compared to SurePath. We examined various causes and explored potential for resolution of this discrepancy. Materials and Methods: Totally, 19,422 cases were reviewed and 1000 unsatisfactory specimens were selected and analyzed. 531 specimens were available for wash protocol. Out of 114 unsatisfactory specimens associated with atrophic cellular changes (ACC, 48 were resubmitted by provider and reevaluated. Results: Lubricant and lubricant-like debris/contamination (LUBE was the most common cause of unsatisfactory specimens (68%; 681/1000 followed by blood (7.5%; ACC only (without other interfering factors (2.4%; inflammation (3.0%; and combinations thereof (1.9%. 11.5% showed scant cellularity without an identifiable cause. 3.3% were virtually acellular. Wash protocol improved cellularity in 48% (256/531 of cases. However, only 29% (73/256 of those were satisfactory (with more than 5000 cells. Quantitative reduction in LUBE after wash protocol varied with different morphological subtypes. Interpretation patterns on satisfactory specimens after wash protocol were comparable to the results on selected cohort of specimens during the same study period. Out of 114 ACC, wash protocol was performed on 68 ACC specimens leading to satisfactory TP in 24% (16/68. Totally, 48 cases reported as unsatisfactory with ACC, were resubmitted by the providers between 2 weeks and 2 years. 44 (92% showed increased cellularity, out of which 52% (23/44 did not show ACC. Conclusion: LUBE was the most common cause of unsatisfactory TP in addition to interference by blood and association with atrophic changes. Knowing the morphological spectrum of LUBE would help to identify it as the cause of "unsatisfactory" TP. Communicating the cause of unsatisfactory TP such as LUBE, ACC, and blood would hint the provider to take appropriate precaution during submission of the repeat

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

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    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.

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

    LENUS (Irish Health Repository)

    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.

  19. [Sorting role of p16(INK4a)/Ki-67 double immunostaining in the cervical cytology specimens of ASCUS and LSIL cases].

    Science.gov (United States)

    Yu, J; Zhu, H T; Zhao, J J; Su, J Z; Xia, Y D

    2017-05-08

    Objective: To investigate the sorting effect of p16(INK4a)/Ki-67 double immunostaining method in patients with atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL) cytology results. Methods: Four-hundred and twenty cases collected during April 2014 to February 2015 of cervical cytology of ASCUS (n=318) and LSIL (n=102) were selected, and residual liquid-based cytology specimens were used for p16(INK4a)/Ki-67 double immunostaining. The sensitivity and specificity of the detection of cervical precancerous lesions and cervical cancer were calculated, and the results were compared with high risk HPV. Taking histological follow-up as the gold standard, the test was considered positive when at least one cell exhibited p16(INK4a)/Ki-67 co-staining, without requirement of adjunct morphologic interpretation of positive cells. Results: Further screening CIN2+ in cytology ASCUS and LSIL group , the sensitivity of p16(INK4a)/Ki-67 double immunostaining was slightly lower than high risk HPV (84.2% vs. 94.7%), while the specificity was higher (84.0% vs. 53.9%). For ASCUS patients, the sensitivity of p16(INK4a)/Ki-67 double immunostaining and high risk HPV was 82.6% and 91.3%, and the specificity was 88.8% and 63.7%, respectively. For LSIL patients, the sensitivity of p16(INK4a)/Ki-67 double immunostaining and high risk HPV was 86.7% and 100.0%, and the specificity was 67.8% and 20.7%, respectively. For patients younger and older than 30 years, specificity of p16(INK4a)/Ki-67 double immunostaining was both higher than that of high risk HPV (80.8% vs. 42.3%; 84.6% vs. 56.9%). Conclusions: p16(INK4a)/Ki-67 double immunostaining can effectively identify the high risk population in ASCUS or LSIL, with higher specificity than high risk HPV test. p16(INK4a)/Ki-67 double immunostaining may benefit patients younger than 30 years of age as a preliminary or potential cytology-combining screening tool.

  20. 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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  4. Citología de cuello uterino e impeditividad eléctrica en la detección temprana del cáncer cervical Cervical Cytology and Electrical Impedivity in the Early Detection of the Cervical Cancer

    Directory of Open Access Journals (Sweden)

    Sandra P. Corzo

    2012-12-01

    Full Text Available Se reportan los resultados de un estudio piloto de las propiedades eléctricas del tejido epitelial de cuello uterino por medio de espectroscopia de impeditividad eléctrica, con el propósito de estudiar la detección temprana de la neoplasia intraepitelial con éste método. Para ello, se midieron 636 espectros de impeditividad eléctrica en 53 pacientes de la Liga Santandereana de Lucha Contra el Cáncer, los cuales fueron comparados con las citologías cervicales. Los datos experimentales fueron ajustados al modelo de Cole-Cole con una herramienta computacional basada en algoritmos genéticos. Los resultados del estudio realizado sugieren una sensibilidad y especificidad superiores al 70%. Salud UIS 2012; 44 (2:15-19Are reported the results of a study about the properties of cervical epitelial tissue using electrical impeditivity spectroscopy, with the objective of studying the early detection of intraepithelial neoplasia, with this metled. 636 impedivity spectrums from 53 patients at Liga Santandereana de Lucha contra el cancer were measured and compared with cervical cytology. Experimental data were felted to the Cole-Cole model, using a computational tool based in genetic algorithms. The results of the study suggest a sensibility and specificity above 70%. Salud UIS 2012; 44 (2:15-19

  5. Analysis of patterns of patient compliance after an abnormal Pap smear result: the influence of demographic characteristics on patient compliance.

    Science.gov (United States)

    Rojas, Christine; Zhou, Ming K; Khamis, Harry J; Amesse, Lawrence

    2013-07-01

    This study aimed to determine population characteristics that correlate to suboptimal follow-up after an abnormal cervical cytology result. Nonpregnant women, ages 21 to 65 years, with newly diagnosed abnormal cervical cytology result between January 2009 and January 2012 at an urban clinic were eligible for inclusion in this retrospective chart review. Cervical cytology data and demographic characteristics such as age, ethnicity, employment, marital and smoking status, health insurance and number of pregnancies were abstracted from electronic medical record. A log-linear model was used to determine which factors influenced patient compliance. Of the total of 206 women, 78 (37.9%) had optimal follow-up and 128 (62.1%) had suboptimal follow-up. The 3 variables that were statistically significant in influencing patient follow-up after adjusted analyses included severity of cytology result (p = .0013), ethnicity (p = .02), and employment status (p = .0159). The risk ratio for optimal follow-up for those with severe cytology result was 1.81; for the non-whites, 1.77; and for the employed, 1.53. Ethnicity, severity of cervical cytology result, and employment status play an important role in patient follow-up after an abnormal cervical cytology result. Detecting trends in our patient population that influence adherence to follow-up will help health care providers formulate strategies that target this problem.

  6. Point-Counterpoint: Cervical Cancer Screening Should Be Done by Primary Human Papillomavirus Testing with Genotyping and Reflex Cytology for Women over the Age of 25 Years.

    Science.gov (United States)

    Stoler, Mark H; Austin, R Marshall; Zhao, Chengquan

    2015-09-01

    Screening for cervical cancer with cytology testing has been very effective in reducing cervical cancer in the United States. For decades, the approach was an annual Pap test. In 2000, the Hybrid Capture 2 human papillomavirus (HPV) test was approved by the U.S. Food and Drug Administration (FDA) for screening women who have atypical squamous cells of underdetermined significance (ASCUS) detected by Pap test to determine the need for colposcopy. In 2003, the FDA approved expanding the use of the test to include screening performed in conjunction with a Pap test for women over the age of 30 years, referred to as "cotesting." Cotesting allows women to extend the testing interval to 3 years if both tests have negative results. In April of 2014, the FDA approved the use of an HPV test (the cobas HPV test) for primary cervical cancer screening for women over the age of 25 years, without the need for a concomitant Pap test. The approval recommended either colposcopy or a Pap test for patients with specific high-risk HPV types detected by the HPV test. This was based on the results of the ATHENA trial, which included more than 40,000 women. Reaction to this decision has been mixed. Supporters point to the fact that the primary-screening algorithm found more disease (cervical intraepithelial neoplasia 3 or worse [CIN3+]) and also found it earlier than did cytology or cotesting. Moreover, the positive predictive value and positive-likelihood ratio of the primary-screening algorithm were higher than those of cytology. Opponents of the decision prefer cotesting, as this approach detects more disease than the HPV test alone. In addition, the performance of this new algorithm has not been assessed in routine clinical use. Professional organizations will need to develop guidelines that incorporate this testing algorithm. In this Point-Counterpoint, Dr. Stoler explains why he favors the primary-screening algorithm, while Drs. Austin and Zhao explain why they prefer the cotesting

  7. p16INK4a immunocytochemistry versus human papillomavirus testing for triage of women with minor cytologic abnormalities: a systematic review and meta-analysis.

    Science.gov (United States)

    Roelens, Jolien; Reuschenbach, Miriam; von Knebel Doeberitz, Magnus; Wentzensen, Nicolas; Bergeron, Christine; Arbyn, Marc

    2012-10-25

    The best method for identifying women who have minor cervical lesions that require diagnostic workup remains unclear. The authors of this report performed a meta-analysis to assess the accuracy of cyclin-dependent kinase inhibitor 2A (p16(INK4a)) immunocytochemistry compared with high-risk human papillomavirus DNA testing with Hybrid Capture 2 (HC2) to detect grade 2 or greater cervical intraepithelial neoplasia (CIN2+) and CIN3+ among women who had cervical cytology indicating atypical squamous cells of undetermined significance (ASC-US) or low-grade cervical lesions (LSIL). A literature search was performed in 3 electronic databases to identify studies that were eligible for this meta-analysis. Seventeen studies were included in the meta-analysis. The pooled sensitivity of p16(INK4a) to detect CIN2+ was 83.2% (95% confidence interval [CI], 76.8%-88.2%) and 83.8% (95% CI, 73.5%-90.6%) in ASC-US and LSIL cervical cytology, respectively, and the pooled specificities were 71% (95% CI, 65%-76.4%) and 65.7% (95% CI, 54.2%-75.6%), respectively. Eight studies provided both HC2 and p16(INK4a) triage data. p16(INK4a) and HC2 had similar sensitivity, and p16(INK4a) has significantly higher specificity in the triage of women with ASC-US (relative sensitivity, 0.95 [95% CI, 0.89-1.01]; relative specificity, 1.82 [95% CI, 1.57-2.12]). In the triage of LSIL, p16(INK4a) had significantly lower sensitivity but higher specificity compared with HC2 (relative sensitivity, 0.87 [95% CI, 0.81-0.94]; relative specificity, 2.74 [95% CI, 1.99-3.76]). The published literature indicated the improved accuracy of p16(INK4a) compared with HC2 testing in the triage of women with ASC-US. In LSIL triage, p16(INK4a) was more specific but less sensitive.

  8. p16INK4a immunocytochemistry versus HPV testing for triage of women with minor cytological abnormalities: A systematic review and meta-analysis

    Science.gov (United States)

    Roelens, Jolien; Reuschenbach, Miriam; von Knebel-Doeberitz, Magnus; Wentzensen, Nicolas; Bergeron, Christine; Arbyn, Marc

    2014-01-01

    Background The best method to identify women with minor cervical lesions that require diagnostic work-up remains unclear. We performed a meta-analysis to assess the accuracy of p16INK4a immunocytochemistry compared to hrHPV DNA testing with hybrid capture II (HC2) to detect cervical intraepithelial neoplasia (CIN2+ and CIN3+) in women with a cervical cytology showing atypical squamous cells of undetermined significance (ASC-US) or low-grade cervical lesions (LSIL). Methods A literature search was performed in three electronic databases to identify studies eligible for this meta-analysis. Results Seventeen studies were included in the meta-analysis. The pooled sensitivity of p16INK4a to detect CIN2+ was 83.2% (95%CI: 76.8–88.2%) and 83.8% (95%CI: 73.5–90.6%) in ASC-US and LSIL cervical cytology respectively; pooled specificities were 71.0% (95%CI: 65.0–76.4%) and 65.7% (95%CI: 54.2–75.6%). Eight studies provided both HC2 and p16INK4a triage data. p16INK4a and HC2 have a similar sensitivity and p16INK4a has significantly higher specificity in the triage of women with ASC-US (relative sensitivity: 0.95 (95%CI: 0.89–1.01); relative specificity: 1.82 (95%CI: 1.57–2.12)). In the triage of LSIL, p16INK4a has a significantly lower sensitivity but higher specificity compared to HC2 (relative sensitivity: 0.87 (95%CI: 0.81–0.94); relative specificity: 2.74 (1.99–3.76)). Conclusion The published literature indicates an improved accuracy of p16INK4a compared to HC2 testing in the triage of ASC-US. In LSIL triage p16INK4a is more specific but less sensitive. PMID:22700382

  9. 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

    Institute of Scientific and Technical Information of China (English)

    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

  10. Cervical cancer screening in the Faroe Islands

    DEFF Research Database (Denmark)

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

    2014-01-01

    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...

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

    Directory of Open Access Journals (Sweden)

    Wildermuth Simon

    2010-11-01

    Full Text Available Abstract Background Congenital spinal abnormalities can easily be misdiagnosed on plain radiographs. Additional imaging is warranted in doubtful cases, especially in a setting of acute trauma. Case Presentation 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. Conclusion 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.

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

    Science.gov (United States)

    Guggenberger, Roman; Andreisek, Gustav; Scheffel, Hans; Wildermuth, Simon; Leschka, Sebastian; Stolzmann, Paul

    2010-11-09

    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.

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

    DEFF Research Database (Denmark)

    Ruge, S; Felding, C; Skouby, S O

    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 demonstrated HPV...

  14. 液基细胞学检测()TCTχ²在宫颈病变筛查中的应用%Liquid based cytology test (TCT) used in the screening of cervical lesions

    Institute of Scientific and Technical Information of China (English)

    陈秀俭

    2015-01-01

    Objective To explore the value of liquid based cytology diagnosis in screening of cervical lesions. Methods to ana-lyze the clinical data of patients in our hospital in 968 patients with clinically suspected cervical lesions were treated by liquid based cytology test, histopathological examination of implementation in patients with abnormal test results. Results of 968 specimens of TCT detection of cervical epithelial cells result positive was 10.95%(106/968), atypical squamous cells of 39 cases, 21 cases of low-grade squamous intraepithelial lesions, height of 20 patients with squamous intraepithelial lesions not except for high-grade squamous intraepithelial lesion (9 cases, 10 cases were squamous carcinoma, adenocarcinoma in 7 cases. Atypical squamous cells, low-grade squamous intraepithelial lesions, except height squamous intraepithelial lesions and high-grade squamous intraepithelial lesions and pathological coincidence rate were 92.31%, 76.19%, 85%, 66.67%. Squamous carcinoma and adenocarcinoma and pathological coincidence rate was 100%. Conclusion liquid based cytology detection technique in the diagnosis of cervical lesions with high ac-curacy, in the treatment of non-invasive detection, is an effective method for screening cervical lesion, worth clinical promotion.%目的:探讨液基细胞学检测在宫颈病变筛查中的诊断价值。方法分析了我院妇科对接诊968例临床怀疑宫颈病变的患者采用液基细胞学检测技术的临床资料,对检测结果异常患者实施病理组织学检查。结果968份标本TCT检测宫颈上皮细胞结果阳性占10.95%(106/968),其中不典型鳞状细胞39例,低度鳞状上皮内病变21例,高度鳞状上皮内病变20例,不除外高级别鳞状上皮内病变9例,鳞癌10例,腺癌7例。不典型鳞状细胞、低度鳞状上皮内病变、高度鳞状上皮内病变及除外高级别鳞状上皮内病变与病理符合率分别为92.31%,76.19%,85%,66.67%。鳞

  15. HPV E6/E7 mRNA testing is more specific than cytology in post-colposcopy follow-up of women with negative cervical biopsy.

    Directory of Open Access Journals (Sweden)

    Sveinung Wergeland Sørbye

    Full Text Available BACKGROUND: In Norway, women with negative or low-grade cervical biopsies (normal/CIN1 are followed up after six months in order to decide on further follow-up or recall for screening at three-year intervals. A high specificity and positive predictive value (PPV of the triage test is important to avoid unnecessary diagnostic and therapeutic procedures whereas a low risk of high-grade disease among triage negative women assures safety. MATERIALS AND METHODS: At the University Hospital of North Norway, cytology and the HPV mRNA test PreTect HPV-Proofer, detecting E6/E7 mRNA from HPV types 16, 18, 31, 33 and 45, are used in post-colposcopy follow-up of women with negative or low-grade biopsy. In this study, women with negative biopsy after high grade cytology (ASC-H/HSIL and/or positive HPV mRNA test in the period 2005-2009 were included (n = 520. Histologically confirmed cervical intraepithelial neoplasia of grade 2 or worse (CIN2+ was used as study endpoint. RESULTS: Of 520 women with negative or low-grade biopsy, 124 women (23.8% had CIN2+ in follow-up biopsy. The sensitivity and specificity of the HPV mRNA test were 89.1% (95% CI, 80.1-98.1 and 92.5% (95% CI, 88.2-96.7, respectively. The ratios of sensitivity, specificity and PPV of HPV mRNA testing compared to repeat cytology for finding CIN2+ was 1.05 (95% CI: 0.92-1.21, 1.21 (95% CI: 1.12-1.32, and 1.49 (95% CI: 1.20-1.86, respectively. The PPV of mRNA was 77.3% (95% CI, 59.8-94.8 in women aged 40 or older. CONCLUSION: Women with negative cervical biopsy require follow-up before resumption of routine screening. Post-colposcopy HPV mRNA testing was as sensitive but more specific than post-colposcopy cytology. In addition, the HPV mRNA test showed higher PPV. A positive mRNA test post-colposcopy could justify treatment in women above 40 years.

  16. HPV E6/E7 mRNA Testing Is More Specific than Cytology in Post-Colposcopy Follow-Up of Women with Negative Cervical Biopsy

    Science.gov (United States)

    Sørbye, Sveinung Wergeland; Arbyn, Marc; Fismen, Silje; Gutteberg, Tore Jarl; Mortensen, Elin Synnøve

    2011-01-01

    Background In Norway, women with negative or low-grade cervical biopsies (normal/CIN1) are followed up after six months in order to decide on further follow-up or recall for screening at three-year intervals. A high specificity and positive predictive value (PPV) of the triage test is important to avoid unnecessary diagnostic and therapeutic procedures whereas a low risk of high-grade disease among triage negative women assures safety. Materials and Methods At the University Hospital of North Norway, cytology and the HPV mRNA test PreTect HPV-Proofer, detecting E6/E7 mRNA from HPV types 16, 18, 31, 33 and 45, are used in post-colposcopy follow-up of women with negative or low-grade biopsy. In this study, women with negative biopsy after high grade cytology (ASC-H/HSIL) and/or positive HPV mRNA test in the period 2005–2009 were included (n = 520). Histologically confirmed cervical intraepithelial neoplasia of grade 2 or worse (CIN2+) was used as study endpoint. Results Of 520 women with negative or low-grade biopsy, 124 women (23.8%) had CIN2+ in follow-up biopsy. The sensitivity and specificity of the HPV mRNA test were 89.1% (95% CI, 80.1–98.1) and 92.5% (95% CI, 88.2–96.7), respectively. The ratios of sensitivity, specificity and PPV of HPV mRNA testing compared to repeat cytology for finding CIN2+ was 1.05 (95% CI: 0.92–1.21), 1.21 (95% CI: 1.12–1.32), and 1.49 (95% CI: 1.20–1.86), respectively. The PPV of mRNA was 77.3% (95% CI, 59.8–94.8) in women aged 40 or older. Conclusion Women with negative cervical biopsy require follow-up before resumption of routine screening. Post-colposcopy HPV mRNA testing was as sensitive but more specific than post-colposcopy cytology. In addition, the HPV mRNA test showed higher PPV. A positive mRNA test post-colposcopy could justify treatment in women above 40 years. PMID:21998748

  17. Expression of E6, p53 and p21 proteins and physical state of HPV16 in cervical cytologies with and without low grade lesions.

    Science.gov (United States)

    Tagle, Diana K Jiménez; Sotelo, Daniel Hernández; Illades-Aguiar, Berenice; Leyva-Vazquez, Marco A; Alfaro, Eugenia Flores; Coronel, Yaneth Castro; Hernández, Oscar Del Moral; Romero, Luz Del Carmen Alarcón

    2014-01-01

    The aim of this study was to determine the correlation between expression of HPV16 E6, p53 and p21 proteins and the physical state of HPV16 in cervical cytologies without squamous intraepithelial lesions (Non-SIL) and with low grade squamous intraepithelial lesions (LSIL), both with HPV16 infection. 101 liquid-based cytological samples were analyzed. 50 samples were without squamous intraepithelial lesions (Non-IL) and 51 samples of low grade squamous intraepithelial lesions (LSIL), both with HPV16 infection. HPV16 infection was determined by PCR-RFLP, and the physical state of HPV16 by in situ hybridization with tyramide-amplification. The expression of E6, p53 and p21 proteins was evaluated by immunocytochemistry. The expression of HPV16 E6 protein was significantly higher in LSIL that in Non-SIL samples (p=0.006). We found a significant correlation between E6 expression and the physical state of HPV16 in Non-SIL (p=0.049). Our results suggest that high expression of E6 in LSIL is an early event of cervical carcinogenesis and perhaps can be used as an early marker.

  18. 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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  20. 高危型HPV检测联合细胞学检查在宫颈病变中的意义%Significance of high - risk HPV test combined with cytological examination in cervical lesions

    Institute of Scientific and Technical Information of China (English)

    宋萌颖; 陈东梅

    2012-01-01

    目的:探讨高危型HPV检测联合细胞学检查在宫颈病变中的意义,为预防宫颈癌的发生及早期诊断与治疗提供进一步的指导依据.方法:该院2008年1月~2011年1月门诊自愿接受官颈癌筛查的妇女2 697例,分别进行HR - HPV-DNA、TCT、HR - HPV - DNA+ TCT检查,阳性病例均进行阴道镜活检.结果:2 697例进行筛查的妇女中标本发现异常涂片266例,占9.86%,其中意义不明的不典型鳞状细胞(ASCUS) 170例,占6.30%,低度鳞状上皮内病变(LSIL) 74例,占2.74%,高度鳞状上皮内病变(HSIL) 72例,占2.67%,鳞状细胞癌(SCC)8例,占0.30%.266例TCT检测细胞学异常(ASCUS及以上)标本中高危型HPV阳性162例,HPV感染率60.90%.不同类型标本高危型HPV感染情况结果显示:ASCUS、LSIL、HSIL各组间的HPV感染率有统计学差异(P<0.01).结论:将高危型HPV检测与TCT检测技术相结合应用于早期宫颈癌及癌前病变筛查中,提高了筛查宫颈病变的准确性.%Objective-. To explore the significance of high - risk HPV test combined with cytological examination in cervical lesions, provide further guidance and reference for prevention of occurrence, early diagnosis, and treatment of cervical cancer. Methods; A total of 2 697 women who received cervical screening voluntarily in outpatient department of the hospital from January 2008 to January 2011 were selected, then they underwent HR - HPV - DNA detection, TCT, and HR - HPV - DNA detection combined with TCT, the positive cases received biopsy under colposcope. Results: Among 2 697 cases, 266 cases were found with abnormal smears, accounting for 9. 86% , 170 cases were found with atypical squamous cells of undetermined significance (ASCUS) , accounting for 6. 30% , 74 cases were found with low - grade squamous intraepithelial lesions (LSIL) , accounting for 2. 74% , 72 cases were found with high - grade squamous intraepithelial lesions (HSIL), accounting for 2. 67% , 8 cases were

  1. Presence of High-Risk HPV mRNA in Relation to Future High-Grade Lesions among High-Risk HPV DNA Positive Women with Minor Cytological Abnormalities.

    Directory of Open Access Journals (Sweden)

    Hanna Johansson

    Full Text Available Continuous expression of E6- and E7-oncogenes of high-risk human papillomavirus (HPV types is necessary for the development and maintenance of the dysplastic phenotype. The aim of the study was to determine the sensitivity and specificity of the APTIMA HPV mRNA assay (Hologic in predicting future development of high-grade cervical intraepithelial neoplasia (CIN among high-risk HPV-DNA-positive women with atypical squamous cells of undetermined significance (ASCUS or low-grade squamous epithelial lesion (LSIL cytology.Archived SurePath cervical samples of women ≥ 35 years of age with high-risk HPV DNA-positive ASCUS (n = 211 or LSIL, (n = 131 were tested for the presence of high-risk HPV E6/E7 mRNA using the APTIMA HPV assay, and the women were monitored for development of histopathologically verified CIN2+.Twenty-nine percent (61/211 of the women in the ASCUS group, and 34.3% (45/131 in the LSIL group developed CIN2+ within 4.5 years of follow-up. The prevalence of HPV mRNA was 90.0% (95% CI 85.9-94.0 among women with ASCUS and 95.4% (95% CI 91.8-99.0 among women with LSIL. The presence of HPV E6/E7 mRNA was associated with future development of CIN2+ among women with ASCUS and LSIL (p=0.02. The mRNA assay demonstrated high sensitivity in predicting future CIN2+ and CIN3 for index ASCUS (96.7%; 95% CI 87.6-99.4 and 100%; 95% CI 82.2-100, respectively and LSIL (97.8%, 95% CI 86.8-99.9 and 100%, 95% CI 79.9-100, respectively. The corresponding specificity was low, 12.7% (95% CI 7.9-19.3 and 5.8% (95% CI 2.2-13.6, for future CIN2+, respectively. The negative predictive value of the HPV mRNA assay for detecting future CIN3 was 100%, since no mRNA-negative woman developed CIN3 (0/27 as compared to 13.6% (43/315 of the mRNA-positive women (p = 0.03.The APTIMA mRNA assay demonstrated high sensitivity but low specificity in predicting future CIN2+ among women with minor cytological abnormalities. The assay had high negative predictive value for future

  2. Biospectroscopy insights into the multi-stage process of cervical cancer development: probing for spectral biomarkers in cytology to distinguish grades.

    Science.gov (United States)

    Purandare, Nikhil C; Patel, Imran I; Trevisan, Júlio; Bolger, Noel; Kelehan, Ronan; von Bünau, Günther; Martin-Hirsch, Pierre L; Prendiville, Walter J; Martin, Francis L

    2013-07-21

    Cervical cancer screening programmes have greatly reduced the burden associated with this disease. However, conventional cervical cytology screening still lacks sensitivity and specificity. There is an urgent need for the development of a low-cost robust screening technique. By generating a spectral "biochemical-cell fingerprint", Fourier-transform infrared (FTIR) spectroscopy has been touted as a tool capable of segregating grades of dysplasia. A total of 529 specimens were collected over a period of one year at two colposcopy centres in Dublin, Ireland. Of these, n = 128 were conventionally classed as high-grade, n = 186 as low-grade and n = 215 as normal. Following FTIR spectroscopy, derived spectra were examined for segregation between classes in scores plots generated with subsequent multivariate analysis. A degree of crossover between classes was noted and this could be associated with imperfect conventional screening resulting in an inaccurate diagnosis or an incomplete transition between classes. Maximal crossover associated with n = 102 of 390 specimens analyzed was found between normal and low-grade specimens. However, robust spectral differences (P≤ 0.0001) were still observed at 1512 cm(-1), 1331 cm(-1) and 937 cm(-1). For high-grade vs. low-grade specimens, spectral differences (P≤ 0.0001) were observed at Amide I (1624 cm(-1)), Amide II (1551 cm(-1)) and asymmetric phosphate stretching vibrations (νasPO2(-); 1215 cm(-1)). Least crossover (n = 50 of 343 specimens analyzed) was seen when comparing high-grade vs. normal specimens; significant inter-class spectral differences (P≤ 0.0001) were noted at Amide II (1547 cm(-1)), 1400 cm(-1) and 995 cm(-1). Deeper understanding of the underlying changes in the transition between cervical cytology classes (normal vs. low-grade vs. high-grade) is required in order to develop biospectroscopy tools as a screening approach. This will then allow for the development of blind classification algorithms.

  3. Risk factors for treatment failure following cold coagulation cervical treatment for CIN pathology: a cohort-based study.

    Science.gov (United States)

    Papoutsis, Dimitrios; Underwood, Martyn; Parry-Smith, William; Panikkar, Jane

    2015-12-01

    To determine any risk factors for cytology recurrence in women after cold coagulation ablative treatment for cervical intraepithelial neoplasia (CIN). This was a retrospective observational study of a cohort of women having had cold coagulation between 2001 and 2011 in the colposcopy unit of an NHS hospital. We retrospectively collected data from our colposcopy unit database. Women with previous cervical treatment were excluded. 559 eligible women were identified with a mean age of 28.7 ± 6.2 years. Nulliparous women were 66.3 % with smokers involving 35.3 %. Referral cytology, pretreatment cervical punch biopsies and colposcopy were high grade in 51.9, 71.9 and 45.8 % of women. Endocervical crypt involvement (ECI) on pretreatment cervical punch biopsy involved 9.7 % of women. Mean follow-up was 3.1 ± 2.4 years. Overall cytology recurrence (mild/moderate/severe dyskaryosis) at 6 and 12 months follow-up was 7.4 and 5 %. High-grade cytology recurrence (moderate/severe dyskaryosis) involved 2.7 % of women over the entire follow-up period. Multiple regression analysis showed that ECI on pretreatment cervical punch biopsy was a risk factor for high-grade cytology recurrence (HR 3.72; 95 %CI 1.18-11.71; p = 0.024). There were no risk factors identified for overall cytology recurrence. However, when cytology tests with borderline nuclear changes at follow-up were pooled with mild/moderate/severe dyskaryosis cytology tests, then parity ≥2 was a risk factor for abnormal cytology (HR 1.71; 95 %CI 1.08-2.69; p = 0.022). Endocervical crypt involvement on pretreatment cervical punch biopsy and multiparity ≥2 are risk factors that increase the likelihood of abnormal cytology following cold coagulation. These two risk factors should be taken in consideration when performing cold coagulation cervical treatment for CIN pathology.

  4. Comparison of GP5+/6+-PCR and SPF10-line blot assays for detection of high-risk human papillomavirus in samples from women with normal cytology results who develop grade 3 cervical intraepithelial neoplasia.

    NARCIS (Netherlands)

    Hesselink, A.T.; Ham, M.A.P.C. van; Heideman, D.A.; Groothuismink, Z.M.; Rozendaal, L.; Berkhof, J.; Kemenade, F.J. van; Massuger, L.A.; Melchers, W.J.G.; Meijer, C.J.; Snijders, P.J.L.M.

    2008-01-01

    Using a case control approach, we performed a two-way comparison study between GP5+/6+-PCR and HPV SPF(10)-Line Blot 25 (SPF(10)) assays for detection of 14 types of high-risk human papillomavirus (hrHPV) in samples from women with normal cytology results who had or developed grade 3 cervical

  5. 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

    DEFF Research Database (Denmark)

    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....

  6. 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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  8. Predictive value of p16/Ki-67 immunocytochemistry for triage of women with abnormal Papanicolaou test in cervical cancer screening: a systematic review and meta-analysis.

    Science.gov (United States)

    Chen, Cheng-Chieh; Huang, Lee-Wen; Bai, Chyi-Huey; Lee, Chin-Cheng

    2016-01-01

    The Papanicolaou (Pap) test is one screening strategy used to prevent cervical cancer in developed countries. The p16/Ki-67 immunocytochemistry is a triage test performed on Pap smears in women with atypical squamous cells of undetermined significance (ASCUS) or low grade squamous intraepithelial lesion. Our objective was to review studies investigating the diagnostic performance of p16/Ki-67 dual stain for triage of women with abnormal Pap tests. We conducted a systematic review and meta-analysis of diagnostic test accuracy studies. We followed the protocol of systematic review of diagnostic accuracy studies. We searched PubMed, The Cochrane Library, BioMed Central, and ClinicalTrials.gov for relevant studies. We included research that assessed the accuracy of p16/Ki-67 dual stain and high risk human papillomavirus testing for triage of abnormal Pap smears. Review articles and studies that provided insufficient data to construct 2.2 tables were excluded. Data synthesis was conducted using a random-effects model. Sensitivity and specificity. In seven studies encompassing 2628 patients, the pooled sensitivity and specificity of p16/Ki-67 for triage of abnormal Pap smear results were 0.91 (95% CI, 0.89 to 0.93) and 0.64 (95% CI, 0.62 to 0.66), respectively. No study used a case-control design. A subgroup analysis involving liquid-based cytology showed a sensitivity of 0.91 (95%CI, 0.89 to 0.93) and specificity of 0.64 (95%CI, 0.61 to 0.66). Our meta-analysis of p16/Ki-67 dual stain studies showed that the test achieved high sensitivity and moderate specificity for p16/Ki-67 immunocytochemistry for high-grade squamous intraepi.thelial lesion and cervical cancer. We suggest that p16/Ki-67 dual stain might be a reliable ancillary method identifying high-grade squamous intraepithelial lesions in women with abnormal Pap tests. No study in the meta-analysis examined the accuracy of the p16/Ki-67 dual stain for inter.pretation of glandular neoplasms.

  9. Conventional cytology, visual tests and evaluation of P16INK4A as a biomarker in cervical intraepithelial neoplasia

    Directory of Open Access Journals (Sweden)

    S Kava

    2015-01-01

    Full Text Available Objectives: (1 To detect cervical intraepithelial neoplasia (CIN using Papanicolaou test (PAP test, visual tests (visual inspection after the application of acetic acid [VIA], visual inspection after the application of Lugol's iodine [VILI], colposcopy, and biopsy. (2 To study the biomarker p16INK4A expression by immunostaining. Materials And Methods: Experimental study was conducted from November 2009 to April 2011. 1500 women were screened for cancer cervix using conventional PAP test, VIA, and VILI. Sensitivity, specificity, positive, and negative predictive values of these tests were calculated individually, sequentially, and in parallel. Women having positive results underwent colposcopy and biopsy if required. p16INK4Aexpression in biopsy samples was studied using immunohistochemistry. Results: All test positive cases (n = 235 underwent colposcopy. Sensitivity, specificity, positive predictive value (PPV, and negative predictive value (NPV of PAP with atypical squamous cells of undetermined significance (ASCUS as cut-off was 40%, 99.25%, 35.25%, and 99.39%; VIA was 60%, 93.06%, 8.03%, and 99.56% and VILI was 80%, 86.06%, 5.4%, and 99.76%, respectively. When PAP, VIA, and VILI were used in parallel sensitivity, specificity, PPV, and NPV improved to 100%, 85.18%, 6.38%, and 100%, respectively. Colposcopic abnormalities were detected in 83 and biopsy proven CIN in 15. p16INK4A expression was seen in eight of 15 CIN cases. Conclusions:(1 PAP test and visual techniques are complementary. (2 p16INK4Aexpression was seen in majority of CIN 2 lesions suggesting a higher grade lesion.

  10. 宫颈细胞学阴性HPV阳性妇女的HPV分型检测%HPV genotyping detection of HPV positive women with negative cervical cytology

    Institute of Scientific and Technical Information of China (English)

    张珊; 洪颖; 马莉; 兰明

    2015-01-01

    目的:探讨宫颈细胞学阴性人乳头瘤病毒( HPV)阳性妇女接受HPV分型检测的临床意义。方法宫颈细胞学阴性HPV阳性的妇女200例,对其进行HPV分型检测并转诊阴道镜及组织病理学检查,分析感染HPV型别与宫颈上皮内瘤变( CIN)Ⅱ+的关系,并在受检1 a后对病理检查结果为CINⅠ及宫颈炎症的患者进行随访,随访方法为宫颈新柏氏液基细胞学检查及 HPV 分型检测。结果200例受检者中检出 CIN Ⅱ+患者37例(18.6%),HPV16型感染者发生CINⅡ+的风险是不伴HPV16型感染者的2.608倍(OR值为2.608,P<0.05)。151例完成随访的CIN Ⅰ及宫颈炎症患者中,同型HPV感染者的宫颈上皮内瘤变患病率显著高于非同型感染者(P<0.01),且同型感染者发生病理高级别进展的风险是非同型感染患者的14.89倍。结论 HPV分型检测对宫颈细胞学阴性HPV阳性妇女有重要的临床意义。宫颈细胞学阴性HPV16型感染者应立即转诊阴道镜检查。 HPV分型检测用于细胞学阴性HPV阳性妇女的随访,随访中发现同型HPV阳性的患者应转诊阴道镜检查,尤其HPV16型感染患者。%Objective To investigate the clinical significance of HPV genotyping detection in patients with negative cervi-cal cytology and positive human papilloma virus (HPV). Methods A total of 200 women with negative cervical cytology and positive HPV received the HPV genotyping detection and were referred to colposcopy and histopathological examination. The cor-relation between different HPV subtype infection and cervical intraepithelial neoplasia(CINⅡ) + was analyzed. The women whose pathological diagnosis were CINⅠand cervicitis were followed up for one year by the method of TCT and HPV genotyping detec-tion. Results Of 200 women, 37 patients were CINⅡ+(18. 6%). The risk of patients with HPV16 infection to develop CINⅡ+was 2. 608 times higher than that of patients without HPV16 infection (OR=2. 608, P<0. 05). Of 151

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

    DEFF Research Database (Denmark)

    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...

  12. 北京市大兴区宫颈癌筛查宫颈细胞学结果分析%Analysis of cervical cytology results in cervical cancer screening in Daxing District of Beijing

    Institute of Scientific and Technical Information of China (English)

    聂艳华; 于洪艳; 贾国华; 刘爽

    2015-01-01

    目的:了解北京市大兴区适龄妇女的生殖健康状况。方法对2013至2014年北京市大兴区35~64岁户籍妇女进行妇科及宫颈细胞学检查,记录个人基本信息、个人病史及检查结果。结果宫颈癌筛查39224人,进行传统巴氏细胞学检查的妇女共有25544人,阳性(未明确诊断意义的不典型鳞状上皮细胞及以上)检出率为2.22%。国产液基细胞学技术检查13680人,阳性检出率为2.84%。液基细胞学检查与巴氏涂片相比,不满意涂片率低,经比较差异有统计学意义(χ2=20.00,P<0.01)。液基细胞学检查在癌前病变和癌的阳性检出率均高于巴氏涂片,主要体现在未明确诊断意义的不典型鳞状上皮细胞、鳞状上皮内低度病变、鳞状上皮内高度病变的阳性检出率高,差异均有统计学意义(χ2值分别为6.78、6.68、5.83,均P<0.01)。在细胞学结果为鳞状上皮内高度病变的51人中,有1人被最终确诊为宫颈癌,并且有22人最终诊断为宫颈上皮内瘤变。在细胞学结果为鳞状细胞癌的2人中,均被最终确诊为宫颈癌。结论宫颈细胞学检查在早期发现和及时治疗宫颈癌及癌前病变中起到了非常重要的作用,但由于阅片人员有限及其能力水平的问题,使得细胞学阅片结果阳性率偏低。%Objective To investigate the reproductive health status of women in Daxing District of Beijing.Methods From 2013 to 2014 women aged 35-64 years old accepted cervical cytological and gynecological examination, and personal basic information, personal history and examination results were recorded.Results Totally 39 224 women received cervical cancer screening and a total of 25 544 people received traditional pap cytological examination.The positive detection rate ( ASC-US and above) was 2.22%.Domestic technology of liquid based cytology check was performed among 13 680 people with positive

  13. Review of available scientific and technical evidence regarding liquid-based cytology

    Directory of Open Access Journals (Sweden)

    Alberto Frutos Pérez-Surio

    2017-06-01

    Full Text Available Introduction. Cervical cancer can be prevented by early diagnosis and treatment of patients with abnormal results, thus decreasing their incidence and mortality. In contrast to conventional techniques (Papanicolau, diagnostic techniques have been developed based on the preservation of the sample in a stabilizing solution (liquid-based cytology. The different methods of liquid-based cytology used in the screening of cervical cancer against the Papanicolau technique are evaluated. Material and methods. A systematic review of the literature has been performed (2010-2015. The search was developed by including MeSH terms as cervical intraepithelial neoplasia and papilloma virus infection in the MedLine, Embase, Cochrane Library, CRD, LILACS and IBECS databases. Inclusion criteria were adult women screened for cervical cancer using liquid-based cytology techniques, compared with conventional methods. Results. 464 references were found related to the reliability-precision of the test, of which 13 were included in the report. A health technology assessment report was conducted in 2013 by the Agency for Health Technology Assessment of Andalusia (AETSA. The quality of the studies was moderate and moderate-low. AETSA found studies that included more than 700,000 women between 14 and 90 years old, who were screened by liquid-based cytology, compared to the conventional one. Studies have shown that liquid-based cytology techniques reduce the percentage of unsatisfactory samples compared to conventional ones. The analysis of detection of cellular abnormalities and diagnostic validity indexes showed significant differences when comparing both methods. Conclusions. The studies analyzed presented methodological limitations. Hence, the results should be interpreted with caution. Liquid-based cytology did not present greater diagnostic capacity than conventional methods, but it reduced, with statistically significant results, the number of samples unsatisfactory

  14. Causes and relevance of unsatisfactory and satisfactory but limited smears of liquid-based compared with conventional cervical cytology.

    NARCIS (Netherlands)

    Siebers, A.G.; Klinkhamer, P.J.; Vedder, J.E.M.; Arbyn, M.; Bulten, J.

    2012-01-01

    CONTEXT: Recent randomized controlled trials have shown a significant decrease in unsatisfactory rates for liquid-based cytology (LBC) compared with conventional Papanicolaou test (CP). The underlying causes and relevance of unsatisfactory results for LBC and CP have never been compared within the s

  15. Causes and relevance of unsatisfactory and satisfactory but limited smears of liquid-based compared with conventional cervical cytology.

    NARCIS (Netherlands)

    Siebers, A.G.; Klinkhamer, P.J.; Vedder, J.E.M.; Arbyn, M.; Bulten, J.

    2012-01-01

    CONTEXT: Recent randomized controlled trials have shown a significant decrease in unsatisfactory rates for liquid-based cytology (LBC) compared with conventional Papanicolaou test (CP). The underlying causes and relevance of unsatisfactory results for LBC and CP have never been compared within the s

  16. Clinical significance of liquid-based Thinprep Cytology Test and TBS for cervical diseases screening%液基薄层细胞学结合TBS系统对宫颈癌筛查的临床意义

    Institute of Scientific and Technical Information of China (English)

    张蕾; 赵计端

    2013-01-01

    OBJECTIVE To investigate the differences between the Thinprep Cytology Test (TCT) and pathological results, and to evaluate the accuracy of TCT for cervical lesions screening in clinic. METHODS All 800 cases cytologic screening were analyzed retrospectively. 510 cases of 800 cases cytologic screening were received by biopsies. The results of TCT were compared with that of biopsy. RESULTS Among the 800 cases, there were 484 cases (60.5%, 484/800) of NLIM, 316 cases (39.5%, 316/800) of abnormal epithelial cells, which included 8 cases of ASC-US, 32 cases of ASC-H, 15 cases of AGUS, 118 cases of HSIL, 136 cases of LSIL, 5 cases of SCC, 2 cases of AC. The positive rate of lesions up to LSIL was 51.18 % (261/ 510) in TCT and 56.47% (288/510) in biopsy. There was no significant difference between them (x2=2.88, P> 0.05). The coincidence rate of LSIL was 80.88%, HSIL was 93.22%, SCC was 80.0% and AC was 100%. CONCLUSION The liquid -based TCT is a vital method for cervical cancer screening, which can be adopted combined with biopsy to detect precancerous lesions of uterine cervix. TCT is an effective and perfect method for the cervical cancer screening and treatment.%目的 比较宫颈液基薄层细胞学(TCT)与组织病理学检查结果的差异,评价TCT在宫颈病变诊断中的临床价值.方法 回顾性分析800例行TCT的患者,其中有510例行阴道镜下多点活检或宫颈锥切术后行组织病理学检查,对TCT与组织病理学检查结果进行统计学分析.结果 TCT报告NILM 484例(60.5%,484/800);上皮细胞异常316例(39.5%,316/800);其中ASC-US 8例;ASC-H 32例;AGUS 15例;HSIL 118例;LSIL 136例;SCC 5例;AC2例.细胞学诊断LSIL以上病变的阳性率为51.18% (261/510),组织病理学诊断CIN Ⅰ以上病变的阳性率为56.47%(288/510),两者比较差异无统计学意义(x2=2.88,P>0.05).Spearman等级相关分析显示细胞学和组织学检查结果呈高度正相关(r2=0.949,P< 0.05).细胞学诊断

  17. Diagnostic Accuracy of Liquid-Based Cytology versus Conventional Cytology for Cervical Neoplasia: A Systematic Review of Randomized Controlled Trials%液基细胞学对宫颈癌前病变的诊断价值:随机对照试验的系统评价

    Institute of Scientific and Technical Information of China (English)

    李克敏; 尹如铁; 康德英; 伍伟伟; 文进

    2011-01-01

    Objective To evaluate the diagnostic accuracy of liquid-based cytology versus conventional cytology for cervical neoplasia. Methods Such databases as PubMed, Embase, The Cochrane Library, Cochrane Central Register of Controlled Trials, CNKI and CBM were searched to collect the random control trials (RCTs) about evaluating the diagnostic accuracy of liquid-based cytology versus conventional cytology for cervical neoplasia published before June, 2010. According to the inclusive and exclusive criteria, two assessors independently screened the studies, extracted the data, assessed the quality and conducted meta-analysis by using RevMan 5.0 and Metadisc 1.4 softwares. Results A total of five RCTS were eligible. With the ASCUS regarded as the abnormal critical value, there were significant differences between liquid-based cytology and conventional cytology in specificity for CIN 3+ (RR=0.97, 95%CI 0.97 to 0.97, P<0.000 01) and CIN 2+ of high risk population (RR=1.01, 95%CI 1.01 to 1.01, P<0.000 01), but no significant differences were found in other outcomes. Conclusion Based on the current evidence of evidence-based medicine, the liquid-based cytology is of neither more specificity nor more sensitivity for detecting high grade CIN than the convention cytology in the regular screening program, but it seems to be of more specificity in high risk group.%目的 系统评价液基细胞学与传统细胞学对宫颈癌前病变的诊断价值.方法 计算机检索PubMed、EMbase、Cochrane Library、Cochrane临床对照试验中心注册库、CNKI和CBM,检索时间均从建库至2010年6月,收集比较液基细胞学与传统细胞学诊断宫颈癌前病变的随机对照试验.由2位评价员独立根据纳入排除标准筛选文献、提取资料并评价质量后,采用RevMan 5.0软件和Metadisc l.4软件进行Meta分析.结果 共纳入5个随机对照试验,合计149287例研究对象.其中液基细胞学组69 785例,传统细胞学组79 537例.Meta分析结果

  18. Association of cervical artery dissection with connective tissue abnormalities in skin and arteries.

    Science.gov (United States)

    Brandt, T; Morcher, M; Hausser, I

    2005-01-01

    Spontaneous cervical artery dissections (sCAD) often occur in otherwise healthy individuals without known risk factors for stroke and frequently develop spontaneously without relevant trauma. An underlying arteriopathy leading to a so-called 'weakness of the vessel wall' and predisposing certain individuals to dissection has often been postulated. Therefore, the morphology of connective tissue, a main component of vessel wall and environment, was investigated in carotids and skin. While the overall morphology of dermal connective tissue is normal, about half of patients with sCAD show mild ultrastructural connective tissue alterations. These ultrastructural morphological aberrations can be designated either as 'Ehlers-Danlos syndrome (EDS) III-like', resembling mild findings in patients with the hypermobility type of EDS (EDS III); or coined 'EDS IV-like' with collagen fibers containing fibrils with highly variable diameters resembling mild findings in vascular EDS; or the abnormalities are restricted to the elastic fibers (with fragmentation and minicalcifications) without significant alterations in the morphology of the collagen fibrils. These findings had some similarity with the morphology found in heterozygous carriers of pseudoxanthoma elasticum. A grading scale according to the severity of the findings has been introduced. Similar connective tissue abnormalities were detected in some first-degree relatives of patients with sCAD showing hereditary at least in a subgroup. They can serve as a phenotypic marker for further genetic studies in patients with sCAD and large families to possibly identify the underlying basic molecular defect(s). Very few of patients (connective tissue abnormalities have clinical manifestations of skin, joint, or skeletal abnormalities of a defined heritable connective tissue disorder. In specimens of arterial walls of carotid, aortic, and renal arteries of patients with sCAD, pronounced systemic, histopathological, and

  19. HPV检测联合液基细胞学对宫颈癌筛查的临床研究%Clinical Study on HPV Test Combined With Thinprep Cytologic Test in Cervical Cancer Screening

    Institute of Scientific and Technical Information of China (English)

    张长虹

    2016-01-01

    目的:分析HPV检测联合液基细胞学在宫颈癌筛查中的临床应用。方法8000例接受宫颈癌筛查的女性分别对其进行HPV检测和液基细胞学检查,比较HPV检测联合液基细胞学检查、HPV检测及液基细胞学检查三种检查方法对各期宫颈病变的检测阳性率。结果HPV+TCT检测对早期瘤样病变和癌变的检出率为69.6%,高于HPV检测的55.6%和TCT检测的64.1%,差异有统计学意义(P<0.05)。结论 HPV检测联合液基细胞学检查对宫颈癌早期病变和癌变检出率高。%ObjectiveTo analyze the clinical use of HPV test combined with liquid-based cytology in cervical cancer screening.Methods 8 000 women undergoing cervical cancer screening received HPV test and liquid-based cytology test,the positive rate of al stages of cervical lesion detected by HPV test combined with liquid-based cytology,HPV test and liquid-based cytology were compared.ResultsThe detection rate of early neoplasia and canceration rate by HPV+CT detection was 69.6%,higher than that of HPV detection(55.6%)and TCT detection(64.1%),the difference was significant(P<0.05).Conclusion HPV detection combined with liquid-based cytology has high detection rate of early cervical neoplasia and canceration rate.

  20. Diagnosis value of liquid-based cytology and conventional cytology smears on detecting cervical squamous cell lesions%液基细胞学技术与传统细胞学涂片技术对宫颈病变细胞学的诊断价值

    Institute of Scientific and Technical Information of China (English)

    董彦军; 郑加荣

    2013-01-01

    Objective To compare the value of liquid-based cytology and conventional cytology smears on detection of cervical squamous cell lesions.Methods One thousand and two hundred women were detected by cervical liquid-based cytology and conventional cytology smear screening from Oct.2009 to Oct.2012,of which positive cases were detected by colposcopy and biopsy as the gold standard as a positive control.The diagnostic value of the liquid-based cytology on cervical lesions was assessed.Results The positive detection rate of ASCUS/A-GUS and above lesions was 16.00% (96 cases) by liquid-based cytology detection,and positive detection rate of pap ⅡB level and above lesions was 4.83 % (29 cases).The positive detection rate by liquid-based cytology was significantly higher than that of conventional cytology smears,the difference was statistically significant (P < 0.05).Colposcopic and histopathological findings as the gold standard,cervical liquid-based cytology screening coincidence rate was 76.80%,conventional cytology smear screening coincidence rate was 38.16%,and the difference was statistically significant (P < 0.05).Conclusions Liquid-based cytology screening for cervical squamous cell lesions is significantly superior to conventional cytology smears.%目的 比较液基细胞学技术与传统细胞学涂片在宫颈鳞状细胞病变检测中的价值.方法 对2009年10月至2012年10月1200例妇女采用宫颈液基细胞学或传统细胞学涂片进行筛查,并对筛查阳性病例以其阴道镜检查及病理活检结果为金标准作为阳性对照,评估液基细胞学技术对宫颈不同病变的诊断价值.结果 宫颈液基细胞学筛查出ASCUS/A-GUS及以上分级病例96例,阳性检出率为16.00%;传统细胞学涂片筛查出巴氏ⅡB级及以上分级病例29例,阳性检出率为4.83%;宫颈液基细胞学阳性检出率明显高于传统细胞学涂片,差异有统计学意义(P<0.05).以阴道镜及病理组织学

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  2. Comparison of false negative rates between 100% rapid review and 10% random full rescreening as internal quality control methods in cervical cytology screening.

    Science.gov (United States)

    Lee, Benjamin Chi Kui; Lam, Sui Yue; Walker, Todd

    2009-01-01

    To compare and contrast the 100% partial rapid review (RR) method against 10% randomly selected full rescreening to determine the better means of internal quality control (QC) by which the cervical screening laboratory should adopt. A total of 4,150 conventional Pap smears reported as negative during 2003 were 100% rescreened rapidly in large field jumps. From this cohort, 415 (10%) were selected again randomly for full rescreening. The false negative rates (FNRs) were calculated and compared accordingly. The 100% RR method reclassified 30 false negative (FN) cases, while the 10% random full rescreening reclassified only 5. The FNRs were calculated to be 8.2% and 12.9%, respectively. A chi2 test (p FNRs calculated by both methods. The 100% RR proved to be a better method for QC purpose in reducing the FNRs and detected more missing cases. This study is the first of its type from Hong Kong and confirms previous publications from elsewhere that 100% RR is a better method for internal QC in cervical cytology screening.

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

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    Seyed Reza Najafizadeh

    2011-11-01

    Full Text Available Background: 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.Objectives: 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.Patients and Methods: 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.Results: 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.Conclusions: 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.

  4. Can Genomic Amplification of Human Telomerase Gene and C-MYC in Liquid-Based Cytological Specimens Be Used as a Method for Opportunistic Cervical Cancer Screening?

    Science.gov (United States)

    Gao, Kun; Eurasian, Menglan; Zhang, Jieqing; Wei, Yuluan; Zheng, Qian; Ye, Hongtao; Li, Li

    2015-01-01

    To evaluate the effectiveness of five methods including the ThinPrep cytological test (TCT), liquid-based cytology, the human papillomavirus (HPV) test, detection of the TERC and C-MYC genes and visual inspection with acetic acid/Lugol's iodine (VIA/VILI) for opportunistic cervical cancer screening, and to explore whether genomic amplification of the human telomerase gene and C-MYC in liquid-based cytological specimens can be used as a method for opportunistic cervical cancer screening. Data were collected prospectively from 1,010 consecutive patients who visited the gynecology clinic and agreed to participate in opportunistic cervical cancer screening at our institution from November 2010 to July 2011. The five methods mentioned above were used for the screening in all cases. The histopathological diagnosis served as the gold standard for the evaluation. A comparison between the five screening methods for the diagnosis of high-grade cervical intraepithelial neoplasia (CIN II and III) was performed for their sensitivity, specificity, false-positive rate, false-negative rate, accuracy rate, positive likelihood ratio and negative likelihood ratio. A comprehensive comparison of the different combination programs for screening was performed according to the analysis of the receiver operating characteristic (ROC) curve area. The accuracy of the five screening methods for the diagnosis of high-grade CIN (CIN II and III) was compared in the different age groups. A joint model for the diagnosis using different combinations of the five methods was developed according to the analysis by the SAS 8.0 software. The model was used to evaluate the accuracy of the different combination programs for the diagnosis of high-grade CIN, and the results were confirmed by the histopathological examination. The sensitivity and specificity of the single screen method (TCT, HPV test, detection of the TERC and C-MYC genes, and VIA/VILI method) for CIN II was 80.9, 70.2, 72.3, 76.6, and 72

  5. Cervical Stenosis

    Science.gov (United States)

    ... on the cervix When doctors cannot insert an instrument into the cervix to obtain a sample of tissue from the cervix for a Papanicolaou (Pap) or human papilloma virus (HPV) test (called cervical cytology testing) or a sample ...

  6. Biomarkers in Cervical Cancer Screening

    Directory of Open Access Journals (Sweden)

    Nicolas Wentzensen

    2007-01-01

    Full Text Available In industrialized countries, population wide cytological screening programs using the Pap test have led to a substantial reduction of the incidence of cervical cancer. Despite this evident success, screening programs that rely on Pap-stained cytological samples have several limitations. First, a number of equivocal or mildly abnormal test results require costly work up by either repeated retesting or direct colposcopy and biopsy, since a certain percentage of high grade lesions that require immediate treatment hide among these unclear test results. This work up of mildly abnormal or equivocal cytological tests consumes a large amount of the overall costs spent for cervical cancer screening. Improved triage of these samples might substantially reduce the costs. Cervical cancer is induced by persistent infections with oncogenic human papilloma viruses (HPV. While HPV infection is an indispensable factor, it is not sufficient to cause cancer. The majority of acute HPV infections induce low grade precursor lesions that are cleared spontaneously after several months in more than 90% of cases, and less than 10% eventually progress to high grade lesions or invasive cancer. Progression is characterized by the deregulated expression of the viral oncogenes E6 and E7 in infected basal and parabasal cells. Novel biomarkers that allow monitoring these essential molecular events in histological or cytological specimens are likely to improve the detection of lesions that have a high risk of progression in both primary screening and triage settings. In this review, we will discuss potential biomarkers for cervical cancer screening with a focus on the level of clinical evidence that supports their application as novel markers in refined cervical cancer screening programs.

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

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    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.

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

    Science.gov (United States)

    de Bekker-Grob, Esther W; de Kok, Inge M C M; Bulten, Johan; van Rosmalen, Joost; Vedder, Judith E M; Arbyn, Marc; Klinkhamer, Paul J J M; Siebers, Albertus G; van Ballegooijen, Marjolein

    2012-08-01

    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-effectiveness threshold analyses to investigate under what circumstances manually screened ThinPrep LBC is cost-effective for screening. The MISCAN-Cervix microsimulation model and data from the Dutch NETHCON trial (including 89,784 women) were used to estimate the costs and (quality-adjusted) life years ((QA)LYs) gained for EU screening schedules, varying cost-effectiveness threshold values. Screening strategies were primary cytological screening with LBC or CP, and triage with human papillomavirus (HPV) testing. Threshold analyses showed that screening with LBC as a primary test can be cost-effective if LBC is less than 3.2 more costly per test than CP, if the sensitivity of LBC is at least 3-5 % points higher than CP, if the quality of life for women in triage follow-up is only 0.39, or if the rate of inadequate CP smears is at least 16.2 %. Regarding test characteristics and costs of LBC and CP, only under certain conditions will a change from CP to manually screened ThinPrep LBC be cost-effective. If none of these conditions are met, implementation of manually screened ThinPrep LBC seems warranted only if there are advantages other than cost-effectiveness. Further research is needed to establish whether other LBC systems will be more favorable with regard to cost-effectiveness.

  9. 液基细胞学技术与传统细胞学涂片检测宫颈鳞状细胞病变的比较%Comparison of liquid - based cytological test and routine cytological smears in detection of cervical squamous cell lesions

    Institute of Scientific and Technical Information of China (English)

    印永祥; 赵华; 黄望珍

    2012-01-01

    目的:评价液基细胞学技术与传统细胞学涂片检测宫颈鳞状细胞病变的差异.方法:比较同地区、同期宫颈液基细胞学筛查病例及传统细胞学涂片筛查病例,同时收集液基细胞组中289例阴道镜检查及病理活检结果及传统细胞组中62例阴道镜检查及病理活检结果进行分析,评估不同病变的假阳性率.结果:液基细胞组标本不满意率(2.71%)明显低于传统细胞组标本(3.96%)(P<0.01).液基细胞组对不明意义的非典型鳞状细胞(ASC - US)及更高级别的病变检出率(2.25%)明显高于传统细胞组(0.74%)(P<0.01).液基细胞组ASC - US占低度鳞状上皮内病变(LSIL)、非典型鳞状细胞不除外高度病变( ASC - H)、高度鳞状上皮内病变(HSIL)及鳞癌(SCC)总数的比例(0.82%)明显低于传统细胞组(2.11%)(P<0.01).传统细胞组与液基细胞组假阳性率比较,差异有统计学意义(P<0.01),传统细胞组ASC -US、ASC -H和SCC中假阳性率与液基细胞组比较差异无统计学意义.组织学活检与细胞学结果比较,年龄≥35岁液基细胞组ASC - US阳性预测值与传统细胞组比较差异无统计学意义(P>0.01);年龄<35岁液基细胞组ASC - US阳性预测值明显高于传统细胞组(P<0.01).结论:液基细胞学技术检测宫颈鳞状细胞病变明显优于传统细胞学涂片,高质量的宫颈细胞标本对提高诊断的准确性非常重要;选择不同方法筛查宫颈病变时,目标人群的年龄是一个重要的决定因素.%Objective; To evaluate the difference of liquid - based cytological technique and routine cytological smears in detection of cervical squamous cell lesions. Methods; The cases receiving cervical liquid - based cytological screening and the cases receiving routine cytological smears screening in the same region and during the same period were compared. The results of colposcopy and pathological biopsy of 289 cases from liquid - based

  10. HPV infection, cervical abnormalities, and cancer in HIV-infected women in Mumbai, India: 12-month follow-up

    Directory of Open Access Journals (Sweden)

    Isaakidis P

    2013-08-01

    Full Text Available Petros Isaakidis,1,2 Sharmila Pimple,3 Bhanumati Varghese,1 Samsuddin Khan,1 Homa Mansoor,1 Joanna Ladomirska,1 Neelakumari Sharma,1 Esdras Da Silva,1 Carol Metcalf,4 Severine Caluwaerts,4 Petra Alders,4 Evangelia E Ntzani,2 Tony Reid41Médecins Sans Frontières, Mumbai, India; 2Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece; 3Preventive Oncology Department, Tata Memorial Hospital, Mumbai, India; 4Médecins Sans Frontières, Brussels, BelgiumBackground: HIV-infected women are at a higher risk of cervical intraepithelial neoplasia (CIN and cancer than women in the general population, partly due to a high prevalence of persistent human papillomavirus (HPV infection. The aim of the study was to assess the burden of HPV infection, cervical abnormalities, and cervical cancer among a cohort of HIV-infected women as part of a routine screening in an urban overpopulated slum setting in Mumbai, India.Methods: From May 2010 to October 2010, Médecins Sans Frontières and Tata Memorial Hospital Mumbai offered routine annual Pap smears and HPV DNA testing of women attending an antiretroviral therapy (ART clinic and a 12-month follow-up. Women with abnormal test results were offered cervical biopsy and treatment, including treatment for sexually transmitted infections (STIs.Results: Ninety-five women were screened. Median age was 38 years (IQR: 33–41; median nadir CD4-count 143 cells/µL (IQR: 79–270; and median time on ART 23 months (IQR:10–41. HPV DNA was detected in 30/94 women (32%, and 18/94 (19% showed either low-grade or high-grade squamous intraepithelial lesions (LSIL/HSIL on Pap smear. Overall, >50% had cervical inflammatory reactions including STIs. Of the 43 women with a cervical biopsy, eight (8.4% had CIN-1, five (5.3% CIN-2, and two (2.1% carcinoma in situ. All but one had HPV DNA detected (risk ratio: 11, 95% confidence interval: 3.3–34. By

  11. 克拉玛依地区11051例宫颈液基细胞学检查结果分析%Retrospective analysis of 11 051 cases of liquid-based cytology test in diagnosis of cervical cancer in Karamay district

    Institute of Scientific and Technical Information of China (English)

    姜敏; 于民; 胡新梅; 王超; 郭国庆; 刁兆杰

    2012-01-01

    目的 探讨液基细胞学在宫颈癌及癌前痛变筛查中的应用价值.方法 回顾性分析克拉玛依市中心医院门诊11051例液基细胞检测和TBS分类系统结果,对异常结果与阴道镜下活组织检查病理诊断结果进行比较.结果 11051例液基细胞学检测中,筛检出不典型鳞状细胞(ASC-US)及以上病例451例,阳性检出率为3.25%,其中意义不明确的ASC-US216例(1.96%),不除外高度鳞状上皮内病变的不典型鳞状细胞(ASC-H)77例(0.70%),低度鳞状上皮内病变(LSIL)54例(0.49%),高度鳞状上皮内病变(HSIL)4例(0.02%).液基细胞学检测与阴道镜下病理活检结果的符合率为78.8%.结论 液基细胞学与宫颈组织病理学诊断有较高的诊断符合率,细胞学医生正确掌握TBS的诊断标准是提高宫颈细胞学诊断质量的保证.%Objective To investigate the application value of liquid-based cytology test in diagnosis of cervical cancer and precancerous lesion.Methods The results of liquid-based cyology test and TBS cytology subdivision from 11 051 patients were retrospectively analyzed,and the abnormal results and the results of biopsy pathological diagnosis underwent colposcopy were compared.Results Four hundred and fifty-one positive cases of abnormal epirthelial cells were diagnozed by TCT,the positive rate was 3.25%,216 cases ( 1.96% ) were atypical squamous cell ( ASC-US ) of undetermined significance,77 cases (0.70% ) were ASC-H,54 cases ( 0.49% )were LSIL,4 cases (0.02%) were HSIL.In 219 histopathological results,the accordance rate of liquid-based cytology and histopathological diagnosis was 78.8%.Conclusions Liquid-based cervical cytology has high diagnostic accordance rate with histopathological diagnosis.It's the key to improve the quality asccurance of cervical cytology that cytologic doctors master the diagnostic criteria of TBS.

  12. 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

    Directory of Open Access Journals (Sweden)

    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

  13. Coverage of cervical cancer screening in Catalonia for the period 2008-2011 among immigrants and Spanish-born women.

    Directory of Open Access Journals (Sweden)

    Vanesa eRodriguez-Sales

    2013-12-01

    Full Text Available Background: The Public Health system in Catalonia, Spain provides a free of charge opportunistic cervical cancer screening. In June 2006 a revised recommendations for cervical cancer screening was introduced to increase coverage and to promote a three-year interval between screening tests. Aim: This study examines cervical cancer screening coverage and prevalence of cytology abnormalities in Catalonia by immigration status.Methods: The study analyses the cytologies registered among women aged 25-65 that have been attended at the Primary Health Centers (PHC for any reason (n=1,242,105 during 2008-11. Coverage was estimated from Governmental data base Information System Primary Care (SISAP that includes 77% of PHC. The database is anonymous, and includes information on age, country of birth, diagnostic center and cytology results Results: During the period 2008-2011, 758,690 smears were performed in a total of 595,868 women over 14 years, of whom 18.3% were immigrants. Cytology coverage was higher among immigrant women compared to Spanish born (51.2% and 39% respectively. Immigrant women also had a higher prevalence of abnormal Paps compared to the Spanish population, 4.9% and 3.3% respectively.Conclusion: Immigrant women in Catalonia have a good access to the Public Health Services and to cervical cancer screening facilities. The higher prevalence of abnormal cytologies in immigrant women compared to native women indicates the relevance to prioritize cervical cancer screening activities on a regular base in new comers.

  14. Clinical comparison between traditional Bethesda smears and liquid-based cytology test in the screening of cervical cancer%两种宫颈癌筛查方法对比研究及临床分析

    Institute of Scientific and Technical Information of China (English)

    李新敏; 古雅丽

    2012-01-01

    目的:探讨传统巴氏涂片法和液基细胞学法在宫颈癌筛查中的临床意义.方法:分别对12302例和15750例患者分别进行传统巴氏涂片法和液基细胞学检测的宫颈癌筛查.对细胞学阳性者进行阴道镜下活检并分析结果.结果:传统巴氏涂片法和液基细胞学检测的阳性检出率分别为5.45%和6.06%,差异无统计学意义(P>0.05);两种方法与活检符合率分别为22.84%和55.57%,差异有统计学意义(P<0.05);两种方法的假阳性率分别为77.16%和44.42%,差异有统计学意义(P<0.05).结论:液基细胞学检测用于宫颈癌的筛查与活检的符合率高,假阳性率低,优于传统巴氏涂片,值得在临床推广应用.%Objective: To explore clinical value of traditional Bethesda smears and liquid - based cytology test in the screening of cervical cancer. Methods: Traditional Bethesda smears and liquid-based cytology test were used to screen 12302 and 15750 subjects with cervical cancer, respectively. Biopsy under the colposcope was performed for the subjects with the positive outcome of cytological examination. Results: The positive rates identified by traditional Bethesda smears and liquid-based cytology test were 5.45% and 6.06%, respectively (P>0.05). The coincidence positive rate for traditional Bethesda smear and biopsy under the colposcope was 22.84%. The coincidence positive rate for liquid-based cytology test and biopsy under the colposcope was 55.57% (P<0.05). The fake positive rates for traditional Bethesda smear and liquid-based cytology test were 77.16% and 44.42%, respectively (P<0.05). Conclusion: Liquid-based cytology test is worth to be recommended in the clinical examination of cervical cancer due to its higher coincidence rate with pathological examination and its lower fake-positive rate.

  15. 兰陵地区子宫颈液基细胞学筛查结果分析%Liquid-based cytology screening for cervical cancer in Lanling district

    Institute of Scientific and Technical Information of China (English)

    张丽冉; 王新国; 谢凤祥; 赵东曼; 范波涛; 李欣; 祁德波

    2015-01-01

    目的:收集和分析兰陵地区子宫颈癌筛查结果,为子宫颈癌防治提供科学依据。方法以2015年上半年兰陵地区已婚女性入组研究,收集子宫颈脱落细胞标本,采用液基细胞学制片,巴氏染色,在严格诊断质量控制下按子宫颈细胞学Bethesda报告系统的诊断标准进行判读。结果收集标本13832例,标本满意率达99.96%。微生物检出情况:真菌感染99例(0.72%),滴虫感染120例(0.87%),放线菌感染30例(0.22%),细菌性阴道病770例(5.57%),共1019例(7.37%)。子宫颈液基细胞学检测(liquid-based cytology testing,LCT)情况:不能明确意义的不典型鳞状细胞(atypical squamous cells of unknown significance,ASC-US)479例(3.46%),不除外高级别鳞状上皮内病变的不典型鳞状上皮细胞(atypical squamous cells cannot exclude HSIL,ASC-H)25例(0.18%),低级别鳞状上皮内病变(low grade squamous intraepithelial lesions ,LSIL)235例(1.70%),高级别鳞状上皮内病变(high grade squamous intraepithelial lesions ,HSIL)90例(0.65%),鳞状细胞癌(squamous cell carcinomas,SCC)1例(0.01%),不典型腺细胞(atypical glandular cells,AGC)4例(0.03%)。细胞学检查异常共834例,占6.03%。细胞学检查异常人群集中在25~55岁。诊断质量控制结果:不典型鳞状上皮细胞与上皮内病变的比值(ASC/SIL)为1.546;27例HSIL宫颈活检病理结果显示26例为子宫颈上皮内瘤变( cervical intraepithelial neoplasia,CIN)Ⅱ级、Ⅲ级,符合率为96.3%。结论子宫颈液基细胞学检测能发现子宫颈微生物感染及癌前病变,为子宫颈癌筛查工作提供科学依据。%Objective To screen married women in Lanling District for cervical cancer using liquid-based cytology testing(LCT). Methods Married women in Lanling district were enrolled into this study in the first half of 2015 based

  16. Screening cervical lesions with Fourier transform infrared spectroscopy

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The screening results were reported based on the Fourier transform infrared spectroscopy (FTIR) analysis of the samples of exfoliated cervical cells from 354 women. Their spectra can be sorted into two types based on the emerging or not of the absorption bands near 970 cm-1 and 1 170 cm-1: T1 (83.1%) type without emerging, and T2 (16.9%) type with obviously emerging. All of the samples assigned to T1 were cytologically diagnosed as normal or within normal limits (PapⅠ). 28.9% and 71.1% of samples exhibiting T2 profile, were cytologically evaluated as Pap Ⅰand abnormal respectively. 3 women in the abnormal group were diagnosed as to have cervical cells with changes associated with high grade of inflammation, cervical scar and cervical erosion. Furthermore, based on the progressive change of the relative intensities of the absorption bands, both T1 and T2 profiles can be categorized into 6 subtypes. The observed heterogeneous spectra and the progressive changes in the absorption frequencies and the relative intensities exhibit features suggestive of the progressive process of cervical lesion. The FTIR method has the potential to complement the cytological smear for large-volume screening of cervical lesions.

  17. Proof-of-principle study of a novel cervical screening and triage strategy: Computer-analyzed cytology to decide which HPV-positive women are likely to have ≥CIN2.

    Science.gov (United States)

    Schiffman, Mark; Yu, Kai; Zuna, Rosemary; Terence Dunn, S; Zhang, Han; Walker, Joan; Gold, Michael; Hyun, Noorie; Rydzak, Greg; Katki, Hormuzd A; Wentzensen, Nicolas

    2017-02-01

    A challenge in implementation of sensitive HPV-based screening is limiting unnecessary referrals to colposcopic biopsy. We combined two commonly recommended triage methods: partial HPV typing and "reflex" cytology, evaluating the possibility of automated cytology. This investigation was based on 1,178 exfoliated cervical specimens collected during the enrollment phase of The Study to Understand Cervical Cancer Early Endpoints and Determinants (SUCCEED, Oklahoma City, OK). We chose a colposcopy clinic population to maximize number of outcomes, for this proof-of-principle cross-sectional study. Residual aliquots of PreservCyt were HPV-typed using Linear Array (LA, Roche Molecular Systems, Pleasanton, CA). High-risk HPV typing data and cytologic results (conventional and automated) were used jointly to predict risk of histologically defined ≥CIN2. We developed a novel computer algorithm that uses the same optical scanning features that are generated by the FocalPoint Slide Profiler (BD, Burlington, NC). We used the Least Absolute Shrinkage and Selection Operator (LASSO) method to build the prediction model based on a training dataset (n = 600). In the validation set (n = 578), for triage of all HPV-positive women, a cytologic threshold of ≥ASC-US had a sensitivity of 0.94, and specificity of 0.30, in this colposcopy clinic setting. When we chose a threshold for the severity score (generated by the computer algorithm) that had an equal specificity of 0.30, the sensitivity was 0.91. Automated cytology also matched ≥ASC-US when partial HPV typing was added to the triage strategy, and when we re-defined cases as ≥CIN3. If this strategy works in a prospective screening setting, a totally automated screening and triage technology might be possible.

  18. 宫颈液基薄层细胞学检测5100例的结果分析%Analysis of 5 100 cases of cervical liquid based cytology test results

    Institute of Scientific and Technical Information of China (English)

    刘斌; 李燕维

    2015-01-01

    目的:探讨宫颈液基薄层细胞学检测在妇女疾病普查中的意义.方法:收集5 100例宫颈液基薄层细胞学检测结果,均采用液基薄层细胞学检查系统制片,应用 TBS 系统进行分类及报告.结果:阳性检出率 6.51%;在 HSIL中,两者检测结果符合率 74.07%;在 LSIL 中,符合率 53.33%;在 ASCU-H 和 ASCUS 中,检出率 22.04%.结论:针对宫颈癌前病变筛查,液基薄层细胞学检测结果准确性高,但仍然存在一些假阳性与假阴性现象.%Objective:To investigate the significance of thin layer cytology test for cervical liquid based cytology in women. Methods:5 100 cases of cervical liquid based thin layer cytology test results were collected,and the TBS system was used to classify and report.Results:The positive detection rate was 6.51% ;in HSIL,the coincidence rate was 74.07% ;in LSIL,the coincidence rate was 53.33%,the detection rate was 22.04% in ASCUS and ASCU-H.Conclusion:For the screening of cervical precancerous lesions,the accuracy of liquid based cytology is high,but there are still some false positive and false negative.

  19. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  20. HPV for cervical cancer screening (HPV FOCAL): Complete Round 1 results of a randomized trial comparing HPV-based primary screening to liquid-based cytology for cervical cancer.

    Science.gov (United States)

    Ogilvie, Gina S; Krajden, Mel; van Niekerk, Dirk; Smith, Laurie W; Cook, Darrel; Ceballos, Kathy; Lee, Marette; Gentile, Laura; Gondara, Lovedeep; Elwood-Martin, Ruth; Peacock, Stuart; Stuart, Gavin; Franco, Eduardo L; Coldman, Andrew J

    2017-01-15

    Complete Round 1 data (baseline and 12-month follow-up) for HPV FOCAL, a randomized trial establishing the efficacy of HPV DNA testing with cytology triage as a primary screen for cervical cancer are presented. Women were randomized to one of three arms: Control arm - Baseline liquid-based cytology (LBC) with ASCUS results triaged with HPV testing; Intervention and Safety arms - Baseline HPV with LBC triage for HPV positives. Results are presented for 15,744 women allocated to the HPV (intervention and safety combined) and 9,408 to the control arms. For all age cohorts, the CIN3+ detection rate was higher in the HPV (7.5/1,000; 95%CI: 6.2, 8.9) compared to the control arm (4.6/1,000; 95%CI: 3.4, 6.2). The CIN2+ detection rates were also significantly higher in the HPV (16.5/1,000; 95%CI: 14.6, 18.6) vs. the control arm (10.1/1,000; 95%CI: 8.3, 12.4). In women ≥35 years, the overall detection rates for CIN2+ and CIN3+ were higher in the HPV vs. the control arm (CIN2+:10.0/1,000 vs. 5.2/1,000; CIN3+: 4.2/1,000 vs. 2.2/1,000 respectively, with a statistically significant difference for CIN2+). HPV testing detected significantly more CIN2+ in women 25-29 compared to LBC (63.7/1,000; 95%CI: 51.9, 78.0 vs. 32.4/1,000; 95%CI: 22.3, 46.8). HPV testing resulted in significantly higher colposcopy referral rates for all age cohorts (HPV: 58.9/1,000; 95%CI: 55.4, 62.7 vs.

  1. Cervical cytology screening among low-income, minority adolescents in New York City following the 2009 ACOG guidelines

    Science.gov (United States)

    Tsui, Jennifer; Hofstetter, Annika M.; Soren, Karen

    2014-01-01

    Objectives In December 2009, the American College of Obstetricians and Gynecologists recommended cervical cancer screening begin at age 21 for young women. In this study, we examine receipt of first lifetime Papanicolaou (Pap) test and predictors of over-screening among adolescents within a large urban ambulatory care network. Methods We compared the proportion of first lifetime Pap test of adolescents aged 13-20 years between June 2007-November 2009 (n=7700) and December 2009-June 2012 (n=9637) using electronic health records. We employed multivariable regression models to identify demographic and health care factors associated with receiving a first lifetime Pap test at age <21 years in the post-guideline period (over-screening). Results The proportion of Pap tests declined from 19.3% to 4.2% (p <0.001) between the two periods. Multivariable logistic regression results showed receiving care from gynecology/obstetrics/family planning clinics compared to pediatric clinics, having more clinic encounters, and older age were associated with over-screening in the post-guideline period. Conclusions We found that guideline adherence differed by clinic type, insurance status, and health care encounters. In the quickly evolving field of cervical cancer control, it is important to monitor practice trends as they relate to shifts in population-based guidelines, especially in high-risk populations. PMID:24650625

  2. Clinical significance and treatment of cervical cytology as ASCUS%宫颈细胞学检查为ASCUS的临床意义及处理

    Institute of Scientific and Technical Information of China (English)

    徐明霞; 王爱芹

    2011-01-01

    Objective: To investigate the clinical significance and treatment of the thin-cytologic test (TCT) result as atypical squamouns cell of undetermined significance (ASCUS).Methods: 132 patients from June 2006 to June 2009 were selected to do TCT, the results were ASCUS, 132 patients were given colposcopy and multiple punch biopsy, and its results were analyzed.Results: Of the 132 patients, biopsy for the inflammation were 81 cases, accounted for 61.36%; cervical intraep-ithelial neoplasia I (CINI) were 24 cases, accounted for 18.18%; cervical intraepithelial neoplasia II (CINII) were 14 cases, accounted for 10.61%; cervical intraepithelial neoplasia III (CINIII) were 11 cases, accounted for 8.33%; carcinoma were 2 cases, accounted for 1.52%.Colposcopy be diagnosed as cervical intraepithelial neoplasia (CIN) and invasive carcinoma of the sensitivity, specificity, positive predictive value, negative predictive value were 98.04%, 95.06%, 92.59%, 98.72% respectivly.Conclusion: Colposcopy for the diagnosis of cervical lesions has higher value, the ASCUS patients can do colposcopy and biopsy for histopathological multi-point inspection in primary hospital immediately.%目的:探讨薄层细胞学技术(TCT)结果为未明确意义不典型鳞状细胞(atypical squamouns cell of undetermined significance,ASCUS)的临床意义及处理方法.方法:对2006年6月~2009年6月北京市顺义区老年妇幼保健院妇科门诊行液基TCT检查结果回报为ASCUS的患者132例均进行阴道镜检查及多点活检,对其结果进行临床及病理分析.结果:132例ASCUS患者活检病理为炎症81例,占61.36%;轻度宫颈上皮非典型增生(CINI)24例,占18.18%;中度宫颈上皮非典型增生(CINⅡ)14例;占10.61%I重度宫颈上皮非典型增生及宫颈原位癌(CINⅢ)11例,占8.33%;浸润癌2例,占1.52%.阴道镜拟诊为宫颈上皮内瘤变(CIN)及浸润癌的灵敏度、特异度、阳性预测值、阴性预测值分别为98.04%、95

  3. Paralytic strabismus compensatory head position and abnormal cervical motion%麻痹性斜视代偿头位与颈椎异常运动

    Institute of Scientific and Technical Information of China (English)

    郭文华

    2016-01-01

    在眼科临床诊疗过程中,眼性斜颈比较常见。麻痹斜视与颈椎异常运动相互联系,相互影响。颈椎是脊椎的带头“大哥”,颈椎的异常运动引发整个脊柱的运动异常,出现全身姿势异常。%In the clinical diagnosis and treatment process of the ophthalmology,the ocular torticollis is more common.The paralytic strabismus and abnormal cervical motion have mutual connection and mutual influence.Cervical spine is the lead "big brother" of spine,and the abnormal movement of the cervical spine causes the abnormal movement of the entire spine,appears abnormal body posture.

  4. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  5. 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

    OpenAIRE

    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...

  6. Management of the abnormal Papanicolaou smear and colposcopy in pregnancy: an evidenced-based review.

    Science.gov (United States)

    Fleury, A C; Birsner, M L; Fader, A N

    2012-04-01

    Women diagnosed with abnormal Papanicolau smears or cervical abnormalities during pregnancy present a challenge to health care providers, as conventional management guidelines appropriate for the non-pregnant population may be contraindicated. The physiologic effects of pregnancy that may result in greater difficulty with the colposcopic examination include increased cervical mucus production that may obscure visualization, cervical hyperemia, gland prominence, and eversion of the columnar epithelium. The squamo-columnar junction may also be difficult to visualize in early pregnancy, but will often evert as the pregnancy continues. Because of these changes, cervical dysplasia may have a more prominent appearance in the gravid patient. Therefore, colposcopy should be performed by a skilled examiner with expertise in the cervical changes of pregnancy. The primary goal of colposcopy during pregnancy is to exclude the presence of invasive cancer, and thus, many cervical lesions may be followed with serial cytology and colposcopy during pregnancy or by deferring further colposcopic examination until the postpartum period. Cervical biopsy should be avoided unless a malignancy is suspected and endocervical sampling is contraindicated. Herein, we present a contemporary, evidence-based review of the colposcopic examination and guidelines for triaging and evaluating abnormal cervical cytology and lesions that are diagnosed during pregnancy.

  7. Human Papillomavirus Testing in the Prevention of Cervical Cancer

    Science.gov (United States)

    Wentzensen, Nicolas; Wacholder, Sholom; Kinney, Walter; Gage, Julia C.; Castle, Philip E.

    2011-01-01

    Strong evidence now supports the adoption of cervical cancer prevention strategies that explicitly focus on persistent infection with the causal agent, human papillomavirus (HPV). To inform an evidence-based transition to a new public health approach for cervical cancer screening, we summarize the natural history and cervical carcinogenicity of HPV and discuss the promise and uncertainties of currently available screening methods. New HPV infections acquired at any age are virtually always benign, but persistent infections with one of approximately 12 carcinogenic HPV types explain virtually all cases of cervical cancer. In the absence of an overtly persistent HPV infection, the risk of cervical cancer is extremely low. Thus, HPV test results predict the risk of cervical cancer and its precursors (cervical intraepithelial neoplasia grade 3) better and longer than cytological or colposcopic abnormalities, which are signs of HPV infection. The logical and inevitable move to HPV-based cervical cancer prevention strategies will require longer screening intervals that will disrupt current gynecologic and cytology laboratory practices built on frequent screening. A major challenge will be implementing programs that do not overtreat HPV-positive women who do not have obvious long-term persistence of HPV or treatable lesions at the time of initial evaluation. The greatest potential for reduction in cervical cancer rates from HPV screening is in low-resource regions that can implement infrequent rounds of low-cost HPV testing and treatment. PMID:21282563

  8. Improved identification of dystonic cervical muscles via abnormal muscle activity during isometric contractions

    NARCIS (Netherlands)

    De Bruijn, E.; Nijmeijer, S. W. R.; Forbes, P. A.; Koelman, J. H. T. M.; van der Helm, F. C. T.; Tijssen, M. A. J.; Happee, R.

    2015-01-01

    Background: The preferred treatment for cervical dystonia (CD) is injection of botulinum toxin in the dystonic muscles. Unfortunately, in the absence of reliable diagnostic methods it can be difficult to discriminate dystonic muscles from healthy muscles acting in compensation. We investigated if dy

  9. Improved identification of dystonic cervical muscles via abnormal muscle activity during isometric contractions

    NARCIS (Netherlands)

    De Bruijn, E; Nijmeijer, S W R; Forbes, P A; Koelman, J H T M; van der Helm, F C T; Tijssen, M A J; Happee, R

    2015-01-01

    BACKGROUND: The preferred treatment for cervical dystonia (CD) is injection of botulinum toxin in the dystonic muscles. Unfortunately, in the absence of reliable diagnostic methods it can be difficult to discriminate dystonic muscles from healthy muscles acting in compensation. We investigated if dy

  10. Should liquid-based cytology be performed prior to colposcopy? A comparison of the accuracy, unsatisfactory rates and cost in a tertiary referral setting.

    Science.gov (United States)

    Angstetra, Donald; Tait, Thomas; Tan, Jeffrey; Symonds, Ian

    2009-12-01

    To compare the use of liquid-based cytology (LBC) with conventional cytology (CC) in the assessment cervical intraepithelial neoplasia (CIN) prior to colposcopy. Retrospective Cohort Study. Liquid-based cytology and CC findings were compared with colposcopic assessment and directed cervical biopsy in terms of sensitivity and specificity for high grade lesions only and for any abnormalities. The degree of correlation was sought. Secondary outcomes were unsatisfactory rate and cost. A total of 1961 women had colposcopy of whom 528 had cervical biopsy. LBC and CC have similar sensitivity and specificity for both high-grade lesions and any abnormalities. In comparison with cervical biopsy, LBC and CC sensitivity for high-grade disease was 89.1% and 88.6% respectively and for any abnormalities, the sensitivity was 86.6% and 87.0%. Specificity for high-grade disease was 83.1% and 84.7% and for any abnormalities, the specificity was 53.8% and 56.4%. The unsatisfactory rate was significantly lower in LBC 4.38% compared to 1.84% (P < 0.001). However, the use of LBC was associated with an additional cost of A$1496 for each unsatisfactory smear avoided. In high prevalence setting, LBC showed no statistically significant difference in sensitivity and specificity from CC for the detection of CIN. A reduction in unsatisfactory smears was evident, but at significant additional cost.

  11. Comparative study of the results from conventional cervico-vaginal oncotic cytology and liquid-based cytology

    OpenAIRE

    Stabile,Sueli Aparecida Batista; Evangelista,Dilson Henrique Ramos; Talamonte,Valdely Helena; Lippi,Umberto Gazi; Lopes, Reginaldo Guedes Coelho

    2012-01-01

    OBJECTIVE: To compare two oncotic cervical cytology techniques, the conventional and the liquid-based cytology, in low risk patients for uterine cervical cancer. METHODS: Comparative prospective study with 100 patients who came to their annual gynecological exam, and were submitted simultaneously to both techniques. We used the McNemar test, with a significance level of p

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

    NARCIS (Netherlands)

    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.

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

    NARCIS (Netherlands)

    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

  14. 宫颈细胞学为ASCUS的临床意义及处理措施探讨%Clinical Significance and Treatment Measures of Cervical Cytology for AS-CUS

    Institute of Scientific and Technical Information of China (English)

    柯丽娟

    2016-01-01

    目的:分析宫颈细胞学为ASCUS的临床意义及处理措施。方法整群选择2014年5月—2015年3月来该院妇科门诊就诊的156例宫颈细胞学为ASCUS的患者为研究对象,对所有患者进行阴道镜检查及宫颈组织活检,同时对其中100名患者进行了HPV(人乳头瘤病毒)的高危检测,分析其检查结果。结果156名ASCUS患者中58名宫颈组织病理提示宫颈上皮内瘤变,发生率为37.18%,其中高级别CIN及浸润癌发生率为23.72%,阴道镜诊断出高级别CIN及浸润癌为24例,符合率为64.86%。 HPV阳性者CIN检出率82.89%,4例浸润癌均为HPV阳性,明显高于阴性组。结论宫颈细胞学为ASCUS提示可能发生宫颈上皮内瘤变,应该警惕其高级别CIN和浸润癌的可能。联合应用阴道镜检查可以明显提高宫颈病变的检出情况。高危HPV是ASCUS分流管理的一种有效手段,可以明显提高宫颈上皮内瘤变的检出。%Objective To analyze the clinical significance and treatment measures of cervical cytology for ASCUS. Methods Gropu selection May 2014 to March 2015 to gynecological outpatients from 156 cervical cytology ascus patients as the re-search object, for all patients of colposcopy and cervical biopsy, detection of high risk HPV (human papilloma virus) of the 100 patients at the same time, analysis the examination results. Results 156 patients with ASCUS 58 cervical pathological prompt cervical intraepithelial neoplasia, incidence of 37.18%, the high grade CIN and invasive carcinoma incidence was 23.72% and colposcopy in the diagnosis of a high grade cervical intraepithelial neoplasia (CIN) and invasive carcinoma in 24 cases, in line with the rate was 64.86%. HPV positive detection rate of CIN was 82.89%, 4 cases of invasive carcinoma were HPV positive, significantly higher than the negative group. Conclusion Cervical cytology was ASCUS suggesting that the occurrence of cervical intraepithelial neoplasia, should

  15. 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

    Science.gov (United States)

    2012-01-01

    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 C-MYC test showed lower sensitivity (80.0% vs. 84.0%) and higher specificity (77.7% vs. 64.3%). Using a cut-off value of 5% or more aberrant cells, the TERC test showed the highest combination of sensitivity and specificity. The CIN2+ group showed more high-level TERC gene copy number (GCN) cells than did the normal/CIN1 group (p C-MYC, no significant difference between the two histological categories was detected (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

  16. Improvization of conventional cytology by centrifuged liquid-based cytology in oral exfoliative cytology specimen

    National Research Council Canada - National Science Library

    Nambiar, Shwetha; Hegde, Veda; Yadav, Nikhil; Hallikeri, Kaveri

    2016-01-01

    ...-based cytology (LBC) was initially developed for cervical uterine cancer screening. As compared to conventional smears, this technique reduces the number of unsatisfactory and false positive results with significant improvement in cytodiagnostic accuracy. [4] Most LBC preparations showed a good quality of preparation including cytoplasmic and...

  17. 观察HPV联合液基细胞学检查在宫颈癌筛查中的应用效果%To observe the effect of HPV combined with liquid based cytology testin cervical cancer screening

    Institute of Scientific and Technical Information of China (English)

    唐利华

    2015-01-01

    Objective Application of HPV in cervical cancer screening joint liquid based cytology effects were observed. Methods From the hospital outpatient service of department of gynaecology in from January 2012 to December 2012 received line in patients with cervical cancer screening randomly 320 cases were studied, and randomly divided into control group 160 cases, liquid based cytology examination and observation group 160 cases, HPV joint liquid based cytology, compare the positive detection rate of two groups of patients.Results The positive detection rate of 59.375% in the control group and observation group was 74.375%, by comparison, the observation group is significantly higher than the control group, the differences between groups (P<0.05). Conclusion Combined use of HPV in cervical cancer screening and liquid based cytology, can improve the diagnostic accuracy, has high clinical value.%目的:对宫颈癌筛查中应用HPV联合液基细胞学检查的效果进行观察。方法选取2012年1月~2013年12月在我院妇科门诊行宫颈癌筛查患者320例为研究对象,将其随机分成对照组和观察组,各160例。对照组行液基细胞学检查,观察组行HPV联合液基细胞学检查,比较两组患者的阳性检出率。结果对照组的阳性检出率为59.375%,观察组为74.375%,差异有统计学意义(P<0.05)。结论在宫颈癌筛查中联合应用HPV和液基细胞学检查,可以提高诊断准确率,具有较高的临床应用价值。

  18. 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

    Institute of Scientific and Technical Information of China (English)

    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。

  19. Value of Cervical Fluid Based Cytology and Vaginal Examination in Early Screening for Cervical Lesions%宫颈病变早期筛查中宫颈液基细胞学和阴道镜检查的应用价值探析

    Institute of Scientific and Technical Information of China (English)

    张书霞

    2015-01-01

    目的 研究和探析宫颈病变早期筛查中宫颈液基细胞学和阴道镜检查的应用价值. 方法 收集2013年1月-2014年12月到该院妇科门诊行宫颈检查的患者共1 037例,所有患者均接受宫颈液基细胞学检测,对检查结果呈阳性者进行阴道镜检查. 结果 37例(3.6%)患者宫颈液基细胞学检测呈阳性,经过阴道镜检查后,23例显示阳性,其中炎症12例(32.4%),宫颈上皮内瘤样病变Ⅰ期14例(37.8%), 宫颈上皮内瘤样病变Ⅱ~Ⅲ6例(16.2%). 阴道镜下的活检组织病理学检查结果与宫颈液基细胞学的检查结果的差异有统计学意义(P<0.05).结论 在宫颈病变早期筛查中,宫颈液基细胞学和阴道镜活组织病理检查联合使用,有助于尽早发现宫颈病变,值得推广应用.%Objective To study the application value of cervical fluid based cytology and vaginal examination in early screening for cervical lesions. Methods 1037 gynecological outpatients who underwent inspection of the cervix in the hospital between January 2013 and December 2014 were included. All of them received cervical fluid based cytology, and for those with positive results vaginoscopy was carried out. Results Out of 37 patients (3.6%) who showed positive result from cervical fluid based cytology, 23 showed positive result after vaginoscopy, including 12 (32.4%) cases of f inflammation and 14(37.8%) cases of stage I cervical in-traepithelial neoplasia, and 6 (16.2%) cases of stage II-III cervical intraepithelial neoplasia. Therefore, there was statistically sig-nificant difference in the outcomes between vaginoscopy and cervical fluid based cytology, P<0.05. Conclusion In the early screening of cervical lesions, the cervical fluid based cytology combined with pathological examination of biopsy under vaginoscope is beneficial to the early detection of cervical lesions, therefore it is worthy of popularization and application.

  20. Risk Assessment of Cervical Lesion by Combined Detection of Papillomavirus L1 Capsid Protein and Human Papillomavirus Genotyping, Thinprep-cytology Test%HPV L1壳蛋白联合HPV分型、TCT检测技术对子宫颈病变进展风险的评估

    Institute of Scientific and Technical Information of China (English)

    宋晓霞; 刘玉玲; 杨晓; 王丽丽

    2013-01-01

    Objective:To explore risk assessment of cervical lesion and guidance of the best clinical triage management and treatment by combined detection of human papillomavirus LI capsid protein and human papillomavirus(HPV) genotyping, thinprep cytology test(TCT). Methods:Retrospective analysis of 1 593 women of cervical cancer screening in the gynecological clinic of the Second Affiliated Hospital of Zhengzhou University from September 2010 to December 2011 ,and TCT and genotyping of HPV-DNA testing at the same time,in which 592 patients who was HPV-positive or TCT positive or both abnormal were sent to colposcopic biopsy for pathological examination and who was HPV-DNA typing-positive were detection of HPV L1 capsid protein expression. Results:TCT combined with HPV-DNA detection in cervical intraepithelial neoplasia HI (CIN III ) and the above cases had the highest rate and reached 100% positivity in squamous cell carcinoma (SCC) ;the positive rate of HPV LI capsid protein expression show a decreased trend with the increasing level of cervical lesions,the expression of HPV LI capsid protein and SCC was O. The positive expression rate of HPVL1 capsid protein in each group was significantly different (P<0.05). Conclusions:It is an essential indicator that TCT combined HPV genotyping in cervical lesions screening,and HPVL1 capsid protein detection had important guiding value on risk assessment of cervical lesions. Three factors effective combination can be timely and accurate diversion and treatment of patients with cervical lesions.%目的:探讨人乳头瘤病毒L1 (human papilloma virus L1,HPV L1)壳蛋白联合HPV分型、液基薄层细胞学(thinprap cytology test,TCT)技术对预测子宫颈病变进展的风险评估以及指导临床最佳的分流管理与治疗.方法:回顾性分析2010年9月-2011年12月在郑州大学第二附属医院妇科门诊因宫颈病变就诊的1 593例有性生活的妇女,即同时进行TCT和HPV-DNA分型检测,对其中HPV阳性

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

    DEFF Research Database (Denmark)

    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...... 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...

  2. Diagnostic accuracy of liquid-based endometrial cytology in the evaluation of endometrial pathology in postmenopausal women.

    Science.gov (United States)

    Remondi, C; Sesti, F; Bonanno, E; Pietropolli, A; Piccione, E

    2013-12-01

    The aim of this study was to compare liquid-based endometrial cytology with hysteroscopy and endometrial biopsy regarding its diagnostic accuracy in a series of postmenopausal women with abnormal uterine bleeding (AUB) or asymptomatic women with thickened endometrium assessed by transvaginal ultrasound as a screening procedure.   Inclusion criteria were: menopausal status; the presence of AUB and/or thickened endometrium assessed by ultrasound (cut-off 4 mm); a normal Papanicolaou (Pap) smear; and no adnexal pathology at ultrasound. Exclusion criteria were: previous endometrial pathology; and previous operative hysteroscopy. Of 768 postmenopausal women referred to our general gynaecology clinics, 121 fulfilled the inclusion criteria and were recruited to the trial. Twenty-one refused to participate. Cytological sampling was carried out by brushing the uterine cavity using the Endoflower device with no cervical dilation and the vial was processed using a ThinPrep® 2000 automated slide processor. The slides were stained using a Pap method.   In 98 cases with histological biopsies, endometrial cytology detected five cases of endometrial carcinoma, 10 of atypical hyperplasia and 47 of non-atypical hyperplasia; 36 cases were negative. In two cases cytology was inadequate because of uterine cervical stenosis. Taking atypical hyperplasia or worse as a positive test and outcome, the diagnostic accuracy of the endometrial cytology was 93.5%, with a sensitivity of 92% and specificity of 95%, a positive predictive value of 73% and a negative predictive value of 99%. All the carcinomas were detected by cytology. Only 42% of women with a positive diagnosis were symptomatic. The cytological sampling was well tolerated by all patients. No complication was registered.  Liquid-based endometrial cytology can be considered an useful diagnostic method in the detection of endometrial pathology as a first-line approach, particularly if associated with transvaginal ultrasound.

  3. Prevalence of human papillomavirus in 5,072 consecutive cervical SurePath samples evaluated with the Roche cobas HPV real-time PCR assay.

    Directory of Open Access Journals (Sweden)

    Sarah Preisler

    Full Text Available New commercially available Human Papillomavirus (HPV assays need to be evaluated in a variety of cervical screening settings. Cobas HPV Test (cobas is a real-time PCR-based assay allowing for separate detection of HPV genotypes 16 and 18 and a bulk of 12 other high-risk genotypes. The aim of the present study, Horizon, was to assess the prevalence of high-risk HPV infections in an area with a high background risk of cervical cancer, where women aged 23-65 years are targeted for cervical screening. We collected 6,258 consecutive cervical samples from the largest cervical screening laboratory in Denmark serving the whole of Copenhagen. All samples were stored in SurePath media. In total, 5,072 samples were tested with cobas, Hybrid Capture 2 High Risk HPV DNA test (HC2 and liquid-based cytology. Of these, 27% tested positive on cobas. This proportion decreased by age, being 43% in women aged 23-29 years and 10% in women aged 60-65 years. HC2 assay was positive in 20% of samples, and cytology was abnormal (≥ atypical squamous cells of undetermined significance for 7% samples. When only samples without recent abnormalities were taken into account, 24% tested positive on cobas, 19% on HC2, and 5% had abnormal cytology. The proportion of positive cobas samples was higher than in the ATHENA trial. The age-standardized cobas positivity vs. cytology abnormality was 3.9 in our study and 1.7 in ATHENA. If in Copenhagen the presently used cytology would be replaced by cobas in women above age 30 years, an extra 11% of women would based on historical data be expected to have a positive cobas test without an underlying cervical intraepithelial lesion grade 3 or worse. Countries with a high prevalence of HPV infections should therefore proceed to primary HPV-based cervical screening with caution.

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

    NARCIS (Netherlands)

    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

  5. Value of computer-assisted slide-screening system in ThinPrep cervical cytology%电脑辅助阅片系统在宫颈液基细胞涂片诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    杨静; 陶琨; 杨华; 郭振华; 胡月梅; 谈振宇

    2013-01-01

    Objective To investigate the value of computer-assisted slide-screening system (ThinPrep imaging system,TIS) in the diagnosis of cervical Thinprep smears.Methods A total of 19 600 ThinPrep smears were collected,including 9800 slides by TIS-assisted screening from September 2011 to March 2012 and 9800 slides by manual screening from September 2010 to April 2011 as control.The detection rates of abnormal cells and common microbial infection by the different screening methods were compared.With histopathological diagnosis of colposcopic biopsy as the gold standard,the screening efficiency and correlation of cytologic diagnosis among different screening methods were analyzed.Results Compared with manual screening,the detection rate of abnormal cells in 9800 cases by TIS-assisted screen was increased from 5.4% (525/9800) to 6.8% (665/9800),mainly in the categories of ASCUS and LSIL (P < 0.05).TIS had a higher accordance rate between cytologic diagnosis and histopathological diagnosis in the NILM and ASCUS than that by manual screening.False-negative rate of finding abnormal cells by TIS decreased from 8.5% (17/200) to 0.7% (2/289,P < 0.01) with an increased sensitivity compared to manual screening,althoughthe specificity was similar.Both TIS and manual screening had advantages and disadvantages respectively in the detection of microbial organisms.TIS improved screening efficiency by 50%.Conclusion TIS improves not only the screening efficiency but also the detection of abnormal cells with a reduced false negativity,and it therefore has a broad application prospect.%目的 探讨电脑辅助阅片系统(TIS)在宫颈薄层液基细胞涂片诊断中的价值.方法 共收集19 600例液基细胞涂片,其中2011年9月至2012年3月期间9800例经TIS阅片,2010年9月至2011年4月期间9800例经人工阅片作为对照,比较两种阅片方法异常细胞检出率和常见微生物检出率;以阴道镜活检的组织病理学诊断结果作为金标

  6. 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

    Institute of Scientific and Technical Information of China (English)

    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

  7. 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

    Directory of Open Access Journals (Sweden)

    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

  8. Quality control analysis on cervical cytology of free cervical cancer screening for 35-64-year-old women in Beijing in 2013%北京市2013年适龄妇女免费宫颈癌筛查宫颈细胞学阅片质量控制结果分析

    Institute of Scientific and Technical Information of China (English)

    沈洁; 张月; 高丽丽; 韩历丽

    2015-01-01

    目的:探讨2013年北京市宫颈癌免费筛查获得的宫颈细胞学阅片的质量控制情况,并进行相关分析。方法自2013年在北京市16个区、县宫颈癌筛查机构接受宫颈癌免费筛查获取的286781张宫颈涂片信息中,采用概率随机抽样法,随机抽取9907张宫颈涂片进行质量控制结果分析。本研究以专家阅片结果作为宫颈细胞学诊断金标准,对传统巴氏涂片及液基细胞涂片的宫颈细胞学检出阳性率差异、各质量控制指标差异及涂片不满意率差异等进行统计学比较。结果①液基细胞涂片的总检出阳性率、低度鳞状上皮内瘤变(LSIL)及高度鳞状上皮内瘤变(HSIL)的检出阳性率均较巴氏涂片高,且差异有统计学意义(2.41% vs 2.05%,χ2=39.885,P =0.000;0.58% vs 0.31%,χ2=113.772,P =0.000;0.14% vs 0.11%,χ2=4.464,P =0.035)。②抽取进行质量控制结果分析的涂片中,巴氏涂片与液基细胞涂片的假阴性率、特异度及符合率比较,差异均无统计学意义(P >0.05);巴氏涂片假阳性率较液基细胞涂片低,而其灵敏度较液基细胞涂片高,且差异均有统计学意义(0 vs 0.55%,χ2=18.342,P =0.000;100.00% vs 75.00%,χ2=98.980,P =0.000)。③本组宫颈涂片中,涂片不满意率为4.17%(413/9907),首要原因为染色偏浅和(或)结构不清(54.24%);其次为细胞量不足(43.09%)。因细胞量不足导致的不满意率,巴氏涂片较液基细胞涂片高(2.45% vs 1.44%),而因染色偏浅和(或)结构不清导致的不满意率,则为液基细胞涂片较巴氏涂片高(3.34% vs 0.26%),且差异均有统计学意义(χ2=12.452,93.311;P =0.000)。结论北京市宫颈癌免费筛查的宫颈细胞学检出阳性率有待进一步提高。建立完善的宫颈细胞学质量控制评价系统,对涂片的取材、制片及染色等环节加以控制,以提高涂片满意度及宫颈细胞学阅片质量。%Objective To analyze the data of cervical cytology quality

  9. Risk of invasive cervical cancer after atypical glandular cells in cervical screening: nationwide cohort study

    Science.gov (United States)

    Andrae, Bengt; Sundström, Karin; Ström, Peter; Ploner, Alexander; Elfström, K Miriam; Arnheim-Dahlström, Lisen; Dillner, Joakim; Sparén, Pär

    2016-01-01

    Objectives To investigate the risks of invasive cervical cancer after detection of atypical glandular cells (AGC) during cervical screening. Design Nationwide population based cohort study. Setting Cancer and population registries in Sweden. Participants 3 054 328 women living in Sweden at any time between 1 January 1980 and 1 July 2011 who had any record of cervical cytological testing at ages 23-59. Of these, 2 899 968 women had normal cytology results at the first screening record. The first recorded abnormal result was atypical glandular cells (AGC) in 14 625, high grade squamous intraepithelial lesion (HSIL) in 65 633, and low grade squamous intraepithelial lesions (LSIL) in 244 168. Main outcome measures Cumulative incidence of invasive cervical cancer over 15.5 years; proportion of invasive cervical cancer within six months of abnormality (prevalence); crude incidence rates for invasive cervical cancer over 0.5-15.5 years of follow-up; incidence rate ratios compared with women with normal cytology, estimated with Poisson regression adjusted for age and stratified by histopathology of cancer; distribution of clinical assessment within six months after the abnormality. Results The prevalence of cervical cancer was 1.4% for women with AGC, which was lower than for women with HSIL (2.5%) but higher than for women with LSIL (0.2%); adenocarcinoma accounted for 73.2% of the prevalent cases associated with AGC. The incidence rate of invasive cervical cancer after AGC was significantly higher than for women with normal results on cytology for up to 15.5 years and higher than HSIL and LSIL for up to 6.5 years. The incidence rate of adenocarcinoma was 61 times higher than for women with normal results on cytology in the first screening round after AGC, and remained nine times higher for up to 15.5 years. Incidence and prevalence of invasive cervical cancer was highest when AGC was found at ages 30-39. Only 54% of women with AGC underwent histology assessment

  10. Cervical screening in HIV-positive women in the East of England: recent CD4 as the predictive risk factor.

    Science.gov (United States)

    Davies, Olubanke; Rajamanoharan, Sasikala; Balachandran, Thambiah

    2015-11-01

    This study examines the relationship between CD4 count and cervical cytological abnormality in HIV-positive women attending two district general hospital genitourinary medicine clinics in the East of England. It aims to determine whether the rate of cervical cytological abnormalities differs in HIV-positive women with CD4 count >350 cells/µl and those with CD4 count ≤350 cells/µl; and to compare the rates of abnormalities with that of the general population. We retrospectively reviewed data from a cross-sectional audit undertaken between December 2010 and December 2011 and analysed them using multivariable statistics. There was a significant association between recent CD4 count ≤350 cells/µl and cervical cytological abnormality (p 350 cells/µl had abnormal cervical smear results, compared with 6.6% of the general population in the screening period 2010-11 and 7.2% of the general population in the screening period 2009-10. In our study population of women with recent CD4 counts >350 cells/µl, the proportions of mild, moderate and severe dysplasia were also similar to national figures. This raises important questions about the cost effectiveness of blanket annual screening for HIV-positive women.

  11. 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

    Directory of Open Access Journals (Sweden)

    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.

  12. Role of p16(INK4a) cytology testing as an adjunct to enhance the diagnostic specificity and accuracy in human papillomavirus-positive women within an organized cervical cancer screening program.

    Science.gov (United States)

    Gustinucci, Daniela; Passamonti, Basilio; Cesarini, Elena; Butera, Daniela; Palmieri, Emiliano Antonio; Bulletti, Simonetta; Carlani, Angela; Staiano, Maria; D'Amico, Maria Rosaria; D'Angelo, Valentina; Di Dato, Eugenio; Martinelli, Nadia; Malaspina, Morena; Spita, Nicoletta; Tintori, Beatrice; Fulciniti, Franco

    2012-01-01

    We evaluated the performance of cytologic p16(INK4a) (p16) immunostaining within a cervical cancer screening program for the categories of atypical squamous cells of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesion (LS after triage with high-risk human papillomavirus (HR-HPV) testing and atypical squamous cells, cannot exclude high-grade intraepithelial squamous lesion (ASC-H) and high-grade squamous intraepithelial lesion (HSIL). We also verified whether the routine introduction of p16 staining might enhance the specificity and positive predictive value (PPV) for cervical intraepithelial neoplasia grade 2 or higher (CIN2+) lesions predicted by a cytological screening test. Performance of the p16 cytology test was estimated in 578 cytological samples, of which 213 were HR-HPV+ ASC-US, 186 were HR-HPV+ LSIL, 74 were ASC-H, 56 were HSIL-CIN2 and 49 were HSIL-CIN3. All samples had histological follow-up. In the ASC-US category, p16 sensitivity was 91% for CIN2+ and 100% for CIN3, while specificity was 64 and 58%, respectively, negative predictive value (NPV) was 96 and 100%, respectively, and PPV was 39%. In the LSIL category, sensitivity was 77 and 75%, respectively, for CIN2+ and CIN3, while specificity was 64 and 57%, NPV was 93 and 98% and PPV was 30%. Sensitivity for ASC-H and HSIL-CIN3 was 100% for CIN2+ and CIN3, while for HSIL-CIN2 it was 91 and 95%, respectively; NPV for ASC-H was 100%, and for HSIL-CIN2 it was 43 and 86%, respectively. Follow-up examinations of 8 cases diagnosed as p16+ ASC-H and HSIL-CIN3, but histologically negative or CIN1 on the first biopsy, showed 4 CIN2 and 4 CIN3 lesions. Sensitivity, specificity, PPV and NPV confirm the importance of the utilization of p16 in the categories ASC-US and LSIL after triage with an HR-HPV test. In the ASC-H and HSIL-CIN3 lesions, p16 was shown to be an excellent marker for picking up CIN2+ lesions, especially in cases with cytohistological discordance. Copyright © 2012 S

  13. 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

    Institute of Scientific and Technical Information of China (English)

    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

  14. 液基细胞学在宫颈癌筛查中的应用分析%Applied Analysis of Liquid-base Cytology in Screening of Cervical Cancer

    Institute of Scientific and Technical Information of China (English)

    刘丽英

    2015-01-01

    Objective To explore clinical value of liquid-base cytology application in screening of cervical cancer. Methods We chose 44 cervical cancer patients who are treated in hospital from January 2013 to January 2014. Patients in study group were given liquid-base cytology examination,while patients in control group were given pap smear examination. And then make a comparison between these two groups in terms of positive detection rate,patients’ satisfaction rate and positive coincidence rate. Results The positive detection rate(54.55%),patients’satisfaction rate(90.91%)and positive coincidence rate(93.18%)in study group rather higher than counterparts in control group(22.73%)、(68.18%)、(52.27%),there was a treatment differential between two groups and such a differential had statistic value(P<0.05). Conclusion Applying liquid-base cytology in cervical cancer screening is effective to increase detection rate,such a method is of application value.%目的:分析宫颈癌筛查中应用液基细胞学检查的临床价值。方法选取我院2013年1月~2014年1月间收治的宫颈癌患者44例,实验组给予液基细胞学检查,对照组给予巴氏涂片法检查,比较两组阳性检出率、满意率、阳性符合率。结果实验组阳性检出率(54.55%)、满意率(90.91%)与阳性符合率(93.18%)与对照组(22.73%)、(68.18%)、(52.27%)比较相对较高,两种检查结果差异有统计学意义(P<0.05)。结论宫颈癌筛查应用液基细胞学检查可以提高检出率,应用价值高。

  15. Cervical Cancer Screening System and Liquid Based Cytology Test in ervical Lesion Screening Study%宫颈癌筛查系统与液基细胞学检测在宫颈病变初筛中的研究

    Institute of Scientific and Technical Information of China (English)

    李霞; 黄俊霞

    2011-01-01

    目的:探讨宫颈癌筛查系统(TruScreen)与液基细胞学检测(TCT)在宫颈病变初筛中的应用价值.方法:对1 201例患者依次进行TruScreen、TCT及宫颈活检病理学检查,将其病理结果与TruScreen和TCT结果对照分析.结果:TruScreen、TCT阳性结果分别为316例和207例,病理学检查阳性结果为115例.TruScreen、TCT检测的敏感度分别为81.7%、71.3%,特异度分别为79.6%、88.5%,假阴性率分别为18.3%、28.7%,假阳性率分别为20.4%、11.5%.TruScreen检查敏感度略高于TCT,差异无统计学意义(P>0.05).结论:TruScreen的效果评价略优于TCT,具有较低的假阴性率及相对不高的假阳性率,有望成为我国宫颈病变初筛的独立方法.%Objective:To study the value of cervical cancer screening system and liquid based cytology test in detection of cervical lesions.Methods:Cervical cancer screening system,liquid based cytology test and pathological test were performed in a 1201 cases,and the results of the former two were compared with pathological outcomes.Results:A total of 316,207 and 115 cases were shown as positive according to cervical cancer screening system, liquid based cytology test and pathological test respectively indicating sensitivity of 81.7%,71.3%;specificity of 79.6%,88.5%;false negative rate of 18.3%,28.7%;and false positive rate of 20.4%,11.5% for cervical cancer screening system and liquid based cytology test.Sensitivity of cervical cancer screening system was slightly higher than that of the liquid based cytology test,while the difference was insignificant (P>0.05).Conclusion: Efficacy of cervical cancer screening system is better than that of liquid based cytology test. With low false negative rate and comparatively low false positive rate,it might be used alone as primary screening method for cervical lesions in China.

  16. [Cervical cancer screening: Is active recruitment worth the effort?].

    Science.gov (United States)

    Morales Martínez, Ángeles; Blanco Rodríguez, Lorena; Morales Martínez, Cristina; Tejuca Somoano, Sonia

    2015-12-01

    To determine the percentage of women who have had a Pap smear in the last 5 years, and the place where it was carried out. To detect cytological abnormalities and precursors of cervical cancer in un-screened or inadequately screened women and the prevalence of HPV-positive determinations. Cross sectional study. Natahoyo Health Centre, Gijón (Spain). Women aged 40-50 years living in the area and assigned to the Health Centre. The information was collected from databases, telephone and home surveys. There was active recruitment of unscreened women or inadequately screened in Primary Care as well as offering to perform cytology and HPV determination. Of the 1420 women aged 40 to 50 years, 1236 (87%) had cytology in the last 5 years, and 184 women (13%) had no screening or it was inadequate. Of these 184 women, 108 (58.7%) agreed to have cytology and HPV test performed. No high-grade cervical dysplasia was diagnosed. The prevalence of HPV-positive was 8.3%. In our population there is a high coverage of opportunistic screening for cervical cancer. The active recruitment of women who were not in the screening program was not useful. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  17. 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

    Institute of Scientific and Technical Information of China (English)

    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

  18. The significance in expression of protein p16 in liquid-based thinner cytology to cervical screening%宫颈薄层液基细胞中P16ink4a的表达在宫颈癌筛查中的意义

    Institute of Scientific and Technical Information of China (English)

    韩雪松; 王钫; 徐琳; 许妙玲

    2011-01-01

    Objective To evaluate the significance in expression of protein pl6 which is the product of tumor-suppressing gene P16ink4a in liquid-based cytology to cervical screening and the confidence to be the biological marker of cervical intraepithelial neo-plasia(CIN) .Methods SP immunohistochemistry detection of protein pl6 was performed on 78 specimens remaining from liquid-based cytology which HPV detection was positive ,and compared with the results of biopsy histology .Results In patients with cytolog-ical diagnosis of negative for intraepithelial lesion or malignancy (NILM ) ,atypical squamous cells (ASC ) ,low-grade squamous intraep-ithelial lesion(LSIL) ,and high-grade squamous intraepithelial lesion (HSIL) ,the positive rates of protein pl6 were 0(0/20)、38.9% (14/36),25 .0% (5/2)、85 .0% (17/20),respectively .The positive rate in ASC and HSIL groups was significantly higher than NILM group( ρ<0 .05) .Whereas for LSIL group was not ( ρ>0 .05) .Compared with the results of biopsy histology ,one case was positive of protein pl6 in chronic cervicitis group (2 .70% ,1/36) ,40 cases in CIN (72 .7% ,40 /55 ) ,and 5cases in SCC (100 .0% ,5 / 5 ) .The difference in the positive rates between the first two groups ( ρ<0 .05 ) .Conclusion The abnormal expression of protein pl6 has connected with the development of CIN ,which can become the maker of CIN to help cytology screening .%目的 探讨肿瘤抑制基因P16ink4a的编码产物p16蛋白的表达在宫颈液基薄层细胞学(liquid based cytological test,LCT)筛查中的意义及作为宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)生物标志物的可行性和临床意义.方法 选择96例HPV阳性的宫颈液基薄层细胞学剩余标本,制作液基薄片,利用SP免疫组化法检测LCT标本中p16蛋白,并与组织活检结果进行对照.结果 p16蛋白在宫颈细胞学诊断未见上皮内病变及癌变(NILM)、非典型鳞状上皮细胞(ASC)、低度鳞状上皮内

  19. Application of Liquid Based Cytology Test on Early Screening of Cervical Precancerous Pathological Changes%液基细胞学检测在宫颈癌早期筛查中的价值

    Institute of Scientific and Technical Information of China (English)

    孙翠琴; 范洪斌

    2012-01-01

      Objective:To describe the value of Liquid-based cytology test(TCT)on early screening of cervical intraepithelial neoplasia.Method:The behesda system(TBS)was used to analyze the TCT of 625 patients.Colposcopy was performed on 126 cases,including 76 positive patients and 50 clinic highly questionable cases.So that to study the value of TCT in the clinical context and research the age distribution characteristics and clinical features of the patients.Result:According to TBS test,divide into:40 ASCUS,4 AGUS,3 ASC-H,18 LSIL,7 HSIL,3 SCC and 1 AC.The agreement rate of cytology and vaginal microscopically living tissue diagnosis in LSIL,HSIL and SCC each are 72.22%,85.71%and 100%.There are 4.64%cases in the 76 patents were with cervical intraepithelial neoplasia.The study shows that,females 31 to 40 years old are the higher age level of cervical intraepithelial neoplasia,about 46.05%.Conclusion:TCT are useful in early detection and treatment of cervical intraepithelial neoplasia.%  目的:探讨液基细胞技术在宫颈癌早期筛查中的应用价值.方法:对625例患者行TCT,用TBS诊断方法进行分析,对76例细胞学阳性及临床上高度可疑的50例共计126例患者行阴道镜检查,以评价TCT在临床上的应用价值,同时调查他们的疾病构成及年龄分布特征.结果:TBS诊断ASCUS 40例,AGUS 4例,ASC-H 3例,LSIL 18例,HSIL 7例,SCC 3例,AC 1例.细胞学与阴道镜下活组织病理诊断符合率分别为LSIL 72.22%,HSIL 85.71%,SCC 100%,76例患者中宫颈病变占4.64%,31~40岁的妇女为宫颈病变的最高发年龄段,占46.05%.结论:采用TCT技术对早期发现与治疗宫颈病变及宫颈癌有积极的临床作用.

  20. 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

    Institute of Scientific and Technical Information of China (English)

    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

  1. Abnormality of cervical vestibular-evoked myogenic potentials and ocular vestibular-evoked myogenic potentials in patients with recurrent benign paroxysmal postitional vertigo.

    Science.gov (United States)

    Lee, Jong Dae; Park, Moo Kyun; Lee, Byung Don; Lee, Tae Kyeong; Sung, Ki-Bum; Park, Ji Yun

    2013-02-01

    Our results show that cervical vestibular-evoked myogenic potential (cVEMP) or ocular VEMP (oVEMP) abnormalities in the recurrent benign paroxysmal positional vertigo (BPPV) group were significantly higher than those in the non-recurrent BPPV group. Therefore, we can infer that VEMP abnormality is one of risk factors for BPPV recurrence. This prospective study aimed to test the hypothesis that otolith dysfunction using the VEMP test is a cause of recurrence of BPPV. cVEMP and oVEMP tests using 500 Hz tone-burst stimuli were performed on 16 patients with recurrent BPPV between March 2010 and December 2011. Both VEMP tests were performed in 20 patients with non-recurrent BPPV. The differences in age, sex, and involved canal between the recurrent and non-recurrent BPPV groups were not significant. Abnormal cVEMP responses were detected in 5 of 16 (31.3%) subjects in the recurrent BPPV group and abnormal oVMEP responses were detected in 4 of 16 (25%) subjects in the recurrent BPPV group. When we defined VEMP abnormality as an abnormal cVEMP or abnormal oVEMP, VEMP abnormalities were detected in eight (50%) subjects in the recurrent BPPV group and in three (15%) subjects in the non-recurrent BPPV group; the difference between groups was significant.

  2. Thinprep液基细胞学在中山市大规模宫颈癌筛查中的应用%Application of Thinprep liquid based cytology in large-scale screening of cervical cancer in Zhongshan city

    Institute of Scientific and Technical Information of China (English)

    王莹; 陈昂; 米贤军; 沈铿; 余艳红; 肖琳; 徐秀梅; 孪峰; 钟守军; 段立锋

    2012-01-01

    Objective: To evaluate the application value of Thinprep liquid based eytologic test (TCT) in large —scale screening of cervical cancer. Methods: The cervical cells of 44 936 cases were detected by TCT, then TBS classification was performed; the cases with cervical lesions above atypical squamous cells of undetermined significance ( ASCUS) /atypical glandular cells ( AGC) were designed as cytological positive cases, and colposcopic multiple punch biopsy was conducted, the cases with cervical intraepithelial neoplasia (CIN) or a-bove CIN lesions were designed as histopathological positive cases, the pathological results were designed as gold standards, then the cytolog-ical results were compared with pathological results after biopsy. Results: Among 44 936 cases, 1 413 cases were diagnosed as cytological positive cases, the total detection rate was 3. 14% , including 202 eases with LSIL (0. 45% ) , 128 cases with HSIL (0. 28% ) , 4 cases with squamous cell carcinoma (SCC) (0. 09‰) , one case with AC (0. 02‰) , 119 cases with ASC - H (0. 27% ) , 919 cases with ASCUS (2. 05% ) , and 40 cases with AGC (0. 09% ) . A total of 761 cases underwent pathological examination, then the results were compared with cytological results, the pathological positive rates of ACC, AC, HSIL, LSIL, ASC - H, ASCIIS, and AGS detected by TCT were 100.00% (4/4), 100.00% (1/1), 90.40% (66/73), 47.27% (52/110), 67.69% (44/65), 16. 32% (79/484), and 41.66% (10/24) , respectively. The pathological accurate ra.es of SCC, AC, HSIL, and LSIL detected by TCT were 100.00% (4/4) , 100.00% ( 1/1) , 60 01% (46/73) , ard 37. 20% (41/110) , respectively. Conclusion: TCT is a convenient and power - efficient screening method for cervical cancer and cervicd precmcerous lesion, which is useful for early diagnosis and early treatment of cervical cancer and cervical precancerous lesion.%目的:评价Thinprep液基细胞学检测技术(TCT)在大规模宫颈癌筛查中的应用价值.方法:对44 936例

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Development of an Abnormal Curvature Cervical Spine Finite Element Model%曲度异常颈椎三维有限元模型的建立#

    Institute of Scientific and Technical Information of China (English)

    何帆

    2015-01-01

    目的:建立生理曲度异常的人颈椎三维有限元模型,并进行应力分析。方法:采集1位颈椎生理曲度变直患者的CT数据,利用 MIMICS软件进行数据处理,建立实体模型,然后导入有限元分析软件 Abaqus,建立颈椎有限元模型。在此模型上施加作用力,模拟颈椎在后伸工况下的状态。结果:建立了包括完整颈椎椎体、椎间盘和模拟主要韧带的颈椎模型,得到了在外力作用下的颈椎应力云图。结论:建立的有限元模型可用于生理曲度异常颈椎的生物力学研究。%Objective: To develop an abnormal curvature cervical spine finite element model, for the use of subsequent biomechanical analyses of human cervical.Methods:The computed tomography data of an abnormal cervical curvature patient were used in the study. The data were input to MIMICS software to process and output a three dimension entity model, then the model was input into the finite element software abaqus to obtain a cervical finite element model. The model accuracy was tested in vitro experimental results for the movement of rear bending.Results:The finite element model comprised all cervical vertebras, discs and the main ligaments was established. The nephogram of the cervical spine under the force was got.Conclusion:The established finite element model is competent in the use of the biomechanical analysis in clinical study of abnormal curvature cervical spine.

  6. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  7. 宫颈液基细胞学检查及上皮内瘤变中Ki-67和PTEN表达的临床意义%Liquid-based cervical cytology and expression of Ki-67 and PTEN in the clinic significance of cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    张观宇; 许立莉; 王建琴; 孙凤娟; 韩吉萍

    2011-01-01

    Objective: To investigate liquid-based cervical cytology and expression of Ki-67 and PTEN in the clinic significance of cervical intraepithelial neoplasia to provide guidance for clinical treatment. Methods: 1 330 patients were detected by liquid-based cervical cytology (LCT), antitypical squamous cells were found in 61 cases, 24 cases were cervical intraepithelial neoplasia by biopsy, in which CIN I were 11, CIN II -CIN Ⅲ were 13, Ki-67 and PTEN were detected by im-mmunohistochemical method (Ultrasensitive TMHRP) in 24 cases of CIN and 20 cases cervicitis. Results: In cervicitis, Ki-67 and PTEN expression rates were 5% and 100% respectively. In CIN I , Ki-67 and PTEN expression rates were 18.2% and 72.7% respectively, which was no significantly difference with cervicitis (P>0.05). In CIN II -CIN Ⅲ, Ki-67 and PTEN expression rates were 76.9% and 15.4% respectively, which was significantly diference with CIN I (P<0.05). Correlation association was found between Ki-67 and PTEN in CIN (r=-0.818 ,P<0.05). Conclusion: Liquid-based cervical cytology and expression of Ki-67, PTEN can be used as important markers to distinguish benign cervical lesions, it plays important role in evaluating the risk of CIN.%目的:探讨宫颈液基细胞学检查(TCT)及上皮内瘤变中Ki-67和PTEN表达的临床意义.方法:收集液基细胞检查患者1 330例,其中,有非典型鳞状细胞以上病变61例,经活检证实24例为上皮内瘤变,包括低度上皮内瘤变(CINⅠ)11例,高度上皮内瘤变(CINⅡ~CINⅢ)13例.同时选取20例宫颈炎作为对照,分别进行超敏TMHRP法免疫组织化学染色,检测Ki-67和PTEN表达情况.结果:对照组Ki-67阳性率5%,PTEN阳性率100%;低度上皮内瘤变(CINⅠ)Ki-67阳性率18.2%,PTEN阳性率72.7%;高度上皮内瘤变(CINⅡ~CINⅢ)Ki-67阳性率76.9%,PTEN阳性率15.4%.对照组与低度上皮内瘤变比较差异无统计学意义(P>0.05),低度上皮内瘤变与高度上皮内瘤变比

  8. Differential detection of Human Papillomavirus genotypes and cervical intraepithelial neoplasia by four commercial assays

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Bonde, Jesper; Preisler, Sarah;

    2016-01-01

    Laboratories can nowadays choose from >100 Human Papillomavirus (HPV) assays for cervical screening. Our previous analysis based on the data from the Danish Horizon study, however, showed that four widely used assays, Hybrid Capture 2 (HC2), cobas, CLART and APTIMA, frequently do not detect...... the same HPV infections. Here, we determined the characteristics of the concordant (all four assays returning a positive HPV test result) and discordant samples (all other HPV-positive samples) in primary cervical screening at 30-65 years (n=2859) and in a concurrent referral population from the same...... catchment area (n=885). HPV testing followed the manufacturers' protocols. Women with abnormal cytology were managed according to the routine recommendations. Cytology-normal/HPV-positive women were invited for repeated testing in 18 months. Screening history and histologically confirmed cervical...

  9. Risk of newly detected infections and cervical abnormalities in women seropositive for naturally acquired human papillomavirus type 16/18 antibodies: analysis of the control arm of PATRICIA.

    Science.gov (United States)

    Castellsagué, Xavier; Naud, Paulo; Chow, Song-Nan; Wheeler, Cosette M; Germar, Maria Julieta V; Lehtinen, Matti; Paavonen, Jorma; Jaisamrarn, Unnop; Garland, Suzanne M; Salmerón, Jorge; Apter, Dan; Kitchener, Henry; Teixeira, Julio C; Skinner, S Rachel; Limson, Genara; Szarewski, Anne; Romanowski, Barbara; Aoki, Fred Y; Schwarz, Tino F; Poppe, Willy A J; Bosch, F Xavier; de Carvalho, Newton S; Peters, Klaus; Tjalma, Wiebren A A; Safaeian, Mahboobeh; Raillard, Alice; Descamps, Dominique; Struyf, Frank; Dubin, Gary; Rosillon, Dominique; Baril, Laurence

    2014-08-15

    We examined risk of newly detected human papillomavirus (HPV) infection and cervical abnormalities in relation to HPV type 16/18 antibody levels at enrollment in PATRICIA (Papilloma Trial Against Cancer in Young Adults; NCT00122681). Using Poisson regression, we compared risk of newly detected infection and cervical abnormalities associated with HPV-16/18 between seronegative vs seropositive women (15-25 years) in the control arm (DNA negative at baseline for the corresponding HPV type [HPV-16: n = 8193; HPV-18: n = 8463]). High titers of naturally acquired HPV-16 antibodies and/or linear trend for increasing antibody levels were significantly associated with lower risk of incident and persistent infection, atypical squamous cells of undetermined significance or greater (ASCUS+), and cervical intraepithelial neoplasia grades 1/2 or greater (CIN1+, CIN2+). For HPV-18, although seropositivity was associated with lower risk of ASCUS+ and CIN1+, no association between naturally acquired antibodies and infection was demonstrated. Naturally acquired HPV-16 antibody levels of 371 (95% confidence interval [CI], 242-794), 204 (95% CI, 129-480), and 480 (95% CI, 250-5756) EU/mL were associated with 90% reduction of incident infection, 6-month persistent infection, and ASCUS+, respectively. Naturally acquired antibodies to HPV-16, and to a lesser extent HPV-18, are associated with some reduced risk of subsequent infection and cervical abnormalities associated with the same HPV type. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

  10. Cervical Screening within HIV Care: Findings from an HIV-Positive Cohort in Ukraine

    Science.gov (United States)

    Bailey, Heather; Thorne, Claire; Semenenko, Igor; Malyuta, Ruslan; Tereschenko, Rostislav; Adeyanova, Irina; Kulakovskaya, Elena; Ostrovskaya, Lyudmila; Kvasha, Liliana; Cortina-Borja, Mario; Townsend, Claire L.

    2012-01-01

    Introduction HIV-positive women have an increased risk of invasive cervical cancer but cytologic screening is effective in reducing incidence. Little is known about cervical screening coverage or the prevalence of abnormal cytology among HIV-positive women in Ukraine, which has the most severe HIV epidemic in Europe. Methods Poisson regression models were fitted to data from 1120 women enrolled at three sites of the Ukraine Cohort Study of HIV-infected Childbearing Women to investigate factors associated with receiving cervical screening as part of HIV care. All women had been diagnosed as HIV-positive before or during their most recent pregnancy. Prevalence of cervical abnormalities (high/low grade squamous intraepithelial lesions) among women who had been screened was estimated, and associated factors explored. Results Overall, 30% (337/1120) of women had received a cervical screening test as part of HIV care at study enrolment (median 10 months postpartum), a third (115/334) of whom had been tested >12 months previously. In adjusted analyses, women diagnosed as HIV-positive during (vs before) their most recent pregnancy were significantly less likely to have a screening test reported, on adjusting for other potential risk factors (adjusted prevalence ratio (APR) 0.62, 95% CI 0.51–0.75 p<0.01 for 1st/2nd trimester diagnosis and APR 0.42, 95% CI 0.28–0.63 p<0.01 for 3rd trimester/intrapartum diagnosis). Among those with a cervical screening result reported at any time (including follow-up), 21% (68/325) had a finding of cervical abnormality. In adjusted analyses, Herpes simplex virus 2 seropositivity and a recent diagnosis of bacterial vaginosis were associated with an increased risk of abnormal cervical cytology (APR 1.83 95% CI 1.07–3.11 and APR 3.49 95% CI 2.11–5.76 respectively). Conclusions In this high risk population, cervical screening coverage as part of HIV care was low and could be improved by an organised cervical screening programme for HIV

  11. Cervical screening within HIV care: findings from an HIV-positive cohort in Ukraine.

    Directory of Open Access Journals (Sweden)

    Heather Bailey

    Full Text Available INTRODUCTION: HIV-positive women have an increased risk of invasive cervical cancer but cytologic screening is effective in reducing incidence. Little is known about cervical screening coverage or the prevalence of abnormal cytology among HIV-positive women in Ukraine, which has the most severe HIV epidemic in Europe. METHODS: Poisson regression models were fitted to data from 1120 women enrolled at three sites of the Ukraine Cohort Study of HIV-infected Childbearing Women to investigate factors associated with receiving cervical screening as part of HIV care. All women had been diagnosed as HIV-positive before or during their most recent pregnancy. Prevalence of cervical abnormalities (high/low grade squamous intraepithelial lesions among women who had been screened was estimated, and associated factors explored. RESULTS: Overall, 30% (337/1120 of women had received a cervical screening test as part of HIV care at study enrolment (median 10 months postpartum, a third (115/334 of whom had been tested >12 months previously. In adjusted analyses, women diagnosed as HIV-positive during (vs before their most recent pregnancy were significantly less likely to have a screening test reported, on adjusting for other potential risk factors (adjusted prevalence ratio (APR 0.62, 95% CI 0.51-0.75 p<0.01 for 1(st/2(nd trimester diagnosis and APR 0.42, 95% CI 0.28-0.63 p<0.01 for 3(rd trimester/intrapartum diagnosis. Among those with a cervical screening result reported at any time (including follow-up, 21% (68/325 had a finding of cervical abnormality. In adjusted analyses, Herpes simplex virus 2 seropositivity and a recent diagnosis of bacterial vaginosis were associated with an increased risk of abnormal cervical cytology (APR 1.83 95% CI 1.07-3.11 and APR 3.49 95% CI 2.11-5.76 respectively. CONCLUSIONS: In this high risk population, cervical screening coverage as part of HIV care was low and could be improved by an organised cervical screening programme

  12. Sensitivity, specificity, and clinical value of human papillomavirus (HPV) E6/E7 mRNA assay as a triage test for cervical cytology and HPV DNA test.

    Science.gov (United States)

    Benevolo, Maria; Vocaturo, Amina; Caraceni, Donatella; French, Deborah; Rosini, Sandra; Zappacosta, Roberta; Terrenato, Irene; Ciccocioppo, Lucia; Frega, Antonio; Giorgi Rossi, Paolo

    2011-07-01

    There is evidence that testing for human papillomavirus (HPV) E6/E7 mRNA is more specific than testing for HPV DNA. A retrospective study was carried out to evaluate the performance of the PreTect HPV-Proofer E6/E7 mRNA assay (Norchip) as a triage test for cytology and HPV DNA testing. This study analyzed 1,201 women, 688 of whom had a colposcopy follow-up and 195 of whom had histology-confirmed high-grade intraepithelial neoplasia or worse (CIN2+). The proportion of positive results and the sensitivity and specificity for CIN2+ were determined for HPV mRNA in comparison to HPV DNA and cytology. All data were adjusted for follow-up completeness. Stratified by cytological grades, the HPV mRNA sensitivity was 83% (95% confidence interval [CI] = 63 to 94%) in ASC-US (atypical squamous cells of undetermined significance), 62% (95% CI = 47 to 75%) in L-SIL (low-grade squamous intraepithelial lesion), and 67% (95% CI = 57 to 76%) in H-SIL (high-grade squamous intraepithelial lesion). The corresponding figures were 99, 91, and 96%, respectively, for HPV DNA. The specificities were 82, 76, and 45%, respectively, for HPV mRNA and 29, 13, and 4%, respectively, for HPV DNA. Used as a triage test for ASC-US and L-SIL, mRNA reduced colposcopies by 79% (95% CI = 74 to 83%) and 69% (95% CI = 65 to 74%), respectively, while HPV DNA reduced colposcopies by 38% (95% CI = 32 to 44%) and by 15% (95% CI = 12 to 19%), respectively. As a HPV DNA positivity triage test, mRNA reduced colposcopies by 63% (95% CI = 60 to 66%), having 68% sensitivity (95% CI = 61 to 75%), whereas cytology at the ASC-US+ threshold reduced colposcopies by 23% (95% CI = 20 to 26%), showing 92% sensitivity (95% CI = 87 to 95%). In conclusion, PreTect HPV-Proofer mRNA can serve as a better triage test than HPV DNA to reduce colposcopy referral in both ASC-US and L-SIL. It is also more efficient than cytology for the triage of HPV DNA-positive women. Nevertheless, its low sensitivity demands a strict follow-up of

  13. Human papillomavirus infections in Mexican women with normal cytology, precancerous lesions, and cervical cancer: type-specific prevalence and HPV coinfections.

    Science.gov (United States)

    Aguilar-Lemarroy, Adriana; Vallejo-Ruiz, Verónica; Cortés-Gutiérrez, Elva I; Salgado-Bernabé, Manuel Eduardo; Ramos-González, Norma Patricia; Ortega-Cervantes, Laura; Arias-Flores, Rafael; Medina-Díaz, Irma M; Hernández-Garza, Fernando; Santos-López, Gerardo; Piña-Sánchez, Patricia

    2015-05-01

    The prevalence and genotype distribution of human papillomavirus (HPV) provides the basis for designing HPV prevention programs. The prevalence rates of type-specific HPV and coinfections in samples of Mexican women were investigated in 822 women aged 18-87 years. HPV detection was performed using a Linear Array™ genotyping test. HPV infection was found in 12.4% of controls, 46.3% of those with cervical intraepithelial neoplasia 1, and 100% of those with cervical intraepithelial neoplasia 3 or cervical cancer. HPV 16 was the most prevalent type in all diagnosis groups. The HPV types most frequently found in cervical cancers were 16, 18, 45, 52, 58, and 39; HPV types 16, 62, 51, 84, 18, 53, and CP6108 were the most prevalent in control women. Considering HPV-positive samples only, coinfections occurred most often in controls (63%) and were less frequent in those with cervical cancer (26%). The most frequent viral types in coinfections with HPV 16 in control women were HPV 62, 51, and 84; in women with cervical cancers, HPV 18, 39, and 70 were most common. In conclusion, in addition to HPV types 16 and 18, types 45, 39, 58, 52, and 71 were found in cervical cancers in Mexican women (78%); among them, only 65% were attributable to HPV types 16 and 18. Therefore, it is necessary to consider these viral types in the design of new vaccines, and to determine whether certain HPV types coinfecting with HPV 16 in precursor lesions determine tumor progression or regression.

  14. The APTIMA HPV assay versus the Hybrid Capture 2 test in triage of women with ASC-US or LSIL cervical cytology: a meta-analysis of the diagnostic accuracy.

    Science.gov (United States)

    Arbyn, Marc; Roelens, Jolien; Cuschieri, Kate; Cuzick, Jack; Szarewski, Ann; Ratnam, Sam; Reuschenbach, Miriam; Belinson, Suzanne; Belinson, Jerome L; Monsonego, Joseph

    2013-01-01

    Testing for DNA of 13 high-risk HPV types with the Hybrid Capture 2 (HC2) test has consistently been shown to perform better in triage of women with cervical cytology results showing atypical squamous cells of undetermined significance (ASC-US) but often not in triage of low-grade squamous intraepithelial lesions (LSIL) detected in cervical cancer screening. In a meta-analysis, we compared the accuracy of the APTIMA HPV test, which identifies RNA of 14 high-risk HPV types, to HC2 for the triage of women with ASC-US or LSIL. Literature search-targeted studies where the accuracy of APTIMA HPV and HC2 for detection of underlying CIN2/3+ was assessed concomitantly including verification of all cases of ASC-US and LSIL. HSROC (Hierarchical Summary ROC) curve regression was used to compute the pooled absolute and relative sensitivity and specificity. Eight studies, comprising 1,839 ASC-US and 1,887 LSIL cases, were retrieved. The pooled sensitivity and specificity of APTIMA to triage ASC-US to detect underlying CIN3 or worse was 96.2% (95% CI = 91.7-98.3%) and 54.9% (95% CI = 43.5-65.9%), respectively. APTIMA and HC2 showed similar pooled sensitivity; however, the specificity of the former was significantly higher (ratio: 1.19; 95% CI = 1.08-1.31 for CIN2+). The pooled sensitivity and specificity of APTIMA to triage LSIL were 96.7% (95% CI = 91.4-98.9%) and 38.7% (95% CI = 30.5-47.6%) for CIN3+. APTIMA was as sensitive as HC2 but more specific (ratio: 1.35; 95% CI = 1.11-1.66). Results were similar for detection of CIN2 or worse. In both triage of ASC-US and LSIL, APTIMA is as sensitive but more specific than HC2 for detecting cervical precancer.

  15. 液基细胞学联合初善仪检测在宫颈癌筛查中的应用%Value of TruScreen combined with Thinprep cytology test in screening of cervical lesions

    Institute of Scientific and Technical Information of China (English)

    杜欣欣; 赛晓勇; 刘爱军; 张云; 付晓宇; 李江华; 孟元光

    2015-01-01

    目的:探讨液基细胞学(TCT)与初善仪(TS)在宫颈病变筛查中的联合应用价值。方法选择2013年12月~2014年11月就诊于解放军总医院妇科门诊阴道镜室的患者218例,所有患者均给予TCT及TS检查,并根据TCT及TS检查结果进行分组,结合病理学结果分析两种检测方法细胞学诊断价值的差异。结果TCT结果显示,218例患者中,不能明确意义的非典型鳞状细胞(ASC-US)76例,非典型鳞状细胞不除上皮内高度病变(ASC-H)43例,低度鳞状上皮内病变(LSIL)58例,高度鳞状上皮内病变(HSIL)41例;TS检测异常者94例。病理结果正常者106例,LSIL/CIN 141例,HSIL/CIN 2~371例。病理结果正常患者中,细胞学ASC-H与LSIL的检出率分别为53.5%和56.9%;低级别病变患者中,ASC-US和LSIL的检出率显著高于ASC-H及HSIL组(P=0.005);高级别病变患者中,ASC-H及HSIL的检出率显著高于ASC-US和LSIL(P=0.004)。经TS分层后,TS阴性而病理结果正常的患者中,TCT各组的检出率均提高;TS阳性而病理低级别病变患者中,ASC-US与LSIL的检出率升高,ASC-H与HSIL呈下降趋势,高级别病变患者中,TBS分级四组的检出率均升高。结论联合应用TS可以减少阴道镜门诊的过度转诊并能够更灵敏地发现高级别病变患者。%Objective To investigate the value of TruScreen (TS) combined with Thinprep cytology test in screening of cervical lesions. Methods 218 patients from December 2013 to November 2014 in Outpatient Vaginoscopy Room of PLA General Hospital, all patients were given the detection of TCT and TS, they were divided into different group ac-cording the detection results of TCT and TS, and diagnostic value of TCT and TS were evaluated by pathology result as a golden standard. Results The results of TCT showed that, there were 76 cases of ASC-US, 43 cases of ASC-H, 58 cases of LSIL and 41 cases of HSIL in total of 218 patients; TS showed that 94 cases were abnormal. Pathological re

  16. Potential applications of oral brush cytology with liquid-based technology: results from a cohort of normal oral mucosa.

    Science.gov (United States)

    Kujan, Omar; Desai, Mina; Sargent, Alexandra; Bailey, Andrew; Turner, Andrew; Sloan, Philip

    2006-09-01

    Fifty healthy volunteers were studied to assess the potential applications of oral brush sampling using liquid-based cytology. Three specimens from the buccal mucosa and lateral border of tongue were collected from each subject by using cervical brushes and brooms. The brush was immersed in a preservative fluid. The sample in the preservative fluid was processed according to the manufacturer's directions (SurePath, UK). Slides were stained by the Papanicolaou method and assessed for squamous cell adequacy by the same criteria used for cervical cytology screening. Immunocytochemical staining for FHIT (Fragile Histidine Triad) was applied in liquid-based preparations following the streptavidin-biotin-peroxidase method. Human papillomavirus (HPV) detection was performed using the Hybrid Capture 2 assay (Digene) and the PCR-based Roche AMPLICOR HPV Test. LBC preparation slides showed good sample preservation, specimen adequacy and visualization of cell morphology. Interestingly, nine cases showed borderline cytological abnormalities from apparently normal oral mucosa. All cases showed good quality positive FHIT immunoreactivity staining. All studied cases were high-risk HPV negative using HC2 assay method. However, the AMPLICOR Roche Test detected four samples with positive results for high-risk HPVs. Liquid-based cytology has potential as a screening tool for oral cancer and precancer. The method may also have applications for research and practice in the field of oral cancer and precancer. However a special custom-designed oral cytobrush is required.

  17. 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

    Institute of Scientific and Technical Information of China (English)

    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,

  18. Conjunctival impression cytology in contact lens wearers.

    Directory of Open Access Journals (Sweden)

    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. Study of ASC in Cervical Exfoliated Cytology%宫颈脱落细胞学中 ASC 的研究与分析

    Institute of Scientific and Technical Information of China (English)

    张志兴

    2015-01-01

    Objective To investigate the significance of thinprep cytoligic test (TCT) in the diagnosis of atypical squamous cells.Methods A retrospective analysis was conducted among TCT samples from which those with atypical squamous cells were diag-nosed from July 2012 till July 2014.Results Of all 349 cases, 152 were HPV-positive, and 44.7% were diagnosed with cervical intraepithelial neoplasia or cervical cancer; among 197 cases of HPV-negative patients, 8 cases of patients were with cervical intraepi-thelial neoplasia or cervical cancer.since atypical squamous cells were correlated with age, women older than 40 years old composed the main part of ASC.Conclusion TCT was meaningful for an early detection of cervical lesions