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Sample records for cervical papanicolaou cytology

  1. 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

  2. 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.

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

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    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.

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

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    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.

  5. 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...

  6. 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...

  7. 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...

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

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    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. Diagnosis of human papillomatosis by polymerase chain reaction in cases of divergence between results of hybrid capture and papanicolaou cytology

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    Luiz Carlos Garcez Novaes

    2006-06-01

    Full Text Available As various types of human papillomavirus (HPV are involved in the pathogenesis of cervical cancer, correct diagnosis is of fundamental importance for screening programs. We evaluated the divergence of results between Papanicolaou cytology and hybrid capture by PCR detection of HPV DNA . A transversal study was conducted on 70 women attending private gynecological clinics in Brasilia, Brazil. PCRs were conducted with specific primers for general and high-risk HPV DNA. Based on the PCR results, hybrid capture was a superior diagnostic technique. When Papanicolaou was compared with the molecular biology methods, it was found that a positive Papanicolaou result does not necessarily indicate the presence of HPV. The agreement between PCR and hybrid capture results can be attributed to the fact that both methods detect latent infection, while Papanicolaou detects only microscopic cellular alterations.

  10. 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...

  11. CERVICAL ACID PHOSPHATASE: EVALUATION AS AN ADJUVANT TO PAPANICOLAOU SMEAR SCREENING IN CERVICAL CANCER DETECTION

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    Niranjan

    2015-02-01

    Full Text Available INTRODUCTION: Carcinoma of cervix accounts for 15% of all cancers diagnosed worldwide and is the second most common cancer in women. In the year 2000 there were over 4,71,000 new cases diagnosed and 2,88,000 deaths from cervical cancer. (1 Approximately 79% of these deaths occurred in developing countries. (2 Cervical cancer is preventable, but most women in poorer countries do not have access to effective screening programs. In India it is estimated that approximately 100,000 women develop cervical cancer each year. (3 Cancer cervix occupies either the top r ank or second among cancers in women in developing countries, whereas, in the developed countries cancer cervix does not find a place even in top five leading cancers in women. This is due to routine screening by cervical smear. Cervical smear cytology scr eening by Papanicolaou (Pap stained smears is the most efficacious and cost - effective method of cancer screening, decreasing the incidence and mortality from cervical cancer. (4 However, cervical smear screening has significant rates of false - positive and false - negative results, ranging from 10.3% for false positive cases to 5.6% for false negative cases. (5,6 To improve the detection and screening of cancerous and precancerous lesions of the cervix a number of sophisticated tests are available which are e xpensive and can be done only in a tertiary laboratory. To over - come this problems a cost effective cytochemical stain was introduced to measure the acid phosphatase activity in the cervical epithelium. (7 Since the description of the new Cervical Acid Phosphatase Test (CAP Test for visualization of cervical acid phosphatase activity (CAP inside abnormal cervical cells on smears, it has become possible to explore this enzyme as a biomarker for cervical dys plasia, and as a possible surrogate for PAP smear in detection of cervical intraepithelial neoplasia (CIN. AIMS AND OBJECTIVES: To assess the utility of Cervical Acid

  12. Significance of atypia in conventional Papanicolaou smears and liquid-based cytology: a follow-up study

    DEFF Research Database (Denmark)

    Schledermann, D; Ejersbo, D; Hoelund, B

    2004-01-01

    The diagnosis of atypical squamous epithelial cells, borderline nuclear changes, is associated with some controversy, as it encompasses benign, reactive, as well as possible neoplastic conditions. The aim of this study was to evaluate the follow-up diagnoses of cytological atypia in conventional...... Papanicolaou smears (CP) and liquid-based samples by the ThinPrep Pap Test (TP). A total of 1607 CP smears from 1 January 2000 to 31 December 2000 and 798 TP samples from 1 January 2002 to 31 December 2002 diagnosed as atypia were included. The results show that the detection rate of atypia in cervical...... cytological samples was reduced by 41.3% (P Cytological and histological follow-up data showed the presence of neoplastic lesions in 34.7% of patients screened by TP versus 22.3% of patients screened by CP, corresponding to a 55.6% increase in TP (P

  13. 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...

  14. Techniques for cytologic sampling of pancreatic and bile duct lesions: The Papanicolaou Society of Cytopathology Guidelines.

    Science.gov (United States)

    Brugge, William R; De Witt, John; Klapman, Jason B; Ashfaq, Raheela; Shidham, Vinod; Chhieng, David; Kwon, Richard; Baloch, Zubair; Zarka, Matthew; Staerkel, Gregg

    2014-01-01

    The Papanicolaou Society of Cytopathology has developed a set of guidelines for pancreatobiliary cytology, including indications for endoscopic ultrasound guided fine-needle aspiration biopsy, techniques of the endoscopic retrograde cholangiopancreatography, terminology and nomenclature of pancreatobiliary disease, ancillary testing, and postbiopsy management. All documents are based on the expertise of the authors, a review of literature, discussions of the draft document at several national and international meetings over an 18 month period and synthesis of online comments of the draft document on the Papanicolaou Society of Cytopathology website [www.papsociety.org]. This document presents the results of these discussions regarding the use of sampling techniques in the cytological diagnosis of biliary and pancreatic lesions. This document summarizes the current state of the art for techniques in acquiring cytology specimens from the biliary tree as well as solid and cystic lesions of the pancreas.

  15. Women with Cervical Cancer: Perceptions about the Papanicolaou Test

    OpenAIRE

    Maria-Teresa Urrutia; Lauren Poupin

    2015-01-01

    Objetivo: examinar las percepciones acerca de la prueba de Papanicolaou (Pap) desde la perspectiva de las mujeres chilenas con cáncer cervical. Diseño: un estudio descriptivo, transversal realizado en Santiago, Chile. Participantes: ciento veintisiete mujeres chilenas. Resultados: Las principales razones para no haber hecho la prueba de PAP fueron dilación y obstáculos relacionados con el miedo, la vergüenza, la incomodidad, el hecho de no estar preocupada, la falta de tiempo y la falta de co...

  16. Pioneers of exfoliative cytology in the 19th century: the predecessors of George Papanicolaou.

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    Diamantis, A; Magiorkinis, E

    2014-08-01

    The purpose of our study was to summarize the knowledge on exfoliative cytology during the 19th century and to track down Papanicolaou's predecessors. A thorough study of texts, medical books and reports, together with a review of the available literature in PubMed, was undertaken. The study of cytological preparations as a diagnostic procedure can be traced back to the work of the famous French microscopist Alfred François Donné. However, the systematic study and the criteria for the diagnosis of malignant cells should be attributed to Johannes Müller. The increasing interest in the cytological examination of various fluids of the human body can be confirmed by a plethora of studies published during this period. By the end of the 19th century, the invention of new techniques in pathology, such as the introduction of cell block techniques, tissue sections and new staining methods which provided the opportunity to study surgical specimens in three dimensions, led to a decrease in the interest in exfoliative cytology, which was re-discovered by George Papanicolaou almost three decades later. © 2013 John Wiley & Sons Ltd.

  17. Human papillomavirus (HPV) detection and Papanicolaou cytology in low-resource women in Posadas city, Misiones, Argentina.

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    Badano, Inés; Pedrozo, René W; Ruíz Díaz, Laura S; Galuppo, Juan A; Picconi, María A; Campos, Rodolfo H; Liotta, Domingo J

    2011-01-01

    The objective of this study was to determine the prevalence of HPV infection and cervical lesions present in women who attended a health center in a low-resource area of the city of Posadas, Misiones, Argentina. Cervical cell samples (n = 163) were processed for Papanicolaou cytology and HPV-PCR tests. Socio-cultural risk factors were estimated using the odds ratio (OR, CI 95 %). Cervical lesions were detected in 14.7 % of women. The general prevalence of HPV infection was of 38 %. The most common types among the total population were HPV-16 (9.8 %) and HPV-33 (9.3 %). HPV-16 was detected in association with 29.2 % and 6.5 % of women with and without cervical lesions, respectively, the OR being 5.3 (1.8-15.8). Risk factors for HPV-16 infection were a smoking habit and a history of previous sexually-transmitted diseases. These data are important for the implementation of prevention programs, including an appropriate introduction of vaccination and the baseline for virological surveillance in the vaccine era.

  18. 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.

  19. A brief chronicle of cytology: from Janssen to Papanicolaou and beyond.

    Science.gov (United States)

    Diamantis, Aristides; Beloukas, Apostolos I; Kalogeraki, Alexandra M; Magiorkinis, Emmanouil

    2013-06-01

    The aim of our study was to outline and present the major hallmarks in the history of clinical cytology. For this purpose, an extensive research in modern literature and the PubMed database was undertaken. Furthermore, we studied original papers and books of the pioneers in cytopathology. The development of the first microscope by Hans and Sacharias Janssen is a hallmark in biological sciences, since the study of microcosmos was made feasible. From the discovery of single cells by Robert Hooke and the cell theory by Schleiden and Schwann till the establishment of exfoliative cytology by George Papanicolaou and the invention of fine-needle aspiration biopsy technique by Martin and Ellis, there is a three-century continuum of important discoveries and research. Today, flow cytometry and the introduction of molecular techniques have revolutionized medicine and are expected to change the face of cytology in the near future. Copyright © 2012 Wiley Periodicals, Inc.

  20. Women with Cervical Cancer: Perceptions about the Papanicolaou Test

    Directory of Open Access Journals (Sweden)

    Maria-Teresa Urrutia

    2015-01-01

    Full Text Available Objetivo: examinar las percepciones acerca de la prueba de Papanicolaou (Pap desde la perspectiva de las mujeres chilenas con cáncer cervical. Diseño: un estudio descriptivo, transversal realizado en Santiago, Chile. Participantes: ciento veintisiete mujeres chilenas. Resultados: Las principales razones para no haber hecho la prueba de PAP fueron dilación y obstáculos relacionados con el miedo, la vergüenza, la incomodidad, el hecho de no estar preocupada, la falta de tiempo y la falta de conocimiento. Conclusión: todas las razones dadas por las mujeres chilenas que participaron en el estudio deben ser considerados por los profesionales de la salud que están en una posición para abogar por la educación y la detección del cáncer cervical para las mujeres, especialmente en países donde la enfermedad sigue siendo prevalente. Los resultados pueden servir como una guía para los programas de educación y pueden ser aplicados en la investigación sobre la intervención.

  1. Bethesda System reporting rates for conventional Papanicolaou tests and liquid-based cytology in a large Chinese, College of American Pathologists-certified independent medical laboratory: analysis of 1394389 Papanicolaou test reports.

    Science.gov (United States)

    Zheng, Baowen; Austin, R Marshall; Liang, Xiaoman; Li, Zaibo; Chen, Congde; Yan, Shanshan; Zhao, Chengquan

    2015-03-01

    Reports that use the Bethesda System categories for Chinese Papanicolaou test results are rare. To document and analyze rates reported in the Bethesda System for conventional Papanicolaou tests and liquid-based cytology between 2007 and 2012 in China's largest College of American Pathologists-accredited laboratory. Results from 1,394,389 Papanicolaou tests, rendered between 2007 and 2012 by the Guangzhou Kingmed Diagnostics Cytology Laboratory, were documented by the Bethesda System report categories and Papanicolaou test methodology, which included both conventional Papanicolaou tests and 4 different liquid-based cytology preparations. Results were documented for 326,297 conventional Papanicolaou tests and 1,068,092 liquid-based cytology specimens, which included 928,884 ThinPrep (Hologic, Bedford, Massachusetts), 63,465 SurePath (BD Diagnostics, Franklin Lakes, New Jersey), 50,422 Liqui-Prep (LGM International, Melbourne, Florida), and 25,321 Lituo liquid-cytology (Lituo Biotechnology Co, Hunan, China) specimens. Abnormality rates reported were significantly higher with liquid-based cytology than they were with conventional Papanicolaou tests in all the Bethesda System categories (P < .001). Reporting rates were within the 2006 benchmark ranges from the College of American Pathologists, except for atypical glandular cells (low) and unsatisfactory rates for conventional Papanicolaou tests (low). Participation in the international College of American Pathologists Laboratory Accreditation Program provides laboratory quality standards not otherwise available in many international settings.

  2. 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

  3. Standardized terminology and nomenclature for pancreatobiliary cytology: the Papanicolaou Society of Cytopathology guidelines.

    Science.gov (United States)

    Pitman, Martha B; Centeno, Barbara A; Ali, Syed Z; Genevay, Muriel; Stelow, Ed; Mino-Kenudson, Mari; Fernandez-del Castillo, Carlos; Max Schmidt, C; Brugge, William; Layfield, Lester

    2014-04-01

    The Papanicolaou Society of Cytopathology has developed a set of guidelines for pancreatobiliary cytology including indications for endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) biopsy, techniques of EUS-FNA, terminology and nomenclature of pancreatobiliary disease, ancillary testing, and postbiopsy treatment and management. All documents are based on the expertise of the authors, a review of the literature, discussions of the draft document at several national and international meetings over an 18-month period and synthesis of online comments of the draft document on the Papanicolaou Society of Cytopathology web site (www.papsociety.org). This document selectively presents the results of these discussions and focuses on a proposed standardized terminology scheme for pancreatobiliary specimens that correlate cytological diagnosis with biological behavior and increasingly conservative patient management of surveillance only. The proposed terminology scheme recommends a six-tiered system: Nondiagnostic, Negative, Atypical, Neoplastic (benign or other), Suspicious and Positive. Unique to this scheme is the "Neoplastic" category separated into "benign" (serous cystadenoma), or "Other" (premalignant mucinous cysts, neuroendocrine tumors, and solid-pseudopapillary neoplasms). The positive or malignant category is reserved for high-grade, aggressive malignancies including ductal adenocarcinoma, acinar cell carcinoma, poorly differentiated neuroendocrine carcinomas, pancreatoblastoma, lymphoma, and metastases. Interpretation categories do not have to be used. Some pathology laboratory information systems require an interpretation category, which places the cytological diagnosis into a general category. This proposed scheme provides terminology that standardizes the category of the various diseases of the pancreas, some of which are difficult to diagnose specifically by cytology. In addition, this terminology scheme attempts to provide maximum flexibility

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

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    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.

  5. Value of centrifugated liquid-based cytology by Papanicolaou and May-Grünwald in oral epithelial cells

    Science.gov (United States)

    Ahmed, Hussain Gadelkarim; Edris, Ali Mahmmoud; Mohmed, Eneel Ahmed; Hussein, Mohammed Omer M

    2009-01-01

    For many years, liquid-based cytology (LBC) has been developed for cervical cancer screening and not oral cancer, as it requires automated devices. The aim of this study was to compare the utility of centrifugated CLBC preparation with that of direct preparation in oral lesions, by Papanicolaou (Pap) and May Grünwald-Giemsa's (MGG) methods. A total of 100 consecutive cases of oral lesions were investigated. We compared the results obtained by the CLBC performed by cytocentrifugation with those obtained by direct smear applying Pap and MGG methods. The comparison between CLBC and direct smears was based on the thickening or adequacy of the smear, distribution of cells and staining quality. All smears in CLBC and direct preparation were found adequate. For thickness of the smear, 40% and 42% were excellent, 33% and 30% were good, and 27% and 28% were acceptable by LBC and direct preparation, respectively. For the distribution of cells and scantiness of background elements, 92 (92%) smears of the CLBC have revealed clear, well distributed smears, compared to 70 (70%) of those in direct preparation. For the staining quality with the Pap method, 39% and 69% were excellent staining quality, 25% and 20% were good, and 36% and 11% were acceptable for CLBC and direct preparation, respectively. In MGG method, 9% and 22% were excellent staining quality, 23% and 36% were good and 68% and 43% were acceptable for CLBC and direct preparation respectively. CLBC performed by cytocentrifugation is inexpensive, and reduces inadequate smears and background staining. PMID:21139883

  6. Utility of Papanicolaou test in diagnosis of cervical lesions: a study in a tertiary care centre of western Uttar Pradesh

    Directory of Open Access Journals (Sweden)

    Mithila Bisht

    2015-05-01

    Full Text Available Background: Cervical cancer is the most common cancer among females in India. It is also one of the major causes of deaths among them. Papanicolaou (Pap cytological test helps in detecting the early epithelial abnormalities in cervical cells. The morbidity and mortality due to cervical cancer has come down in countries with well-established screening programmes at national level. This study was conducted to emphasize the value of cervical screening as a tool for early detection of non-neoplastic and neoplastic lesions of cervix. Slide positivity rate was computed and clinico-pathological correlation was done. Methods: This cross-sectional study was conducted from January 2012 to December 2014 (3 years, on 2202 women aged between 20-70 years coming for a Pap smear examination in a tertiary care hospital in Bareilly, India. After staining with conventional Papanicolaou technique, all cases were classified as per Bethesda nomenclature (2001. Results: Out of 2202 cases, 85.16% slides were found to be negative for intraepithelial abnormalities and 14.84% slides were labelled as positive for epithelial lesions. 97.67% of high grade lesions were found in women more than 40 years. Smears with epithelial cell abnormality were found more common in older age groups whereas smears negative for epithelial cell abnormality were found more common in young age groups. Conclusion: Pap test is a cost effective cancer screening and is a simple method to detect various lesions of cervix, non-neoplastic as well as neoplastic. High risk screening programmes should be directed to all women >40 years. Pap test is especially useful to diagnose precancerous lesions of cervix, thereby early detection of these lesions and subsequent proper treatment can be helpful in prevention of cervical cancer. [Int J Res Med Sci 2015; 3(5.000: 1070-1076

  7. Value of centrifugated liquid-based cytology by Papanicolaou and May-Grünwald in oral epithelial cells

    Directory of Open Access Journals (Sweden)

    Hussain Gadelkarim Ahmed

    2009-07-01

    Full Text Available For many years, liquid-based cytology (LBC has been developed for cervical cancer screening and not oral cancer, as it requires automated devices. The aim of this study was to compare the utility of centrifugated CLBC preparation with that of direct preparation in oral lesions, by Papanicolaou (Pap and May Grünwald-Giemsa's (MGG methods. A total of 100 consecutive cases of oral lesions were investigated. We compared the results obtained by the CLBC performed by cytocentrifugation with those obtained by direct smear applying Pap and MGG methods. The comparison between CLBC and direct smears was based on the thickening or adequacy of the smear, distribution of cells and staining quality. All smears in CLBC and direct preparation were found adequate. For thickness of the smear, 40% and 42% were excellent, 33% and 30% were good, and 27% and 28% were acceptable by LBC and direct preparation, respectively. For the distribution of cells and scantiness of background elements, 92 (92% smears of the CLBC have revealed clear, well distributed smears, compared to 70 (70% of those in direct preparation. For the staining quality with the Pap method, 39% and 69% were excellent staining quality, 25% and 20% were good, and 36% and 11% were acceptable for CLBC and direct preparation, respectively. In MGG method, 9% and 22% were excellent staining quality, 23% and 36% were good and 68% and 43% were acceptable for CLBC and direct preparation respectively. CLBC performed by cytocentrifugation is inexpensive, and reduces inadequate smears and background staining.

  8. 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...

  9. 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 ...

  10. Actinomyces-like organisms in the cervical Papanicolaou-stained smears of intrauterine device (IUD) users

    OpenAIRE

    2004-01-01

    p. 159 - 164 The prevalence of Actinomyces-like organisms in cervicovaginal smears of 2,347 Brazilian women, including 151 (6.4%) intrauterine devices (IUD) users for at least six months and as controls 2,196 (93.6%) non-wearers of similar age using hormonal, barrier, or other contraceptive methods or none, living in Salvador, Bahia, has been investigated. Cervical smears were stained by the Papanicolaou method for the microscopic examination of Actinomyces-like organisms. The ...

  11. 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.

  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. 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

  14. 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.

  15. 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

  16. Utilization of ancillary studies in the cytologic diagnosis of biliary and pancreatic lesions: The Papanicolaou Society of Cytopathology Guidelines

    Directory of Open Access Journals (Sweden)

    Lester J. Layfield

    2014-01-01

    Full Text Available The Papanicolaou Society of Cytopathology has developed a set of guidelines for pancreatobiliary cytology including indications for endoscopic ultrasound guided fine needle aspiration, terminology and nomenclature of pancreatobiliary disease, ancillary testing and post-biopsy management. All documents are based on the expertise of the authors, a review of the literature, discussion of the draft document at several national and international meetings and synthesis of selected online comments of the draft document. This document presents the results of these discussions regarding the use of ancillary testing in the cytologic diagnosis of biliary and pancreatic lesions. Currently, fluorescence in-situ hybridization (FISH appears to be the most clinically relevant ancillary technique for cytology of bile duct strictures. The addition of FISH analysis to routine cytologic evaluation appears to yield the highest sensitivity without loss in specificity. Loss of immunohistochemical staining for the protein product of the SMAD4 gene and positive staining for mesothelin support a diagnosis of ductal adenocarcinoma. Immunohistochemical markers for endocrine and exocrine differentiation are sufficient for a diagnosis of endocrine and acinar tumors. Nuclear staining for beta-catenin supports a diagnosis of solid-pseudopapillary neoplasm. Cyst fluid analysis for amylase and carcinoembryonic antigen aids in the pre-operative classification of pancreatic cysts. A number of gene mutations (KRAS, GNAS, von Hippel-Lindau, RNF43 and CTNNB1 may be of aid in the diagnosis of cystic neoplasms. Other ancillary techniques do not appear to improve diagnostic sensitivity sufficiently to justify their increased costs.

  17. Association between cervical lesion grade and micronucleus frequency in the Papanicolaou test

    Directory of Open Access Journals (Sweden)

    Caroline Tanski Bueno

    2014-09-01

    Full Text Available The aim of this study was to evaluate the association between the frequency of micronuclei (MN and the cellular changes detected in the conventional Papanicolaou test. One hundred and seventy-four Papanicolaou test smears with cellular changes were examined. MN screening was done in cytopathological smears by counting 1,000 cervical cells in a light microscope. MN frequencies were significantly higher in the group with cellular changes compared to the control group (p < 0.001. The mean MN frequencies were 0.95 ± 1.12 (mean ± SD in the control group (n = 223, 2.98 ± 1.20 in individuals with atypical squamous cells of undetermined significance (ASC-US (n = 50, 4.04 ± 1.45 in cervical intraepithelial neoplasia (CIN I (n = 52, 5.97 ± 1.83 in CIN II (n = 30, 7.29 ± 1.55 in CIN III (n = 17 and 8.64 ± 1.55 in invasive cancer (n = 25. These findings suggest that MN monitoring should be included as an additional criterion for the early detection of cytogenetic damage in routine examinations. This monitoring should be done in the same smear as used for cytopathological examination. More specific and systematic studies are necessary to confirm this proposal.

  18. Association between cervical lesion grade and micronucleus frequency in the Papanicolaou test.

    Science.gov (United States)

    Bueno, Caroline Tanski; Dornelles da Silva, Cláudia Maria; Barcellos, Regina Bones; da Silva, Juliana; Dos Santos, Carla Rossana; Menezes, João Evangelista Sampaio; Menezes, Honório Sampaio; Rossetti, Maria Lucia Rosa

    2014-09-01

    The aim of this study was to evaluate the association between the frequency of micronuclei (MN) and the cellular changes detected in the conventional Papanicolaou test. One hundred and seventy-four Papanicolaou test smears with cellular changes were examined. MN screening was done in cytopathological smears by counting 1,000 cervical cells in a light microscope. MN frequencies were significantly higher in the group with cellular changes compared to the control group (p < 0.001). The mean MN frequencies were 0.95 ± 1.12 (mean ± SD) in the control group (n = 223), 2.98 ± 1.20 in individuals with atypical squamous cells of undetermined significance (ASC-US) (n = 50), 4.04 ± 1.45 in cervical intraepithelial neoplasia (CIN) I (n = 52), 5.97 ± 1.83 in CIN II (n = 30), 7.29 ± 1.55 in CIN III (n = 17) and 8.64 ± 1.55 in invasive cancer (n = 25). These findings suggest that MN monitoring should be included as an additional criterion for the early detection of cytogenetic damage in routine examinations. This monitoring should be done in the same smear as used for cytopathological examination. More specific and systematic studies are necessary to confirm this proposal.

  19. [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.

  20. 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...

  1. 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

  2. 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

  3. 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.

  4. 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...

  5. 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.

  6. Severe cervical glandular cell lesions and severe cervical combined lesions - Predictive value of the Papanicolaou smear

    NARCIS (Netherlands)

    Erp, AJMV; Smedts, FMM; Vooijs, GP

    2004-01-01

    BACKGROUND. The purpose of the current study was to determine the accuracy of routinely screened cervical smears to predict a glandular cell lesion in histologically confirmed cases of cervical adenocarcinoma in situ (AIS), invasive adenocarcinoma (ADCA), adenosquamous carcinoma (ADSQCA), and severe

  7. 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

  8. 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

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

    Science.gov (United States)

    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.

  10. Clinical evaluation, imaging studies, indications for cytologic study and preprocedural requirements for duct brushing studies and pancreatic fine-needle aspiration: The Papanicolaou Society of Cytopathology Guidelines

    Directory of Open Access Journals (Sweden)

    Douglas Adler

    2014-01-01

    Full Text Available The Papanicolaou Society of Cytopathology has developed a set of guidelines for pancreaticobiliary cytology including indications for endoscopic ultrasound (EUS and fine-needle aspiration (FNA biopsy, techniques for EUS-FNA, terminology and nomenclature to be used for pancreaticobiliary disease, ancillary testing and postbiopsy management. All documents are based on expertise of the authors, literature review, discussions of the draft document at national and international meetings and synthesis of online comments of the draft document. This document selectively presents the results of these discussions. This document summarizes recommendations for the clinical and imaging work-up of pancreatic and biliary tract lesions along with indications for cytologic study of these lesions. Prebrushing and FNA requirements are also discussed.

  11. 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.

  12. Papanicolaou test in the detection of high-grade cervical lesions: a re-evaluation based on cytohistologic non-correlation rates in 356 concurrently obtained samples.

    Science.gov (United States)

    Carns, Bhavini; Fadare, Oluwole

    2008-01-01

    Studies evaluating the routine Papanicolaou (Pap) test have traditionally used as the reference gold standard, the diagnoses on the follow-up histologic samples. Since the latter are typically obtained days to weeks after the Pap test, the accuracy of the resultant comparison may be affected by interim factors, such as regression of human papillomavirus, new lesion acquisitions or colposcopy-associated variability. A subset of our clinicians have routinely obtained cervical cytology samples immediately prior to their colposcopic procedures, which presented a unique opportunity to re-evaluate the test performance of liquid-based cervical cytology in detecting the most clinically significant lesions (i.e. cervical intraepithelial neoplasia 2 or worse: CIN2+), using as gold standard, diagnoses on cervical biopsies that were essentially obtained simultaneously. For each patient, cytohistologic non-correlation between the Pap test and biopsy was considered to be present when either modality displayed a high-grade squamous intraepithelial lesion (HGSIL)/CIN2+ while the other displayed a less severe lesion. Therefore, HGSIL/CIN2+ was present in both the Pap test and biopsy in true positives, and absent in both modalities in true negatives. In false positives, the Pap test showed HGSIL while the biopsy showed less than a CIN2+. In false negatives, Pap tests displaying less than a HGSIL were associated with biopsies displaying CIN2+. Combinations associated with "atypical" interpretations were excluded. A cytohistologic non-correlation was present in 17 (4.8%) of the 356 combinations reviewed. The non-correlation was attributed, by virtue of having the less severe interpretation, to the Pap test in all 17 cases. There were 17, 322, 0, and 17 true positives, true negatives, false positives and false negatives respectively. The sensitivity, specificity, positive predictive value and negative predictive value of the Pap test, at a diagnostic threshold of HGSIL, in identifying

  13. 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

  14. Human papillomavirus (HPV detection and Papanicolaou cytology in low-resource women in Posadas city, Misiones, Argentina Detección del virus papiloma humano (HPV y citología de Papanicolaou en mujeres de bajos recursos de la ciudad de Posadas, Misiones, Argentina

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    Inés Badano

    2011-12-01

    Full Text Available The objective of this study was to determine the prevalence of HPV infection and cervical lesions present in women who attended a health center in a low-resource area of the city of Posadas, Misiones, Argentina. Cervical cell samples (n = 163 were processed for Papanicolaou cytology and HPV-PCR tests. Socio-cultural risk factors were estimated using the odds ratio (OR, CI 95 %. Cervical lesions were detected in 14.7 % of women. The general prevalence of HPV infection was of 38 %. The most common types among the total population were HPV-16 (9.8 % and HPV-33 (9.3 %. HPV-16 was detected in association with 29.2 % and 6.5 % of women with and without cervical lesions, respectively, the OR being 5.3 (1.8-15.8. Risk factors for HPV-16 infection were a smoking habit and a history of previous sexually-transmitted diseases. These data are important for the implementation of prevention programs, including an appropriate introduction of vaccination and the baseline for virological surveillance in the vaccine era.El objetivo de este estudio fue determinar la prevalencia de la infección por HPV y de lesiones cervicales en mujeres asistidas en un centro de salud situado en un área de bajos recursos de la ciudad de Posadas, Misiones, Argentina. Las muestras (n = 163 fueron examinadas mediante las pruebas de Papanicolaou y de PCR para HPV. Los factores socio-culturales de riesgo fueron identifcados mediante el cálculo de la odds ratio (OR, IC 95 %. Se detectaron lesiones cervicales en el 14,7 % de las mujeres. La prevalencia de infección por HPV fue de 38 %. Los tipos más frecuentes en la población total fueron HPV-16 (9,8 % y HPV-33 (9,3 %. El HPV-16 se detectó asociado al 29,2 % y al 6,5 % de las mujeres con lesiones del cuello uterino y sin ellas, respectivamente, con un OR de 5,3 (1,8-15,8. Los factores de riesgo para la infección por HPV-16 fueron el hábito de fumar y el antecedente de enfermedades de transmisión sexual. Estos datos son

  15. 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.

  16. Use of supravital toluidine blue staining to improve the efficiency of fine-needle aspiration cytology reporting in comparison to papanicolaou stain

    Science.gov (United States)

    Saba, Kanwal; Niazi, Shahida; Bukhari, Mulazim Hussain; Imam, Sardar Fakhar

    2015-01-01

    Objective: To see the efficiency, adequacy and accuracy of toluidine blue stained smears of FNAC of Breast thyroid and salivary glands swelling with comparison to conventional stained FNAC smears with Papanicolaou. Methods: A total of 114 aspirates from various sites were included in the study. The smears were stained with toluidine blue and conventional Papanicolaou stain and the cytomorphology of both the smears were compared. The values were tabulated and statistical tests of significance was applied. Results: Of the 114 aspirates included in our study the diagnostic accuracy by using papanicolaou was 78%, while it was upto 100% with supravital toluidine blue stained smears. The percentage of inadequacy was reduced to just 25%. The observations were statistically significant. Breast 37/48 (77%) and Salivary glands 11/48 (23%) respectively. The most commonly used categorization of a five-tier system was used for reporting of breast cytology, with categories ranging from insufficient materials (C1), benign (C2), atypical (C3), suspicious of malignancy (C4), or (C5) frankly malignant. Most of breast lesions were benign 25 (67.56%). There were only 9 (24.32%) malignant cases followed by 2 cases of C-4 and one case of C-3. Benign thyroid lesion were more frequent comprising of 51 (72.27%) cases. One case (1.5%) of papillary carcinoma was found while 13 case were follicular lesions. There were 4 (36.4%) cases of pleomorphic adenoma and 3 (27.3) cases of non-specific sialadenitis. There was one case (9%) of each lesion for mucoepidermoid carcinoma, adenoidcytic carcinoma and benign cyst. Conclusion: Toluidine blue stained study of FNAC improves the diagnostic accuracy by minimizing the smearing and drying artifact, loss of cell sample during fixation and staining which influences the diagnostic accuracy. PMID:26649003

  17. 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.

  18. 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.

  19. 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.

  20. 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...

  1. 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

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

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    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

  3. 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

  4. 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.

  5. 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.

  6. [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.

  7. 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

  8. 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

  9. 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...

  10. Histological-cytological reports correlation and reliability of papanicolau test for the detection of malignant changes in the cervix

    Directory of Open Access Journals (Sweden)

    Vitković L.

    2015-01-01

    Full Text Available The incidence rate of cervical cancer in Serbia is among the highest in Europe and is 23.8 in 100.000. Papanicolaou test, colposcopy and pathohistology report are the basic method of secondary prevention of cervical cancer. The aim of the study was to examine the correlation between histological-cytological findings and reliability of the Papanicolaou test in detection of cervical lesions. We analyzed cervical smears (Papanicolaou test in 3868 women. Among them 190 women had suspect finding and because of that they were underwent to cervical biopsy. We detected premalignant or malignant changes of the cervix in 77 women. LSIL was found at 43 (22.6%, HSIL at 25 (13.2% and carcinoma planocellulare at 9 (4.7% women. There is a statistically significant positive correlation (Spearman=0.829; p<0,001 between histological and cytological findings of the respondents. Most estimates of diagnostic performance of Papanicolaou test in discrimination of LSIL, HSIL and carcinoma planocellulare in accordance with cervicitis are for cytological findings of ASCH (PA IIIa (Sp=90.6% and Sn=100% for carcinoma planocellulare; Sn = 96% for HSIL and Sn=86% for LSIL. In discrimination HSIL from LSIL the best discrimination is achieved by finding LSIL (PAIIIb Papanicolaou test (Sn=72.0%, Sp=67.4%, and in discrimination carcinoma planocellulare from LSIL best discrimination is achieved by finding HSIL (PA IIIb/IV Papanicolaou test (Sn=77.8%, Sp=97.7%. Based on our results we can conclude that there is a positive correlation between histological-cytological findings and that the Papanicolaou test more reliable in detecting severe premalignant lesions. Cytological diagnosis of ASCH (PAIIIa and LSIL (PAIIIb can reliably indicate the presence of premalignant cervical lesions in women, and patients with these findings must be more controlled and treated.

  11. Risk factors for cervical cancer and adherence to papanicolaou among nursing workers

    Directory of Open Access Journals (Sweden)

    Maria Albertina Rocha Diógenes

    2012-04-01

    Full Text Available The objective of this work was to verify the presence of risk factors for cervical cancer and identify adherence to Pap smears in nursing auxiliary and technicians to 20 primary health care, in Fortaleza, Brazil. A descriptive study was conducted from October 2008 to January 2009, involving 77 women. Data were collected using a structured interview, available on tables and treated with absolute and relative frequency. It was Shown that 71.43% of the Women were using oral contraceptives, 19.48% smoked or had smoked, 61.04% had first intercourse between 15 and 20 years of age, 77.92% did not make systematic use of condoms, 22.07% knew the importance of the examination and 84.40% would do so every year. Most joined the regular gynecological exam, but some had risk factors for cervical cancer. It is emphasized the need for an educational intervention directed at these women.

  12. 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.

  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. 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. 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. 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

  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. 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

  19. 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...

  20. 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

  1. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  3. 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.

  4. 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

  5. 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.

  6. 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.

  7. 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...

  8. 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

  9. 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

  10. 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

  11. 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...

  12. 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.

  13. 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

  14. 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.

  15. 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.

  16. 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

  17. 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

  18. 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

  19. 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.

  20. 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

  1. 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.

  2. 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.

  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. [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.

  5. 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.

  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. 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...

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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...

  13. 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

  14. 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

  15. 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.

  16. Only a small fraction of high-grade cervical lesions are discovered after an interpretation of atypical squamous cells of undetermined significance when using imager-assisted, liquid-based papanicolaou tests and the Bethesda 2001 system.

    Science.gov (United States)

    Khan, Kelly A; Smith, Debora A; Thrall, Michael J

    2013-07-01

    Previous work has reported that most high-grade cervical neoplasia is seen in patients with preceding Papanicolaou test results of atypical squamous cells of undetermined significance. This information was based on conventional test results and the Bethesda 1991 reporting system and was determined before the current treatment guidelines. Our objective was to perform a retrospective review of all histologically confirmed, high-grade cervical neoplasia to determine the diagnosis of the preceding liquid-based Papanicolaou test. A total of 189 histologically confirmed, high-grade cervical intraepithelial neoplasia (CIN) cases grade 2 and greater were identified for a 1-year period. Of the 189 cases, 10 (5.3%) had a previous diagnosis of atypical squamous cells of undetermined significance; 55 (29.1%) had low-grade squamous intraepithelial lesions; 31 (16.4%) had low-grade squamous intraepithelial lesions, unable to rule out a high-grade squamous intraepithelial lesion; 21 (11.1%) had atypical squamous cells, unable to rule out a high-grade squamous intraepithelial lesion; 68 (36%) had high-grade squamous intraepithelial lesions; 1 (0.5%) had atypical glandular cells; 1 (0.5%) had adenocarcinoma in situ; and 2 (1%) had invasive carcinoma. Combined "low grade" Papanicolaou test results (atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesion) preceded 51 of 103 cases of CIN 2 (49.5%) and 14 of 103 cases (13.6%) of CIN 3/cancer, whereas "high grade" Papanicolaou test results (atypical squamous cells, unable to rule out a high-grade squamous intraepithelial lesion; low-grade squamous intraepithelial lesions, unable to rule out a high-grade squamous intraepithelial lesion; high-grade squamous intraepithelial lesions; atypical glandular cells; adenocarcinoma in situ; and invasive carcinoma) preceded 52 of 103 CIN 2 cases (50.5%) and 72 of 103 CIN 3/cancer cases (69.9%). Our data show that we can now more-reliably predict high

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

    Directory of Open Access Journals (Sweden)

    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.

  18. 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.

  19. 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

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

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    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.

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

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    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.

  2. Differences in coverage patterns in cervical cytology screening

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    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.

  3. Prevenção do câncer de colo do útero: um modelo teórico para analisar o acesso e a utilização do teste de Papanicolaou Cervical cancer prevention: a theoretical framework to analyze Papanicolaou test access and use

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    Adriana de Araujo Pinho

    2003-03-01

    Full Text Available Vários estudos têm apontado que a permanência das altas taxas de incidência e mortalidade por câncer cérvico-uterino deve-se à baixa qualidade e cobertura do teste de Papanicolaou, principalmente em países em desenvolvimento. Pretende-se neste artigo analizar alguns pontos relacionados às medidas de prevenção e controle do câncer cervical quanto à efetividade do teste de Papanicolaou, a lógica operacional e científica por detrás das políticas públicas de prevenção ao câncer cervical e a cobertura do teste em países norte-americanos, europeus e na América Latina. Consideram-se, ainda, os modelos explicativos que estão sendo propostos para avaliar o acesso e a utilização deste serviço, a partir da análise dos fatores associados à realização do teste de Papanicolaou descritos pela literatura. Propõe-se uma nova abordagem na investigação destes fatores, buscando a integração e interlocução de outros aspectos de cunho social, cultural e organizacional na análise do acesso e da utilização deste exame, visando um planejamento mais coerente das ações de prevenção e promoção à saúde com as necessidades e direitos das mulheres.Several studies have indicated that the prevailing high incidence and mortality rates of cervical cancer, mainly in developing countries, are due to the low quality and coverage of the cervical smear or Papanicolaou (Pap test. This article intends to analise some aspects related to measures of control and prevention of cervical cancer, such as the effectiveness of the Pap test, the operational and scientific rationale of public health policies for the prevention of cervical cancer and coverage of the Papanicolaou test in many countries. It also intends to review the explanatory models that have been proposed to analyze access to this service. For this latter objective, we investigated the factors associated to the use of the Pap test described within the epidemiological literature and

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

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    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

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

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    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.

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

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    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

  7. 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.

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

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    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.

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

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    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

  10. 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.

  11. [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.

  12. 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.

  13. Prevalence, risk factors of human papillomavirus infection and papanicolaou smear pattern among women attending a tertiary health facility in south-west Nigeria

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    Olatunji Mathew Kolawole

    2015-12-01

    Full Text Available Aim: Cervical cancer amongst Nigerian women has been on the increase in the past decade, and is regarded as the second highest cause of cancer deaths among Nigerian women. This study was aimed at determining the prevalence, risk factors of HPV infection, and Papanicolaou smear pattern amongst a cohort of women attending the Gynaecology clinic of a tertiary health facility in Ido-Ekiti, South west Nigeria. Method: This was a cross-sectional study involving the screening of women between the ages of 15-64 years for cervical intraepithelial neoplasia using Papanicolaou smear staining technique and serological diagnosis using IgG enzyme linked immunosorbent assay kits. Respondents were selected through convenience sampling of subjects, while interviewer- administered questionnaire and clinical report form were also used to collect data, and data was analyzed using SPSS version 17. Results: Of the 200 blood samples examined for Human papillomavirus infection, 135 (67.5% were sero-positive while 65 (32.5% were sero-negative. For cervical cytology using Papanicolaou smear, 14 (7% were positive (had presence of cervical abnormality while 186 (93% were negative (had no cervical abnormality. Result showed a direct relationship between seropositivity, development of cervical intraepithelial neoplasia and Human papillomavirus infection. The risk factors for the development of HPV infection included age, type of marriage, parity, history of genital infection and tobacco usage. Non circumcision of male partner was also found to be a risk factor. Conclusion: The presence of abnormal cervical cytology and high level of serological positivity clearly showed why there is need for a holistic approach to the screening, vaccination methodologies and early detection of HPV infection in the country. [TAF Prev Med Bull 2015; 14(6.000: 453-459

  14. 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.

  15. 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

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

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    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.

  17. 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.

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

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    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.

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

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    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.

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

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    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

  1. 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.

  2. [Cytological finding in the pre- and early stages of cervix carcinoma--a contribution to the evaluation of Papanicolau III].

    Science.gov (United States)

    Bader, G; Büttner, H H; Neumann, H G; Rhode, E; Beust, M

    1977-01-01

    Cytologic findings and the histologic diagnosis are compared in 326 cervical cones. We have found following ratio of the groups Papanicolaou (Pap) III: Pap IV--in dysplasia 1: 1: 1, in "more dysplasia than carcinoma in situ (CIS)" 1:2:2. The Pap IV dominates in "pure" CIS and in cones with "more CIS than dysplasia". We take out of the Pap III ("with cytologic control") cases named "Pap III with necessity for histologic diagnosis". We have found in this subgroup of Pap III prestages or early stages of cervical carcinoma.

  3. 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.

  4. 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

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

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    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.

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

    Science.gov (United States)

    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.

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

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    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.

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

    Science.gov (United States)

    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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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...

  14. 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.

  15. 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.

  16. 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

  17. Clinical performance of hybrid capture 2 human papillomavirus testing for recurrent high-grade cervical/vaginal intraepithelial neoplasm in patients with an ASC-US Papanicolaou test result during long-term posttherapy follow-up monitoring.

    Science.gov (United States)

    De Vivar, Andrea Diaz; Dawlett, Marilyn; Wang, Jian-Ping; Jack, Annie; Gong, Yun; Staerkel, Gregg; Guo, Ming

    2015-02-01

    Women who have been treated for high-grade cervical or vaginal intraepithelial neoplasia (CIN or VAIN) or invasive carcinoma are at risk for recurrent/persistent disease and require long-term monitoring. The role of human papillomavirus (HPV) testing in this setting is unclear. To evaluate the clinical performance of the Hybrid Capture 2 (HC2) HPV test for recurrent/residual high-grade CIN or VAIN in patients with a posttherapy abnormal squamous cells of undetermined significance (ASC-US) Papanicolaou test result. We reviewed the follow-up data on 100 patients who had an ASC-US Papanicolaou test and HC2 HPV results after treatment for high-grade CIN/VAIN or carcinoma. Human papillomavirus genotyping was performed for women with a negative HC2 result whose follow-up biopsy revealed CIN/VAIN 2+. The patients' mean age was 47 years. The HC2 test result was positive in 33% of the patients. Follow-up biopsy was available for 17 of these patients (52%) and for 25 of the 67 patients (37%) with a negative HC2 result. A total of 5 of the patients (29%) with a positive HC2 result and 2 of the patients (8%) with a negative HC2 result had CIN/VAIN 3 on follow-up biopsy, a statistically insignificant difference (P = .10). Human papillomavirus 16/18 genotypes were detected in the CIN/VAIN 2+ lesions of 5 patients with a negative HC2 result. HC2 yielded a false-negative rate of 8% for CIN 3. HC2 testing therefore may not be sufficient for triage of patients with an ASC-US Papanicolaou test result. Patients with ASC-US during long-term posttherapy follow-up need close monitoring, with colposcopic evaluation if clinically indicated.

  18. 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.

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

    Science.gov (United States)

    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.

  20. 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'.

  1. 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

  2. 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.

  3. 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.

  4. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  6. 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.

  7. Cervical screening and cervical cancer death among older women: a population-based, case-control study.

    Science.gov (United States)

    Rustagi, Alison S; Kamineni, Aruna; Weinmann, Sheila; Reed, Susan D; Newcomb, Polly; Weiss, Noel S

    2014-05-01

    Recent research suggests that cervical screening of older women is associated with a considerable decrease in cervical cancer incidence. We sought to quantify the efficacy of cervical cytology screening to reduce death from this disease. Among enrollees of 2 US health plans, we compared Papanicolaou smear screening histories of women aged 55-79 years who died of cervical cancer during 1980-2010 (cases) to those of women at risk of cervical cancer (controls). Controls were matched 2:1 to cases on health plan, age, and enrollment duration. Cytology screening during the detectable preclinical phase, estimated as the 5-7 years before diagnosis during which cervical neoplasia is asymptomatic but cytologically detectable, was ascertained from medical records. A total of 39 cases and 80 controls were eligible. The odds ratio of cervical cancer death associated with screening during the presumed detectable preclinical phase was 0.26 (95% confidence interval: 0.10, 0.63) after adjustment for matching characteristics, smoking, marital status, and race/ethnicity using logistic regression. We estimate that cervical cytology screening of all women aged 55-79 years in the United States could avert 630 deaths annually. These results provide a minimum estimate of the efficacy of human papillomavirus DNA screening-a more sensitive test-to reduce cervical cancer death among older women.

  8. 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

  9. 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

  10. 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/.

  11. Is There a Seasonal Difference in the Detection of Trichomonas vaginalis by Cervical Cytology?

    Directory of Open Access Journals (Sweden)

    Sydney Shrader

    2003-01-01

    Full Text Available This objective of our study was to determine the prevalence of a Trichomonas vaginalis diagnosis in routine Papanicolaou smears and whether it is seasonal. We reviewed the diagnosis rendered for 93,681 Papanicolaou smears evaluated at a medical school hospital laboratory between 1992 and 1997. The occurrence of a diagnosis of T. vaginalis was analyzed by year, by quarter, and by month using a generalized linear regression model. The prevalence of a T. vaginalis diagnosis during the 6-year study period was 3.1%. The between-month and between-quarter comparisons of prevalence were not statistically different. In the population reported here, the prevalence of a Papanicolaou smear diagnosis of T. vaginalis was low and no seasonal difference in making this diagnosis was identified.

  12. 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.

  13. 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

  14. 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.

  15. 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

  16. 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

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

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    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.

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

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    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.

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

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    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

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

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    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.

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

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

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    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.

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

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    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.

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

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    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

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

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    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

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

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    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

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

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    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...

  8. 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

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    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

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

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    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

  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. 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

  12. 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.

  13. 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

  14. 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

  15. Guidelines for cytopathologic diagnosis of epithelioid and mixed type malignant mesothelioma. Complementary statement from the International Mesothelioma Interest Group, also endorsed by the International Academy of Cytology and the Papanicolaou Society of Cytopathology

    Science.gov (United States)

    Hjerpe, Anders; Ascoli, Valeria; Bedrossian, Carlos; Boon, Mathilde; Creaney, Jenette; Davidson, Ben; Dejmek, Annika; Dobra, Katalin; Fassina, Ambrogio; Field, Andrew; Firat, Pinar; Kamei, Toshiaki; Kobayashi, Tadao; Michael, Claire W.; Önder, Sevgen; Segal, Amanda; Vielh, Philippe

    2015-01-01

    To provide practical guidelines for the cytopathologic diagnosis of malignant mesothelioma (MM). Cytopathologists involved in the International Mesothelioma Interest Group (IMIG) and the International Academy of Cytology (IAC), who have an interest in the field contributed to this update. Reference material includes peer-reviewed publications and textbooks. This article is the result of discussions during and after the IMIG 2012 conference in Boston, followed by thorough discussions during the 2013 IAC meeting in Paris. Additional contributions have been obtained from cytopathologists and scientists, who could not attend these meetings, with final discussions and input during the IMIG 2014 conference in cape town. During the previous IMIG biennial meetings, thorough discussions have resulted in published guidelines for the pathologic diagnosis of MM. However, previous recommendations have stated that the diagnosis of MM should be based on histological material only.[12] Accumulating evidence now indicates that the cytological diagnosis of MM supported by ancillary techniques is as reliable as that based on histopathology, although the sensitivity with cytology may be somewhat lower.[345] Recognizing that noninvasive diagnostic modalities benefit both the patient and the health system, future recommendations should include cytology as an accepted method for the diagnosis of this malignancy.[67] The article describes the consensus of opinions of the authors on how cytology together with ancillary testing can be used to establish a reliable diagnosis of MM. PMID:26681974

  16. Guidelines for cytopathologic diagnosis of epithelioid and mixed type malignant mesothelioma. Complementary statement from the International Mesothelioma Interest Group, also endorsed by the International Academy of Cytology and the Papanicolaou Society of Cytopathology

    Directory of Open Access Journals (Sweden)

    Anders Hjerpe

    2015-01-01

    Full Text Available To provide practical guidelines for the cytopathologic diagnosis of malignant mesothelioma (MM. Cytopathologists involved in the International Mesothelioma Interest Group (IMIG and the International Academy of Cytology (IAC, who have an interest in the field contributed to this update. Reference material includes peer-reviewed publications and textbooks. This article is the result of discussions during and after the IMIG 2012 conference in Boston, followed by thorough discussions during the 2013 IAC meeting in Paris. Additional contributions have been obtained from cytopathologists and scientists, who could not attend these meetings, with final discussions and input during the IMIG 2014 conference in cape town. During the previous IMIG biennial meetings, thorough discussions have resulted in published guidelines for the pathologic diagnosis of MM. However, previous recommendations have stated that the diagnosis of MM should be based on histological material only. [1],[2] Accumulating evidence now indicates that the cytological diagnosis of MM supported by ancillary techniques is as reliable as that based on histopathology, although the sensitivity with cytology may be somewhat lower. [3],[4],[5] Recognizing that noninvasive diagnostic modalities benefit both the patient and the health system, future recommendations should include cytology as an accepted method for the diagnosis of this malignancy. [6],[7] The article describes the consensus of opinions of the authors on how cytology together with ancillary testing can be used to establish a reliable diagnosis of MM.

  17. 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.

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

    Directory of Open Access Journals (Sweden)

    Ana Flisser

    2002-09-01

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

  19. Comparison of centrifuged liquid based cytology method with conventional brush cytology in oral lesions

    OpenAIRE

    Nidhi Dwivedi; Akhil Agarwal; Vineet Raj; Bina Kashyap; Shaleen Chandra

    2012-01-01

    Background: Exfoliative cytology is the study of cells that are shed or scrapped off from mucosal surfaces. Centrifuged Liquid based cytology is a modified technique employed in the present study. Aims: To compare the utility of centrifuged liquid based cytology with conventional cytology in oral lesions after staining with Papanicolaou (PAP) stain. Materials and Methods: 50 cases of oral lesions comprising of normal mucosa (n=14), hyperkeratotic lesions (n=17), ulcerated lesions (n=7) and at...

  20. 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.

  1. 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.

  2. 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

  3. 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

  4. 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.

  5. 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...

  6. 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+....

  7. 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.

  8. 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...

  9. 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.

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. 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

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    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.

  19. 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

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. 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

  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. 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.

  7. 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.

  8. [Frequency of cervical epithelial lesions reported in the Regional Laboratory of Exfoliative Cytology in Jalisco].

    Science.gov (United States)

    González-López, Sergio; Martínez-Silva, María G; Hernández-Hernández, Dulce M; Aguilar-Lemarroy, Adriana; Jave-Suárez, Luis Felipe

    2015-01-01

    Introducción: La Norma Oficial Mexicana para la prevención, tratamiento y control del Cáncer Cérvico Uterino (CaCU) indica que el Papanicolaou (Pap) es el procedimiento de elección para la detección oportuna de esta neoplasia, por lo que es de interés conocer la prevalencia de casos tamizados mediante esta técnica en la población mexicana. En la presente investigación se muestran los casos que se identificaron como sospecha para CaCU por tamizaje en el estado de Jalisco, México. Métodos: se realizó un estudio retrospectivo de las muestras que llegaron para su análisis al Laboratorio Regional de Citología Exfoliativa (LARCE) del Instituto Mexicano del Seguro Social (IMSS) en Guadalajara, Jalisco. Se consideraron todos los casos de enero de 2010 a diciembre de 2012. Resultados: se analizaron 188 095 casos, de los cuales el 5.3 % se reportaron con sospecha de displasia leve, el 0.18 % de displasia moderada y el 0.05 % de displasia grave. En cáncer microinvasor e invasor se observó una baja frecuencia (0.03 %). Conclusiones: la frecuencia de hallazgos anormales identificados por citología cervicovaginal es relativamente baja. El número de muestras inadecuadas más limitadas para valoración citológica es alto; existe una elevada proporción de mujeres que asisten por primera vez en la vida a estudio citológico en grupos de edad avanzados.

  9. 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.

  10. 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

  11. 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

  12. 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.

  13. 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

  14. 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.

  15. 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.

  16. Liquid-based cytology test use by office-based physicians: United States, 2006-2007.

    Science.gov (United States)

    Hing, Esther; Saraiya, Mona; Roland, Katherine B

    2011-06-01

    In the United States, liquid-based cytology (LBC) has become a common screening method for cervical cancer. However, the extent of LBC use, and how it varies by patient and practice characteristics, is unknown. This report describes the ordering and provision of Papanicolaou (Pap) tests, with a major focus on the extent to which LBC has supplanted conventional cytology. The type of Pap test is examined for visits made to primary care physicians in 2006-2007 by females aged 15-64. Estimates of Pap test cytology use (both LBC and conventional) are based on combined data from the 2006-2007 National Ambulatory Medical Care Survey (NAMCS), an annual nationally representative survey of visits to nonfederal office-based physicians in the United States, as well as on information reported by sample physicians in Cervical Cancer Screening Supplements fielded as part of NAMCS during the same years. In 2006-2007, LBC was used in approximately 75% of Pap tests for which the type of cytology was known. LBC was less likely to be used for Medicare patients than for privately insured patients, although LBC use did not vary significantly according to the other patient or practice characteristics examined. The high percentage of LBC use by office-based physicians in 2006-2007 confirms the widespread use of this screening method among primary care providers, as has been reported in the literature.

  17. 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.

  18. 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

  19. 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

  20. Presence of histopathological premalignant lesions and infection caused by high-risk genotypes of human papillomavirus in patients with suspicious cytological and colposcopy results: A prospective study

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    Golubović Mileta

    2017-01-01

    Full Text Available Background/Aim. In patients with premalignant cervical lesions, human papillomavirus (HPV infection, at any moment, may be spontaneously eliminated, or may persist or transform cervical epithelium from a lower to a higher degree. Due to that, it is necessary to wisely select the patients who are at high risk of cancer development. The aim of the study was to establish the interdependence between a suspicious Papanicolaou (Pap test and colposcopy with the infection caused by high-risk genotypes of human papillomavirus and the presence of premalignant cervical lesions. Methods. This prospective study used cytological, colposcopy, real-time polymerase chain reaction (PCR of high-risk genotypes of human papillomavirus and histopathological analysis of cervical biopsy specimen. Out of 2,578 female patients sent to cytological analyses in Clinical Center of Montenegro, during 2012, 2013 and 2014, the study included 80 women who had to submit their biopsy specimens due to a suspicious Pap test and atypical colposcopy results. Results. In the group of 80 (3.1%; n = 80/2,578 of the selected female patients with suspicious Pap test and colposcopy, 2/3 or 56 (70% of them had cervicitis, and 1/3 or 24 (30% had cervical intraepithelial neoplasia. The most common type in cervical intraepithelial neoplasia was HPV16 in 8 female patients, ie 61.53% out of the number of infected, or 33.33% out of the total number of premalignant lesions. Conclusion. Patients with suspicious Papanicolaou test, colposcopy results and infection which is caused by high-risk HPV infection (HPV 16 in particular often have premalignant cervical lesions. In these cases, histopathological confirmation of lesions is mandatory, since it serves as a definitive diagnostic procedure.

  1. 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+)

  2. [Liquid-based cervical cytology ThinPrep screening in Hungary].

    Science.gov (United States)

    Bak, Mihály; Séberné Éll, Mária; Bóka, Melinda; Veleczki, Zsuzsanna; Nyári, Tibor; Pete, Imre; Szentirmay, Zoltán

    2014-05-04

    Bevezetés: A hagyományos Papanicolaou-cervixkenetet világszerte az úgynevezett folyadékalapú (liquid-based) citológia váltotta fel. Egyértelműen bizonyított, hogy a folyadékalapú citológia alternatív módszer. Célkitűzés: A dolgozat célja a folyadékalapú méhnyakrákszűrés magyarországi eredményeinek, diagnózisainak követése, citohisztológiai összehasonlítása, illetve minőségbiztosítása volt. Módszer: 4573 folyadékalapú citológiai cervixkenetet a Bethesda (2001) beosztás szerint klasszifikálták. A humán papillomavírus tipizálását valós idejű polimeráz láncreakció módszerével határozták meg. Eredmények: A diagnózisok megoszlása: negatív 2323 (50,8%), egyéb, nem neoplasticus 2017 (44,1%) és kóros, neoplasticus 233 (5,1%). A nem értékelhető kenetek száma 43 (0,9%) volt, mérsékelt fokú intraepithelialis laesiót 87 esetben (1,9%), kifejezett fokú intraepithelialis laesiót 24 esetben (0,5%), carcinomát 23 esetben (0,5%) észleltek. A citológiai és hisztológiai leletek közötti korreláció alapján a módszer szenzitivitása 93,2%, specificitása 100%, pozitív prediktív értéke 100%-nak bizonyult. A folyadékalapú citológiai módszerrel a mérsékelt és kifejezett fokú intraepithelialis laesiót mutató kenetek aránya az előző évek azonos időtartamához viszonyítva 0,82%-ról 2,51%-ra emelkedett. Humán papillomavírus-DNS-meghatározást 81 esetben végeztek (pozitív prediktív érték 99%). Az 51 kóros hámelváltozás kapcsán 50 (98%) esetben igazolódott humán papillomavírus-fertőzés, ezek közül 20 (24,7%) alacsony, 46 (56,8%) pedig magas kockázatú volt. Következtetések: A szerzők megállapították, hogy tanulmányukban a folyadékalapú cervixcitológiai vizsgálat minőségbiztosítási eredményei megfelelnek a nemzetközileg elvártaknak. A folyadékalapú vizsgálat alternatív cervixcitológiai módszer, és hatékonysága, valamennyi paramétert tekintve

  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

    2012-12-04

    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.

  4. 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

  5. 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.

  6. 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

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

    Science.gov (United States)

    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.

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

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    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. 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.

  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. Pancreatic cytology: standardised terminology and nomenclature.

    Science.gov (United States)

    Perez-Machado, M A

    2016-06-01

    Pancreatic cytology can make a real difference to the management of patients. However it is a challenge in those cases where a definitive diagnosis of malignancy cannot be made with confidence. This creates the need for a unified terminology and nomenclature system that provides intra- and interdepartmental guidance for diagnosis. The Papanicolaou Society of Cytopathology (PSC) has published new guidelines for pancreaticobiliary cytology, addressing indications, techniques, terminology and nomenclature, ancillary studies, and postprocedure management.

  13. 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

  14. 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

  15. Does a diagnosis of atrophic vaginitis on Papanicolaou test signify the presence of inflammation?

    Science.gov (United States)

    Heller, Debra S; Weiss, Gerson; Bittman, Sara; Goldsmith, Laura

    2015-08-01

    Vaginal atrophy in menopause shows increased parabasal cells on cytology. This may be accompanied by abundant neutrophils. A shift in maturation index in the absence of significant inflammation is more accurately termed "atrophic pattern." This study aims to determine whether a diagnosis of "atrophic vaginitis" or atrophic pattern on Papanicolaou test is a reliable indicator of what is present on the slide. A retrospective review of Papanicolaou test slides from University Hospital Newark was performed. Cases that had been diagnosed as either atrophic vaginitis (n = 100) or atrophic pattern (n = 100) were selected. Exclusion criteria included any additional diagnosis of neoplasia. Slides were re-reviewed and scored based on abundance of neutrophils: 0 to 5, 6 to 10, or more than 10 neutrophils per high-power field (×40), with 10 fields per slide reviewed. Data were analyzed by χ analysis. Among 200 cases with atrophic vaginitis or atrophic pattern, the proportion of those diagnosed with atrophic vaginitis to those diagnosed with atrophic pattern increased across three neutrophil categories (P vaginitis on Papanicolaou test is reliably associated with increased numbers of neutrophils. A diagnosis of atrophic pattern is indicative of low numbers of neutrophils. As the Papanicolaou test diagnosis of atrophic vaginitis does not correlate with clinical symptoms, a single diagnostic term that does not suggest a disease process would more reliably communicate cytology findings to clinicians.

  16. Factors associated with actinomyces-like organisms on Papanicolaou smear in users of intrauterine contraceptive devices.

    Science.gov (United States)

    Petitti, D B; Yamamoto, D; Morgenstern, N

    1983-02-01

    To determine the factors associated with the presence of actinomyces-like organisms on cervicovaginal Papanicolaou smears in users of the intrauterine contraceptive device (IUD), we carried out a case-control study. Among about 80,000 Papanicolaou smears examined in one year in a large cytology laboratory, actinomyces-like organisms were identified on 107 smears; all but three smears were from IUD users. Compared with IUD users who did not have actinomyces-like organisms on Papanicolaou smears, those with actinomyces-like organisms had used the IUD for more years. An increased risk of actinomyces-like organisms on Papanicolaou smear was not apparent until 7 years of IUD use, however. No significant association of actinomyces-like organisms with the type of IUD was found after controlling for differences in duration of use between users of various IUDs. The percentage of women reporting gynecologic symptoms (vaginal discharge, pelvic pain, abnormal bleeding) also did not differ significantly between IUD users with and without actinomyces-like organisms on Papanicolaou smear (p = 0.5).

  17. 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.

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

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    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

  19. CORRELATION OF CERVICAL DYSPLASIA WITH SEROLOGICAL AND MICROBIOLOGICAL TESTS FOR GENITAL INFECTIONS

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    Ishita

    2015-01-01

    Full Text Available AIMS : Prevalence of Sexually transmitted infections (STIs tends to be high which constitutes an important public health problem at present worldwide and in India, being associated with Human Immunodeficiency virus and predisposing to cervical dysplasia and cancer. There is a need to overcome the STI infections throughout the nation by cytological and microbiological screening. SETTING AND DESIGN : The present study was undertaken to investigate the association of Chlamydia trachomatis (CT, Herpes simplex virus 2 (HSV 2, Cytomegalovirus (CMV, Hepatitis B (HBV, Hepatitis C virus (HCV, Trichomonas vaginalis (TV and Candidiasis with cervical cytological changes in symptomatic female in West Bengal. METHOD S : Sera and vaginal samples from 431 syndromic female patients with cervico - vaginal discharge were tested for detection of STIs. The study period extended over two years. Concomitantly, study of cervical cytology on Papanicolaou stained smears was performed in all cases. ELISA was performed for detection of CT IgM, HSV2 IgM, CMV IgM, HBsAg and HCV IgM in sera. Candida spp. and TV were identified by culture of vaginal samples. Cytological findings were interpreted according to Bethesda 2001 classification. Statistical analysis was performed using MedCalc for Windows, version 13.3.1.0 (MedCalc Software, Ostend, Belgium. RESULTS: Out of 431 samples, majority of the patients belonged to the age group of 29 to 42 years, however the mean age of patients presenting with HSIL on PAP was 45 ± 7.93 years. CT, HSV2, TV and Candida spp. were associated with cervical cytological changes of ASCUS or worse. Age greater than 40 years and infection with CT emerged independent risk factors associated with cervical dysplasia on univariate and multivariate analysis with p <0.05 in both. CONCLUSION : C. trachomatis is a risk factor for cervical dysplasia. Early detection and treatment will prevent progression of STIs and development of cervical dysplasia and

  20. 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.

  1. 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.

  2. [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.

  3. 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.

  4. Teste de Papanicolaou: cobertura em dois inquéritos domiciliários realizados no município de São Paulo em 1987 e em 2001-2002 Papanicolaou smear screening: coverage in two home surveys applied in the city of São Paulo in 1987 and 2001-2002

    Directory of Open Access Journals (Sweden)

    Carolina Ozawa

    2011-05-01

    ção à saúde da mulher.PURPOSE: to compare the coverage of conventional Papanicolaou cytology in women aged 15 to 59 years between two home surveys, related to some personal attributes and to the tendency to die from cervical cancer. METHODS: we analyzed data collected in two home surveys, with complex sampling, in the city of São Paulo, Brazil, over the years from 1987 to 2001 and 2002. The self-reported answers of 968 women in the first inquiry and of 1,125 women in the second inquiry were compared regarding the reply to the question about the execution of the Papanicolaou test "sometimes in a lifetime" in relation to age distribution, black skin, marital status, years of education and tendency to die because cervical cancer during the period from 1980 to 2007. The Fisher exact test was used to compare the sample regarding each item, with the level of significance set at p value >5%. RESULTS: from the first to the second inquiry there was a 24% increase in the execution of conventional Papanicolaou cytology (from 68.8% to 85%. The greatest variations in the increased coverage related to the personal attributes of the women were detected in black skin color, among single women and among women of lower schooling. Regarding the tendency to mortality rates due to cervical cancer, no clear ascending or declining tendency was observed along the 28 years studied (1980 to 2007. CONCLUSION: there was an increase in access to the cytological Papanicolaou test among the most vulnerable women. Since 2001 and 2002, the 85% coverage already reached WHO recommendation, although without a clear trend of decline in mortality due to cervical cancer in the following years, indicating that screening is only part of an effective and organized program for the control of cervical cancer, whose model must guarantee full women's health care.

  5. 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.

  6. 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

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    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

  7. Touch imprint cytology with cytokeratin immunostaining versus Papanicolau staining for intraoperative evaluation of sentinel lymph node metastasis in clinically node-negative breast cancer.

    Science.gov (United States)

    Fujishima, M; Watatani, M; Inui, H; Hashimoto, Y; Yamamoto, N; Hojo, T; Hirai, K; Yamato, M; Shiozaki, H

    2009-04-01

    This study investigated whether intraoperative assessment of SLN status in patients with clinically node-negative breast cancer was improved using touch imprint immunohistochemistry. Each SLN was cut into slices 2mm thick and evaluated intraoperatively by touch imprint cytology with Papanicolaou staining until the end of 2005, or by a combination of Papanicolaou staining and immunostaining with an anti-cytokeratin antibody from early 2006. When intraoperative cytology of SLN in 85 patients who were clinically node-negative was evaluated with Papanicolaou staining, 81 patients were diagnosed as negative and four were positive. Intraoperative cytology with Papanicolaou staining had a sensitivity of 30%, specificity of 99%, false-negative rate of 70%, false-positive rate of 1.3%, and accuracy of 90.6%. When intraoperative cytology was done with immunohistochemistry plus Papanicolaou staining for SLN evaluation, 92 patients were diagnosed as negative and 17 patients were positive. Intraoperative cytology with immunohistochemistry had a sensitivity of 79%, specificity of 98%, false-negative rate of 21%, false-positive rate of 2.2%, and accuracy of 94.5%. Compared with intraoperative cytology using Papanicolaou staining alone, the combination of immunohistochemistry and Papanicolaou staining achieved a significant increase in sensitivity and a significant decrease in the false-negative rate. Intraoperative SLN evaluation by imprint cytology with immunohistochemistry achieves a more accurate diagnosis of metastasis than imprint cytology alone. This combined method is considered useful for deciding whether to perform axillary lymph node dissection.

  8. Investigation of Trichomonas Vaginalis by Parasitological and Cytological Methods in Patients Admitted to Gynecology Outpatient Clinics in a University Hospital

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    Özlem Aycan-Kaya

    2015-11-01

    Full Text Available Aim: In this study, it was aimed to compare parasitological and cytological diagnostic methods to detect T. Vaginalis in samples taken from posterior fornix of vagina. Methods: In this cross-sectional study, study population (n=104 were selected from women applying to gynecology outpatient clinic of Mustafa Kemal University Hospital with different complaints between March- August 2013. The presence of T. vaginalis was investigated by parasitological and cytological diagnostic methods. While direct microscopy, giemsa staining and culture in Cysteine-Peptone-Liver-Maltose medium (CPLM were performed for parasitological diagnosis of T. vaginalis in samples taken from posterior fornix of vagina, cervical smear stained by Papanicolaou (PAPS was used for cytological diagnosis. Results: T. vaginalis was detected in 12 (11.5%, 12 (11.5%, 14 (%13.4 of materials by direct microscopy, giemsa staining and culture, respectively. T. vaginalis was detected only 5 (4.8% of materials by cytology. This difference was statistically significant (p<0.05. Conclusion: Our study results showed that parasitological methods are more sensitive than cytological methods in diagnosis of T. vaginalis. Therefore, T. vaginalis should be screened in women with non-specific symptoms in under developed countries where lack of periodic examination and polygamy were seen.

  9. 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

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. 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

  15. 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.

  16. 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.

  17. 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

  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. Cervical pap smear- A prospective study in a tertiary hospital

    Directory of Open Access Journals (Sweden)

    S Pudasaini

    2015-09-01

    Full Text Available Background: Cervical cancer is a leading cause of mortality and morbidity among women worldwide and most common gynaecological cancer in developing countries. Papanicolaou smear is a simple and cost effective screening test for cervical cancer. The aim of this study is to evaluate and interpret the cervical pap smear cytology in a tertiary hospital. The interpretation and reporting of the pap smear is based on 2001Bethesda system.Materials and methods: This is a prospective study conducted in a tertiary hospital, Nepal Medical College over a period of two and a half years (January 2013 to June 2015. All cervical pap smears received in the department of Pathology in the study period were included.Results: A total of 4160 cervical pap smears were reported in the study period. Majority of the cases were Negative for Intraepithelial lesion or malignancy (87.9%. Bacterial vaginosis, atrophy and reactive cellular changes associated with inflammation were seen in 5.3%, 2.4% and 1.5% cases respectively.   Epithelial cell abnormalities (0.5% include Atypical squamous cells of undetermined significance, Low grade squamous intraepithelial lesion and High grade intraepithelial lesion. 88% of Low grade squamous intraepithelial lesion was seen in reproductive age group (20-45 years.Conclusion: Cervical cancer is the most common gynaecological cancer in the developing countries. Pap smear is the simple and cost effective screening tool to detect pre invasive cervical epithelial lesions.

  20. 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.

  1. 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.

  2. 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

  3. 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....

  4. Is a liquid-based cytology more sensitive than a conventional Pap smear?

    Science.gov (United States)

    Sigurdsson, K

    2013-08-01

    The comparative sensitivity of liquid-based cytology (LBC) test and conventional Papanicolaou (Pap) smears is controversial. This study analyses the distribution of cytology, histology, colposcopy and large loop excision of the transformation zone among women screened in Iceland with LBC at the Cancer Detection Clinic in Reykjavik and with a conventional Pap smear outside the Detection Clinic in 2007-2011. The study material included 42 654 LBC tests from 20 439 women and 103 909 Pap smears from 61 574 women. The period 2000-2004 is used to correct for potential bias as a result of unequal distribution of the studied parameters between the study sites before the introduction of LBC. The observed results indicated that women screened with an LBC sample had significantly decreased detection rates of inadequate smears, increased detection of low-grade squamous intraepithelial lesion (LSIL)/atypical cytology and referrals to colposcopy, and an increased detection rate of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) irrespective of age. LBC increased significantly the detection rates of high-grade squamous intraepithelial lesion or worse (HSIL+) cytology and CIN3+ histology only in women under 40 years of age. Taking into consideration the unequal prevalence of the studied parameters between the study sites in 2000-2004 indicated, however, that LBC only affected the rate of inadequate and low-grade cytology tests under the age of 40 years. Positive predictive values for CIN2+ were not significantly different between the tests. The study results support the view that LBC is no more sensitive than Pap smears for the detection of HSIL+ and CIN2+ irrespective of age. LBC decreased the rate of inadequate smears, but increased the rate of low-grade cytology under the age of 40 years and decreased the total rate of abnormal smears over the age of 40 years. © 2013 John Wiley & Sons Ltd.

  5. From Human Papillomavirus (HPV) Detection to Cervical Cancer Prevention in Clinical Practice

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sin Hang, E-mail: shlee01@snet.net; Vigliotti, Jessica S.; Vigliotti, Veronica S.; Jones, William [Department of Pathology, Milford Hospital, 300 Seaside Ave., Milford, CT 06460 (United States)

    2014-10-02

    The newly gained knowledge of the viral etiology in cervical carcinogenesis has prompted industrial interests in developing virology-based tools for cervical cancer prevention. Due to the long incubation period from viral infection to developing an invasive cancer, a process whose outcome is influenced by numerous life-style and genetic factors, the true efficacy of the genotype-specific human papillomavirus (HPV) vaccines in cervical cancer prevention cannot be determined for another 30 years. Most HPV DNA test kits designed to replace the traditional Papanicolaou (Pap) smears for precancer detection lack the analytical sensitivity and specificity to comprehensively detect all potentially carcinogenic HPVs and to perform reliable genotyping. The authors implemented the classic nested PCR and Sanger DNA-sequencing technology for routine HPV testing. The results showed a true negative HPV PCR invariably indicates the absence of precancerous cells in the cytology samples. However, 80.5% of single positive HPV-16 tests and 97.3% of single positive HPV-18 tests were associated with a negative or a largely self-reversible Pap cytology. Routine sensitive and reliable HPV type-specific or perhaps even variant-specific methods are needed to address the issues of persistence of HPV infection if a virology-based primary cervical screen is used to replace the Pap cytology screening paradigm.

  6. From Human Papillomavirus (HPV Detection to Cervical Cancer Prevention in Clinical Practice

    Directory of Open Access Journals (Sweden)

    Sin Hang Lee

    2014-10-01

    Full Text Available The newly gained knowledge of the viral etiology in cervical carcinogenesis has prompted industrial interests in developing virology-based tools for cervical cancer prevention. Due to the long incubation period from viral infection to developing an invasive cancer, a process whose outcome is influenced by numerous life-style and genetic factors, the true efficacy of the genotype-specific human papillomavirus (HPV vaccines in cervical cancer prevention cannot be determined for another 30 years. Most HPV DNA test kits designed to replace the traditional Papanicolaou (Pap smears for precancer detection lack the analytical sensitivity and specificity to comprehensively detect all potentially carcinogenic HPVs and to perform reliable genotyping. The authors implemented the classic nested PCR and Sanger DNA-sequencing technology for routine HPV testing. The results showed a true negative HPV PCR invariably indicates the absence of precancerous cells in the cytology samples. However, 80.5% of single positive HPV-16 tests and 97.3% of single positive HPV-18 tests were associated with a negative or a largely self-reversible Pap cytology. Routine sensitive and reliable HPV type-specific or perhaps even variant-specific methods are needed to address the issues of persistence of HPV infection if a virology-based primary cervical screen is used to replace the Pap cytology screening paradigm.

  7. Detection and prevalence of IUD-associated Actinomyces colonization and related morbidity. A prospective study of 69,925 cervical smears.

    Science.gov (United States)

    Valicenti, J F; Pappas, A A; Graber, C D; Williamson, H O; Willis, N F

    1982-02-26

    Cervical Papanicolaou smears from 69,925 women were screened prospectively for the presence of Actinomyces israelii. The organism was not identified in non-intrauterine (contraceptive) device (IUD)-wearers. The prevalence of A israelii among IUD wearers ranged from 1.6% (general population) to 5.3% (clinic population). Protracted IUD use seemed to predispose to a higher incidence of infection. Direct immunofluorescence proved to be a more accurate and specific method of identification when compared with conventional light microscopy and anaerobic culture. Two of 112 women with direct immunofluorescence-proved A israelii had significant clinical infections. It appears that in the vast majority of cases, IUD-associated Actinomyces colonization produces only a superficial infestation. Conservative management is suggested for asymptomatic patients with cytologically detected Actinomyces to include removal of the IUD and repeated Papanicolaou smear after the next menstrual period.

  8. 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.

  9. 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.

  10. 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

  11. Papanicolau smear chances to be diagnostic for cervical squamous intraepithelial lesions (SIL) with or without detectable HPV DNA at in situ hybridization analysis.

    Science.gov (United States)

    Sopracordevole, F; Cadorin, L; Muffato, G; De Benetti, L; Parin, A

    1993-01-01

    The Authors have correlated 39 cervical diagnostic biopsies for squamous intraepithelial lesions (SILs) with correspective Papanicolau smears (PS), with relation to the presence or the absence of HPV of oncogenic type (HPV-one) detected by in situ hybridization (ISH). Agreement between cytological and histological diagnosis was present in 14 of 16 cases with detectable HPV-one and only in 12 of 23 cases without detectable HPV-one at ISH. The importance of the HPV type in the SILs with relation to the diagnostic accuracy of Papanicolaou smears has been discussed.

  12. 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。

  13. 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

  14. 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...

  15. Comparison of specimen adequacy and smear quality in oral smears prepared by manual liquid-based cytology and conventional methods

    Directory of Open Access Journals (Sweden)

    Surabhi Shukla

    2015-01-01

    Full Text Available Background: Liquid-based cytology (LBC, recommended in the mass screening of potentially malignant cervical and oral lesions, suffers from high cost owing to the use of expensive automated devices and materials. Considering the need for cost-effective LBC techniques, we evaluated the efficacy of an inexpensive manual LBC (MLBC technique against conventional cytological technique in terms of specimen adequacy and smear quality of oral smears. Materials and Methods: Cytological samples were collected from 21 patients using a cytobrush device. After preparation of a conventional smear, the brush containing the remaining sample was immersed in the preservative vial. The preserved material was processed by an MLBC technique and subsequently, direct smears were made from the prepared cell button. Both conventional and MLBC smears were stained by routine Papanicolaou technique and evaluated by an independent observer for the thickness of the smear, cellular distribution, resolution/clarity of cells, cellular staining characteristics and the presence of unsatisfactory background/artifacts. Each parameter was graded as satisfactory; or satisfactory, but limited; or unsatisfactory. Chi-square test was used to compare the values obtained (significance set at P ≤ 0.05. Results: MLBC technique produced a significant number of satisfactory smears with regard to cell distribution, clarity/resolution, staining characteristics and background/artifacts compared to conventional methods. Conclusions: MLBC is a cost-effective cytological technique that may produce oral smears with excellent cytomorphology and longer storage life.

  16. Comparison of specimen adequacy and smear quality in oral smears prepared by manual liquid-based cytology and conventional methods.

    Science.gov (United States)

    Shukla, Surabhi; Einstein, A; Shukla, Abhilasha; Mishra, Deepika

    2015-01-01

    Liquid-based cytology (LBC), recommended in the mass screening of potentially malignant cervical and oral lesions, suffers from high cost owing to the use of expensive automated devices and materials. Considering the need for cost-effective LBC techniques, we evaluated the efficacy of an inexpensive manual LBC (MLBC) technique against conventional cytological technique in terms of specimen adequacy and smear quality of oral smears. Cytological samples were collected from 21 patients using a cytobrush device. After preparation of a conventional smear, the brush containing the remaining sample was immersed in the preservative vial. The preserved material was processed by an MLBC technique and subsequently, direct smears were made from the prepared cell button. Both conventional and MLBC smears were stained by routine Papanicolaou technique and evaluated by an independent observer for the thickness of the smear, cellular distribution, resolution/clarity of cells, cellular staining characteristics and the presence of unsatisfactory background/artifacts. Each parameter was graded as satisfactory; or satisfactory, but limited; or unsatisfactory. Chi-square test was used to compare the values obtained (significance set at P ≤ 0.05). MLBC technique produced a significant number of satisfactory smears with regard to cell distribution, clarity/resolution, staining characteristics and background/artifacts compared to conventional methods. MLBC is a cost-effective cytological technique that may produce oral smears with excellent cytomorphology and longer storage life.

  17. Comparison of specimen adequacy and smear quality in oral smears prepared by manual liquid-based cytology and conventional methods

    Science.gov (United States)

    Shukla, Surabhi; Einstein, A; Shukla, Abhilasha; Mishra, Deepika

    2015-01-01

    Background: Liquid-based cytology (LBC), recommended in the mass screening of potentially malignant cervical and oral lesions, suffers from high cost owing to the use of expensive automated devices and materials. Considering the need for cost-effective LBC techniques, we evaluated the efficacy of an inexpensive manual LBC (MLBC) technique against conventional cytological technique in terms of specimen adequacy and smear quality of oral smears. Materials and Methods: Cytological samples were collected from 21 patients using a cytobrush device. After preparation of a conventional smear, the brush containing the remaining sample was immersed in the preservative vial. The preserved material was processed by an MLBC technique and subsequently, direct smears were made from the prepared cell button. Both conventional and MLBC smears were stained by routine Papanicolaou technique and evaluated by an independent observer for the thickness of the smear, cellular distribution, resolution/clarity of cells, cellular staining characteristics and the presence of unsatisfactory background/artifacts. Each parameter was graded as satisfactory; or satisfactory, but limited; or unsatisfactory. Chi-square test was used to compare the values obtained (significance set at P ≤ 0.05). Results: MLBC technique produced a significant number of satisfactory smears with regard to cell distribution, clarity/resolution, staining characteristics and background/artifacts compared to conventional methods. Conclusions: MLBC is a cost-effective cytological technique that may produce oral smears with excellent cytomorphology and longer storage life. PMID:26980958

  18. 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

  19. 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

  20. Cervical dysplasia and human immunodeficiency virus infection in women: prevalence and associated factors. Groupe d'Epidémiologie Clinique du SIDA en Aquitaine (GESCA).

    Science.gov (United States)

    Hocke, C; Leroy, V; Morlat, P; Rivel, J; Duluc, M C; Boulogne, N; Tandonnet, B; Dupon, M; Brun, J L; Dabis, F

    1998-10-01

    To study the prevalence of Cervical Intraepithelial Neoplasia (CIN) and its association with HIV-I infection, controlling for other risk factors of CIN. Cross-sectional survey. HIV-1 seropositive (HIV+) and seronegative (HIV-) women were enrolled at the Obstetrics-Gynecologic Departments of the Bordeaux University Hospital from April 1993 to June 1995. A gynecologic check-up was performed with a clinical examination, a colposcopy and a Papanicolaou smear. Sexually Transmitted Diseases (STDs) were screened. Colposcopy was interpreted as: normal, low-grade or high-grade lesions. Interpretation of Papanicolaou smears was based on the 1988 Bethesda system using three descriptive diagnoses: normal, low-grade and high-grade Squamous Intraepithelial lesions (SILs). If colposcopy showed a high grade lesion or Papanicolaou smear a high-grade SIL, a cervical biopsy was performed. Absence of CIN was defined by normal Papanicolaou smear and colposcopy. High grade CIN was defined by either identification of high grade SIL on Papanicolaou smear or high grade lesion on colposcopy confirmed by CIN2-3 lesion on biopsy. Other cases were classified as low-grade CIN. HPV infection was diagnosed on presence of koilocytosis on cytological or histological specimens. Prevalence of CIN was significantly higher in the 128 HIV+ women than in the 102 HIV- women: 34.4% vs. 13.7% (O.R.=3.30). Among HIV+ women, 25.8% had low-grade CIN and 8.6% high-grade CIN versus 10.8% and 2.9%, respectively among the HIV- women. Prevalence of HPV infection was 50.0% among women with CIN vs. 5.8% in women without CIN (P= 10(-6)). In the multivariate analysis of the determinants of CIN, smoking more than ten pack-years and HPV infection were the only two variables associated with CIN while association with HIV infection disappeared. Among HIV+ women, the variables associated with CIN were clinical AIDS and HPV infection.

  1. Cervical cancer: The preventive role of HPV vaccine (review article

    Directory of Open Access Journals (Sweden)

    N. Behtash

    2007-05-01

    Full Text Available Cervical cancer is the second most common gynecologic cancer. A steady 70% annual decline in mortality from cervical cancers has been observed since the mid 20th century after the introduction of widespread papanicolaou cytological screening. But also cervical cancer continues to be an important world health problem for women. Cervical cancer is one of the best- understood neoplasm given its well known viral cause of persistent infection with high risk human papillomavirus (HPV. To date, two manufacturers have developed HPV vaccines composed of noninfectious, recombinant HPV viral-like particles (VLPs. This article presents current advances and perspectives on HPV vaccines.The vaccine is administered by intramuscular injection, and the recommended schedule is a 3-dose series with the second and third doses administered 2 and 6 months after the first dose. The recommended age for vaccination of females is 11-12 years. Vaccine can be administered as young as age 9 years. Catch-up vaccination is recommended for females aged 13--26 years who have not been previously vaccinated. Vaccination is not a substitute for routine cervical cancer screening, and vaccinated females should have cervical cancer screening as recommended.

  2. 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.

  3. 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.

  4. 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

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

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    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.

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

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    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.

  7. Performance of the Aptima high-risk human papillomavirus mRNA assay in a referral population in comparison with Hybrid Capture 2 and cytology.

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    Clad, Andreas; Reuschenbach, Miriam; Weinschenk, Johanna; Grote, Ruth; Rahmsdorf, Janina; Freudenberg, Nikolaus

    2011-03-01

    This study compared the Aptima human papillomavirus (HPV) (AHPV; Gen-Probe Incorporated) assay, which detects E6/E7 mRNA from 14 high-risk types, the Hybrid Capture 2 HPV DNA (HC2; Qiagen Incorporated) test, and repeat cytology for their ability to detect high-grade cervical lesions (cervical intraepithelial neoplasia grade 2+ [CIN2+]) in women referred to colposcopy due to an abnormal Papanicolaou (Pap) smear. A total of 424 clinical specimens, stored in liquid-based cytology (LBC) vials at room temperature for up to 3 years, were tested by repeat cytology, the AHPV assay, and the HC2 test. Assay results were compared to each other and to histology results. The overall agreement between the AHPV assay and the HC2 test was 88.4%. The sensitivity (specificity) of cytology, the HC2 test, and the AHPV assay for the detection of CIN2+ was 84.9% (66.3%), 91.3% (61.0%), and 91.7% (75.0%) and for the detection of CIN3+ was 93.9% (54.4%), 95.7% (46.0%), and 98.2% (56.3%), respectively. Of the disease-positive specimens containing high-risk HPV (HR HPV) DNA as determined by Linear Array (Roche Diagnostics), the AHPV assay missed 3 CIN2 and 1 microfocal CIN3 specimen, while the HC2 test missed 6 CIN2, 4 CIN3, and 1 cervical carcinoma specimen. The AHPV assay had a sensitivity similar to but a specificity significantly higher (P < 0.0001) than the HC2 test for the detection of CIN2+. The AHPV assay was significantly more sensitive (P = 0.0041) and significantly more specific (P = 0.0163) than cytology for the detection of disease (CIN2+).

  8. Cobertura do teste de Papanicolaou e fatores associados à não-realização: um olhar sobre o Programa de Prevenção do Câncer do Colo do Útero em Pernambuco, Brasil Pap smear coverage and factors associated with non-participation in cervical cancer screening: an analysis of the Cervical Cancer Prevention Program in Pernambuco State, Brazil

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    Kamila Matos de Albuquerque

    2009-01-01

    Full Text Available Buscou-se avaliar a cobertura do teste Papanicolaou no Estado de Pernambuco, Brasil, nos três anos anteriores à pesquisa, entre mulheres de 18-69 anos, e identificar fatores associados à sua não-realização. Trata-se de um estudo transversal, de base populacional, utilizando-se dados de inquérito realizado no período 2005-2006 com 640 indivíduos, selecionados por amostragem por conglomerados em três estágios de seleção. Foram analisadas informações sobre 258 mulheres. A cobertura do Papanicolaou entre mulheres de 18-69 anos foi de 58,7% e de 25-59 anos de 66,2%. Viver sem companheiro, não ter dado à luz e não ter realizado consulta médica no último ano mostraram associação com a não-realização do teste. Na análise multivariada, o baixo grau de escolaridade mostrou também efeito significativo. A cobertura do Papani-colaou em Pernambuco foi satisfatória, porém insuficiente para impactar no perfil epidemiológico do câncer do colo uterino. É preciso fortalecer e qualificar as ações de promoção da saúde, visando reduzir as desigualdades e estimular o protagonismo das mulheres nas ações de prevenção do câncer do colo uterino.This research aimed to assess coverage of Pap smear screening in the State of Pernambuco, Brazil, during the three years prior to the study, among women 18 to 69 years of age, and to identify factors associated with women's lack of participation in screening. This was a cross-sectional, population-based study, using data from a survey in 2005-2006 with 640 women, selected by three-stage cluster sampling. Information on 258 women was analyzed. Pap smear coverage was 58.7% for women 18 to 69 years of age and 66.2% for those 25 to 59. Single marital status, no history of childbirth, and not having consulted a physician in the previous year were associated with lack of Pap smear screening. In the multivariate analysis, low schooling also showed a significant effect. Pap smear coverage in

  9. 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?

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    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

  10. [Quality of vaginal smear for cervical cancer screening: a concordance study].

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    Cendales, Ricardo; Wiesner, Carolina; Murillo, Raúl Hernando; Piñeros, Marion; Tovar, Sandra; Mejía, Juan Carlos

    2010-01-01

    Cervical cancer is the leading cause of cancer deaths in the female population in Colombia. The low impact of Papanicolaou smears in reducing cervical cancer mortality in some countries has been attributed to their low reproducibility and high rates of false negatives. To evaluate the quality of the Papanicolaou smears in four regions of Colombia comparing the original report given by provincial cytologists or pathologists with a second report made by a team of expert pathologists from the Instituto Nacional de Cancerología of Colombia. A sample of 4,863 Papanicolau smears was selected by a simple stratified randomized sampling method. Three strata were defined according to the original cytological report as negative, positive and unsatisfactory. All slides were newly interpreted with Bethesda 2001 by two independent experienced pathologists blinded to the first results. Non-weighted kappa values were calculated for degree of agreement. Overall, the concordance between the two evaluations was very low with a kappa value of 0.03 (95% CI: 0-0.06). With regard to abnormalities in squamous cells, evaluation concordance was moderate with a value of 0.47 (95% CI: 0.41- 0.53); a trend was noted suggesting higher levels of concordance in the evaluations from the Tolima and Magdalena Provinces. Problems related with the quality of Papanicolau smears or the accurate reading thereof may be factors that explain the low impact of massive screening in cervical cancer mortality in Colombia.

  11. 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.

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

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    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.

  13. 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

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

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    André Luís Ferreira Santos

    2003-08-01

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

  15. Cervical Lesions and Cellular Atypia in a Female Population from Transylvania

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    Lucia C FETICU SIMONCA

    2013-12-01

    Full Text Available Introduction: The purpose of this study was to detect the types of the cervix lesions and to establish the correlations between age, environment of origin, diagnosis and gravity of the lesions. Methods: In the period 2009-2012, all cervical secretions from female subjects presented at Integrated Outpatient Unit, of the Clinical Hospital for Infectious Diseases, Cluj-Napoca, Romania were tested by Babeş-Papanicolaou examination. Babeş-Papanicolaou cytological smear was performed according to the 2001 Bethesda System criteria. Results: From 3153 cervical secretions (2736 female subjects from urban areas and 417 female subjects from rural areas with age 10 - 87 years, 2899 (91.9% smears (372 women from rural area and 2527 women from urban area had normal appearance. Premalignant or malignant lesions (positive cases were detected in 254 (8.1% smears (45 (12.1% cases from rural area, 209 (8.3% cases from urban area. In the urban area, most positive cases were recorded in the age range of 45-54 years, while in the rural areas in the age range of 35-44 years. The multivariate logistic regression analysis showed that environment and age significantly influenced the occurrence of positive cases (OR=1.44 95% CI 1.02-2.02, p=0.04 for rural area, OR=0.71 95% CI 0.60-0.85, p<0.001 for age. The correlation between age and the degree of severity diagnosis (r=-0.09, p=0.14 was not significant. Conclusions: Cervical lesions detected through Babeş-Papanicolaou test in adult women are more common in the rural area.

  16. Robinson′s cytological grading on aspirates of breast carcinoma: Correlation with Bloom Richardson′s histological grading

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    Sinha S

    2009-01-01

    Full Text Available Background : Cytological grading (CG on aspirates of breast carcinoma is a useful tool for surgical maneuver and prognosis. Aims : An endeavor was made to use CG on aspirates of breast carcinoma using Robinson′s grade and to correlate it with Bloom Richardsons′ histopathological grading. Materials and Methods : A total of 59 patients of breast carcinoma, aged 28-57 years, were aspirated and the smears were graded using Robinson′s criteria. All the cases were correlated with Bloom Richardson′s grade on histopathology in mastectomy specimens. Lymphadenopathy in 38 cases was aspirated and stained with Papanicolaou and Romanowsky stain. Results : Robinson′s CG correlated well with Bloom Richardson′s histopathological grading. For grade I and II tumors, there was substantial strength of agreement between cytology and histopathology, while in grade III, the concordance was nearly perfect. Lymph node metastasis was found in 27 of 32 axillary nodes, three of five cervical nodes and the only palpable supraclavicular node. Lymph node metastasis was observed in three with cytological grade II, 28 of grade III and none of grade I. All grade I had stage A, two of grade II had stage B, while all grade III had either stage B or stage C disease. Conclusions : Thus, CG of breast carcinoma correlates well with histopathological grading and may well be useful as a prognostic marker.

  17. 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.

  18. 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.

  19. Factors related to non-adherence to the realization of the Papanicolaou test

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    Márcia Aparecida dos Santos Silva

    2015-09-01

    Full Text Available Objective: to identify reasons for low adherence to the Papanicolaou test in women seeking care in primary health care. Methods: cross-sectional study. Data collection carried out during home visits, applying questionnaire to characterize sociodemographic aspects as well as the reasons for non-adherence to examination and suggestions for facilitating adherence. Results: among 169 women, 67% were of reproductive age and 73.9% have finished elementary school. The failure to previously scheduled examination was due mainly to the beliefs and attitudes (36.1% and service organization (25.4%. The feelings reported by women during the Papanicolaou test were shame (55.6%, discomfort (32.5% and pain (20.7%. Conclusion: Although the screening of cervical cancer is essential for timely intervention, a significant proportion of women still does not adhere to examination by myths and taboos, beliefs, and health attitudes, as well as service organization.

  20. Techniques for cytologic sampling of pancreatic and bile duct lesions.

    Science.gov (United States)

    Brugge, William; Dewitt, John; Klapman, Jason B; Ashfaq, Raheela; Shidham, Vinod; Chhieng, David; Kwon, Richard; Baloch, Zubair; Zarka, Matthew; Staerkel, Gregg

    2014-04-01

    The Papanicolaou Society of Cytopathology has developed a set of guidelines for pancreatobiliary cytology including indications for endoscopic ultrasound guided fine-needle aspiration biopsy, techniques of the endoscopic retrograde cholangiopancreatography, terminology and nomenclature of pancreatobiliary disease, ancillary testing, and postbiopsy management. All documents are based on the expertise of the authors, a review of the literature, discussions of the draft document at several national and international meetings over an 18-month period and synthesis of online comments of the draft document on the Papanicolaou Society of Cytopathology website [www.papsociety.org]. This document presents the results of these discussions regarding the use of ancillary testing in the cytological diagnosis of biliary and pancreatic lesions. This document summarizes the current state of the art for techniques in acquiring cytology specimens from the biliary tree as well as solid and cystic lesions of the pancreas. Copyright © 2014 Wiley Periodicals, Inc.

  1. 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.

  2. 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.

  3. 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.

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

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    Khushboo

    2014-10-01

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

  5. A methodological framework to distinguish spectrum effects from spectrum biases and to assess diagnostic and screening test accuracy for patient populations: Application to the Papanicolaou cervical cancer smear test

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    Coste Joël

    2008-02-01

    Full Text Available Abstract Background A spectrum effect was defined as differences in the sensitivity or specificity of a diagnostic test according to the patient's characteristics or disease features. A spectrum effect can lead to a spectrum bias when subgroup variations in sensitivity or specificity also affect the likelihood ratios and thus post-test probabilities. We propose and illustrate a methodological framework to distinguish spectrum effects from spectrum biases. Methods Data were collected for 1781 women having had a cervical smear test and colposcopy followed by biopsy if abnormalities were detected (the reference standard. Logistic models were constructed to evaluate both the sensitivity and specificity, and the likelihood ratios, of the test and to identify factors independently affecting the test's characteristics. Results For both tests, human papillomavirus test, study setting and age affected sensitivity or specificity of the smear test (spectrum effect, but only human papillomavirus test and study setting modified the likelihood ratios (spectrum bias for clinical reading, whereas only human papillomavirus test and age modified the likelihood ratios (spectrum bias for "optimized" interpretation. Conclusion Fitting sensitivity, specificity and likelihood ratios simultaneously allows the identification of covariates that independently affect diagnostic or screening test results and distinguishes spectrum effect from spectrum bias. We recommend this approach for the development of new tests, and for reporting test accuracy for different patient populations.

  6. 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.

  7. Attitudes toward self-sampling for cervical cancer screening among primary care attendees living on the US-Mexico border.

    Science.gov (United States)

    Penaranda, Eribeth; Molokwu, Jennifer; Hernandez, Ingrid; Salaiz, Rebekah; Nguyen, Norma; Byrd, Theresa; Shokar, Navkiran

    2014-07-01

    Hispanic women living along the US border with Mexico have one of the highest cervical cancer mortality rates in the nation, owing in part to lower rates of screening. The barriers to screening in this population include lack of access to care and fear of and embarrassment about the pelvic examination. Screening for oncogenic or high-risk human papillomavirus during cervical cytology has been added to screening recommendations. A novel method for human papillomavirus testing is self-sampling, in which women collect their own cervicovaginal samples. There is lack of information about the acceptability of self-sampling as an alternative to cytology for cervical cancer screening in women living along the US-Mexico border. We conducted five focus groups with women between the ages of 30 and 65 who were primary care patients of clinics along the US-Mexico border. We used constructs from different health behavioral theories as a framework for the interview guide. A total of 21 women participated in the focus groups, 80% of whom were Hispanic; mean age was 53.4 (standard deviation 7.9). More than one-third (38%) of the participants had not undergone a Papanicolaou test in the last 3 years. Women identified the perceived benefits of self-sampling as ease, convenience, practicability, less embarrassment, and need for child care as compared with a Papanicolaou test. The main barrier to self-sampling was concern about not performing the test correctly. In this qualitative study, we found positive attitudes toward self-sampling among women living along the US border with Mexico. Further research is needed to evaluate interventions that address women's low levels of self-efficacy to perform the test and to evaluate the effectiveness of self-sampling in increasing cervical cancer screening rates.

  8. Cost analysis of different cervical cancer screening strategies in Mexico

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    Christyn M Beal

    2014-09-01

    Full Text Available Objective. To compare the costs and number of undetected cases of four cervical cancer screening strategies (CCSS in Mexico. Materials and methods. We estimated the costs and outcomes of the following CCSS: a conventional Papanicolaou smear (Pap alone; b high-risk human papilloma virus testing (HR-HPV as primary screening with Pap as reflex triage; c HR-HPV as primary screening with HPV-16/18 typing, liquid-based cytology (LBC and immunostaining for p16/Ki67 testing as reflex triage, and d co-testing with HR-HPV and LBC with HPV-16/18 typing and immunostaining for p16/Ki67 as reflex triage. The outcome of interest was high-grade cervical lesions or cervical cancer. Results. HR-HPV testing, HPV typing, LBC testing and immunostaining is the best alternative because it is the least expensive option with an acceptable number of missed cases. Conclusions. The opportunity costs of a poor quality CCSS is many false negatives. Combining multiple tests may be a more cost-effective way to screen for cervical cancer in Mexico

  9. Cost analysis of different cervical cancer screening strategies in Mexico.

    Science.gov (United States)

    Beal, Christyn M; Salmerón, Jorge; Flores, Yvonne N; Torres, Leticia; Granados-García, Víctor; Dugan, Ellen; Lazcano-Ponce, Eduardo

    2014-01-01

    To compare the costs and number of undetected cases of four cervical cancer screening strategies (CCSS) in Mexico. We estimated the costs and outcomes of the following CCSS: a) conventional Papanicolaou smear (Pap) alone; b) high-risk human papilloma virus testing (HR-HPV) as primary screening with Pap as reflex triage; c) HR-HPV as primary screening with HPV-16/18 typing, liquid-based cytology (LBC) and immunostaining for p16/Ki67 testing as reflex triage, and d) co-testing with HR-HPV and LBC with HPV-16/18 typing and immunostaining for p16/Ki67 as reflex triage. The outcome of interest was high-grade cervical lesions or cervical cancer. HR-HPV testing, HPV typing, LBC testing and immunostaining is the best alternative because it is the least expensive option with an acceptable number of missed cases. The opportunity costs of a poor quality CCSS is many false negatives. Combining multiple tests may be a more cost-effective way to screen for cervical cancer in Mexico.

  10. 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

  11. 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.

  12. Conjunctival impression cytology in contact lens wearers.

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    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.

  13. Improvization of conventional cytology by centrifuged liquid-based cytology in oral exfoliative cytology specimen

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    Shwetha Nambiar

    2016-01-01

    Full Text Available Background: Exfoliative cytology is the microscopic examination of shed or desquamated cells from the epithelial surface. Centrifuged liquid-based cytology (CLBC is a modified technique that was used in the current study. Aims: To compare the efficacy of CLBC with conventional cytology in apparently normal mucosa after staining with Papanicolaou (PAP stain. Materials and Methods: Fifty cases of apparently normal mucosa from healthy subjects were selected for the study. The first sample was taken and spread on the slide by the conventional technique. The second sample was flushed out in a suspending solution, centrifuged, and the cell pellet obtained was used to make the smear. The stained smears were compared for seven parameters such as adequate cellularity, clear background, uniform distribution, cellular overlapping, cellular elongation, mucus, and inflammatory cells. Chi-square test was used for statistical analysis and P ≤ 0.05 was considered to be statistically significant. Results: There was a statistically significant difference between CLBC and conventional cytology with parameters such as adequate cellularity (P = 0.001, clear background (P = 0.001, uniform distribution (0.005, cellular overlapping, and cellular elongation (P = 0. The presence of mucus and inflammatory cells was minimal as the samples were collected from healthy subjects. Conclusion: CLBC has better efficacy over the conventional method in all the parameters analyzed.

  14. Improvization of conventional cytology by centrifuged liquid-based cytology in oral exfoliative cytology specimen.

    Science.gov (United States)

    Nambiar, Shwetha; Hegde, Veda; Yadav, Nikhil; Hallikeri, Kaveri

    2016-01-01

    Exfoliative cytology is the microscopic examination of shed or desquamated cells from the epithelial surface. Centrifuged liquid-based cytology (CLBC) is a modified technique that was used in the current study. To compare the efficacy of CLBC with conventional cytology in apparently normal mucosa after staining with Papanicolaou (PAP) stain. Fifty cases of apparently normal mucosa from healthy subjects were selected for the study. The first sample was taken and spread on the slide by the conventional technique. The second sample was flushed out in a suspending solution, centrifuged, and the cell pellet obtained was used to make the smear. The stained smears were compared for seven parameters such as adequate cellularity, clear background, uniform distribution, cellular overlapping, cellular elongation, mucus, and inflammatory cells. Chi-square test was used for statistical analysis and P ≤ 0.05 was considered to be statistically significant. There was a statistically significant difference between CLBC and conventional cytology with parameters such as adequate cellularity (P = 0.001), clear background (P = 0.001), uniform distribution (0.005), cellular overlapping, and cellular elongation (P = 0). The presence of mucus and inflammatory cells was minimal as the samples were collected from healthy subjects. CLBC has better efficacy over the conventional method in all the parameters analyzed.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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

  20. Prevalence of human papillomavirus types 16, 18, and 45 in women with cervical intraepithelial changes: associations with colposcopic and histological findings.

    Science.gov (United States)

    Jarienė, Kristina; Vaitkienė, Daiva; Bartusevičius, Arnoldas; Tvarijonavičienė, Eglė; Minkauskienė, Meilė; Nadišauskienė, Rūta; Kruminis, Valdemaras; Kliučinskas, Mindaugas

    2012-01-01

    The aim of the study was to determine the prevalence of human papillomavirus (HPV) types 16, 18, and 45 in women with cervical intraepithelial changes caused by high-risk HPV in relation to colposcopic and histological findings. MATERIAL AND METHODS. A prospective study of 393 women with cervical cytologic changes confirmed by the Papanicolaou test was undertaken from April 3, 2006, to April 3, 2007. The Hybrid Capture 2 assay was performed. HPV-positive women underwent genotyping for types 16, 18, and 45. Colposcopy and biopsy were performed in 317 (80.7%) and 249 women (63.4%), respectively. The results were analyzed by age groups. RESULTS. Of all the women with cervical intraepithelial changes, 59% were positive for HR HPV, and 62% were positive for HPV types 16, 18, and 45. HPV types 16, 18, and 45 were detected in 54.8% of women with ASC-US/AGUS/ASC-H, 50.0% of women with LSIL, and 75.6% of women with HSIL. After confirmation of any histological and colposcopic changes, HPV types 16, 18, and 45 were detected in 68.0% and 69.0% of women, respectively. Moreover, 84.2% of the women with HSIL and high-grade colposcopic changes, and 78.5% of the women with HSIL and CIN 2/CIN 2-3/CIN 3/carcinoma in situ were positive for HPV types 16, 18, and 45. The sensitivity of the Papanicolaou test together with the Hybrid Capture 2 test compared with the Papanicolaou test together with the HPV 16/18/45 test diagnosing CIN 2+ changes did not differ (96.7% vs. 97.1%), but the specificity was higher (40.3% vs. 8.0%). CONCLUSIONS. The majority of the cytologic, colposcopic, and histological changes were caused by HPV types 16, 18, and 45. Despite the high prevalence of HPV types 16, 18, and 45, testing for these genotypes together with the Papanicolaou test did not improve the diagnosis of high-grade cervical intraepithelial lesions.

  1. 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.

  2. History of high-risk HPV and Pap test results in a large cohort of patients with invasive cervical carcinoma: experience from the largest women's hospital in China.

    Science.gov (United States)

    Tao, Xiang; Griffith, Christopher C; Zhou, Xiangrong; Wang, Zhiheng; Yan, Yabin; Li, Zaibo; Zhao, Chengquan

    2015-07-01

    Current cervical cancer screening guidelines recommend screening with a Papanicolaou (Pap) test or by cotesting (Pap and human papillomavirus [HPV]). Given the importance of high-risk HPV (hrHPV) infection in the development of cervical cancer, some studies are now suggesting the use of primary hrHPV testing as a possible screening modality. To gain further insight into the role of both Pap testing and hrHPV testing, the authors examined prior screening results in a population of Chinese patients with invasive cervical carcinoma. Cases with a histologic diagnosis of invasive cervical carcinoma were retrieved from the Obstetrics and Gynecology Hospital of Fudan University from January 2011 to October 2014. Prior hrHPV testing and Pap test results within 3 years before the cancer diagnosis were recorded. Of 3714 patients with invasive cervical carcinoma, over a 46-month period, 525 had prior hrHPV testing using Hybrid Capture 2 within 3 years and 238 patients had Pap cytology testing within 1 year before the histological diagnosis. Within the 1-year period before diagnosis, the overall hrHPV-negative rate was 15.5% (74 of 477 patients) and the Pap-negative rate was also 15.5% (37 of 238 patients). Only 9 of 231 patients with both hrHPV testing and Pap testing (3.9%) had a double-negative result. Compared with squamous cell carcinoma, adenocarcinoma has significantly higher rates of prior negative results with both hrHPV and Pap cytology. The results of the current study demonstrated prior results of hrHPV testing and Pap cytology in a population of women in China who had not undergone intensive prior screening. Both hrHPV testing and Pap cytology were found to have similar negative rates in this population and, not surprisingly, there were fewer women who had negative testing results using both testing modalities. © 2015 American Cancer Society.

  3. 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。

  4. 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

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

    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

  6. Confocal microscopy and exfoliative cytology.

    Science.gov (United States)

    Reddy, Shyam Prasad; Ramani, Pratibha; Nainani, Purshotam

    2013-05-01

    Early detection of potentially malignant lesions and invasive squamous-cell carcinoma in the oral cavity could be greatly improved through techniques that permit visualization of subtle cellular changes indicative of the neoplastic transformation process. One such technique is confocal microscopy. Combining rapidity with reliability, an innovative idea has been put forward using confocal microscope in exfoliative cytology. The main objective of this study was to assess confocal microscopy for cytological diagnosis and the results were compared with that of the standard PAP stain. Confocal microscope, acridine orange (AO) stain, PAP (Papanicolaou) stain. The study was designed to assess confocal microscopy for cytological diagnosis. In the process, smears of patients with (clinically diagnosed and/or suspected) oral squamous cell carcinoma as well as those of controls (normal people) were stained with acridine orange and observed under confocal microscope. The results were compared with those of the standard PAP method. Samples of buccal mucosa smears from normal patients and squamous cell carcinoma patients were made, fixed in 100% alcohol, followed by AO staining. The corresponding set of smears was stained with PAP stain using rapid PAP stain kit. The results obtained were compared with those obtained with AO confocal microscopy. The study had shown nuclear changes (malignant cells) in the smears of squamous cell carcinoma patients as increased intensity of fluorescence of the nucleus, when observed under confocal microscope. Acridine orange confocal microscopy showed good amount of sensitivity and specificity (93%) in identifying malignant cells in exfoliative cytological smears. Confocal microscopy was found to have good sensitivity in the identification of cancer (malignant) cells in exfoliative cytology, at par with the PAP method. The rapidity of processing and screening a specimen resulted in saving of time. It added a certain amount of objectivity to the

  7. Confocal microscopy and exfoliative cytology

    Directory of Open Access Journals (Sweden)

    Shyam Prasad Reddy

    2013-01-01

    Full Text Available Context: Early detection of potentially malignant lesions and invasive squamous-cell carcinoma in the oral cavity could be greatly improved through techniques that permit visualization of subtle cellular changes indicative of the neoplastic transformation process. One such technique is confocal microscopy. Combining rapidity with reliability, an innovative idea has been put forward using confocal microscope in exfoliative cytology. Aims: The main objective of this study was to assess confocal microscopy for cytological diagnosis and the results were compared with that of the standard PAP stain. Settings and Design: Confocal microscope, acridine orange (AO stain, PAP (Papanicolaou stain. The study was designed to assess confocal microscopy for cytological diagnosis. In the process, smears of patients with (clinically diagnosed and/or suspected oral squamous cell carcinoma as well as those of controls (normal people were stained with acridine orange and observed under confocal microscope. The results were compared with those of the standard PAP method. Materials and Methods: Samples of buccal mucosa smears from normal patients and squamous cell carcinoma patients were made, fixed in 100% alcohol, followed by AO staining. The corresponding set of smears was stained with PAP stain using rapid PAP stain kit. The results obtained were compared with those obtained with AO confocal microscopy. Results: The study had shown nuclear changes (malignant cells in the smears of squamous cell carcinoma patients as increased intensity of fluorescence of the nucleus, when observed under confocal microscope. Acridine orange confocal microscopy showed good amount of sensitivity and specificity (93% in identifying malignant cells in exfoliative cytological smears. Conclusion: Confocal microscopy was found to have good sensitivity in the identification of cancer (malignant cells in exfoliative cytology, at par with the PAP method. The rapidity of processing and

  8. 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

  9. 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

  10. Chlamydia trachomatis in cervicitis and urethritis in women.

    Science.gov (United States)

    Paavonen, J; Vesterinen, E

    1982-01-01

    In the Scandinavian countries today, Chlamydia trachomatis seems to be the most important cause of sexually transmitted diseases. Although C. trachomatis is most prevalent in symptomatic women and in persons visiting venereal disease clinics, the asymptomatic carrier rate, particularly in young women, appears to be surprisingly high. In addition to young age and level of sexual activity, the use of oral contraceptives and the presence of cervical ectopy are important risk factors for chlamydial infection. Chlamydial cervicitis often is characterized by a hypertrophic follicular appearance, with severe edema, erythema, friability, and endocervical mucopurulent discharge. On colposcopy, an atypical transformation zone is frequently observed. Papanicolaou smears taken from C. trachomatis culture-positive patients often reveal benign atypias and dyskaryotic changes. C. trachomatis, therefore, being a venereally transmitted intracellular organism, may well play a role in the development of cervical intraepithelial neoplasia (CIN). Future studies on patients with cytological atypias, therefore, also should include tests for C. trachomatis. Prospective studies are needed to determine the natural history and outcome of C. trachomatis-associated atypias and their behavior after adequate therapy. A large proportion of C. trachomatis-infected women also are culture-positive from the urethra. The demonstration that C. trachomatis is a common causative agent of acute urethral syndrome (also called abacterial urethritis, dysuria-pyuria syndrome) in women has been a valuable contribution. The diagnosis of pyuria in a patient with abacterial dysuria is of critical importance, since it suggests a chlamydial etiology and thus is a potentially treatable condition.

  11. 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

  12. 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...

  13. DNA probes for papillomavirus strains readied for cervical cancer screening

    Energy Technology Data Exchange (ETDEWEB)

    Merz, B.

    1988-11-18

    New Papillomavirus tests are ready to come to the aid of the standard Papanicolauo test in screening for cervical cancer. The new tests, which detect the strains of human papillomavirus (HPV) most commonly associated with human cervical cancer, are designed to be used as an adjunct to rather than as a replacement for the Papanicolaou smears. Their developers say that they can be used to indicated a risk of developing cancer in women whose Papanicolaou smears indicate mild cervical dysplasia, and, eventually, to detect papillomavirus infection in normal Papanicolaou smears. The rationale for HPV testing is derived from a growing body of evidence that HPV is a major factor in the etiology of cervical cancer. Three HPV tests were described recently in Chicago at the Third International Conference on Human Papillomavirus and Squamous Cervical Cancer. Each relies on DNA probes to detect the presence of papillomavirus in cervical cells and/or to distinguish the strain of papillomavirus present.

  14. 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.

  15. 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。

  16. 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。

  17. 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.

  18. Women's initial experience of abnormal papanicolaou smear.

    Science.gov (United States)

    Mitchell, Susan; Hall, Vincent P

    2009-06-01

    To discover the early subjective experience of women affected by abnormal Papanicolaou smear, a qualitative study was undertaken with 8 North Carolina women, 4 to 12 months postnotification of their first abnormal result. Data were analyzed via grounded theory methodology to identify a core theory that could guide interventions to improve follow-up for cancer prevention. This theoretical process is described as a labyrinth journey-an imperative healing process undertaken by all participants, who undertook the following tasks: evaluating peril, seeking refuge, obtaining information, and reframing their self-image. Women who also learned they were infected with the human papillomavirus faced a prolonged sense of threat to their sense of sexual well-being. Their additional tasks related to reevaluating their sexual self-image, and they continued to work on these reframing tasks throughout their 1st year's journey. Progress through the labyrinth depended upon emotional or spiritual support, nonjudgmental acceptance and access to accurate information.

  19. 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

  20. Screening for cervical cancer: new alternatives and research Detección oportuna de cáncer cervical: nuevas alternativas y pautas de investigación

    Directory of Open Access Journals (Sweden)

    Attila T Lörincz

    2003-01-01

    Full Text Available Evidence for the clinical utility of human papillomavirus (HPV DNA testing has increased over the years and has now become very convincing. Some specific uses of HPV detection are a triage of women with cytological determinations of atypical squamous cells of undetermined significance (ASC-US and related management strategies, b as a marker for test of cure post-treatment, and c most importantly, as an adjunct to cytology in routine cervical disease screening programs. There are many studies that support each of these applications and include 8 studies on ASC-US triage, 10 on test of cure and 13 on adjunctive or stand-alone HPV screening. The most notable investigation of ASC-US triage was ALTS, a randomized controlled trial of 3 488 women. With respect to routine HPV screening the combined studies included 77 000 women, providing as a histological endpoint more than 1 000 cases of high-grade cervical intraepithelial neoplasia (CIN or cancer. Testing methods were either the Hybrid Capture 2 (HC2 test or the polymerase chain reaction (PCR test. HPV testing of women with ASC-US cytology had on average a higher sensitivity (90% and specificity (70% than repeating the cytological test (sensitivity 75%, specificity 60% and was also more sensitive than colposcopy for follow-up. As an adjunct to the Papanicolaou (Pap cytology test in routine screening, HPV DNA testing was a more sensitive indicator for prevalent high-grade CIN than either conventional or liquid cytology. A combination of HPV DNA and Papanicolaou testing had almost 100% sensitivity and negative predictive value. The specificity of the combined tests was slightly lower than the specificity of the Papanicolaou test. One "double-negative" HPV DNA and Papanicolaou test indicated a higher prognostic assurance against risk of future CIN 3 than three subsequent negative conventional Papanicolaou tests and may safely allow three-year or longer screening intervals for such low- risk women. It

  1. Cervical squamous intraepithelial lesions among HIV-positive women on antiretroviral therapy in Kenya.

    Science.gov (United States)

    McKenzie, Kevin P; Rogers, Robyn K; Njoroge, Julia W; John-Stewart, Grace; Richardson, Barbra A; Mugo, Nelly R; De Vuyst, Hugo; Pamnani, Ritesh N; Rana, Farzana S; Warui, Danson; Chung, Michael H

    2011-04-01

    The prevalence of cervical squamous intraepithelial lesions (SIL) among HIV-infected women on antiretroviral therapy in sub-Saharan Africa has not been well described. HIV-infected women enrolled in an HIV treatment clinic in Nairobi, Kenya were offered free cervical screening with Papanicolaou (Pap) smear testing if they were 30 to 39 years of age and on antiretroviral therapy. Women with SIL were compared to those without SIL with univariate analyses and logistic regression. Of 595 eligible women, 267 accepted Pap testing and had available cytology results, of whom 258 (97%) were on a non-nucleoside reverse transcriptase inhibitor (NNRTI) based regimen. Median duration of antiretroviral therapy was 13 months [interquartile range (IQR), 8-19]. Abnormal cytology was found in 123 women (46%) with 70 women (26%) having low grade squamous intraepithelial lesions (LSIL), 22 (8%) high grade squamous intraepithelial lesions (HSIL), 30(11%) atypical squamous cells of unknown significance (ASCUS) and 1 (0.4%) atypical glandular cells (AGC). Women with SIL had lower median CD4 cell count (239 vs 287 cells/mm3; P=0.02), lower income (treatment clinics in Africa.

  2. Trichomonas, Candida , and Gardnerella in cervical smears of Iranian women for cancer screening

    Directory of Open Access Journals (Sweden)

    Narges Kalantari

    2014-01-01

    Full Text Available Background: Trichomonas vaginalis, Gardrenella vaginalis, and Candida sp are responsible for 90% of vaginitis which has been reported as important risk factors for cervical cancer. Aim: This study aimed to find the prevalence of T. vaginalis, Candida sp, and G. vaginalis in women attended the cancer clinic charity, Babol, Iran and to identify the associated risk factors. Materials and Methods: This retrospective study carried out from 1996 to July 2012 on women who attended to a cancer screening program at the cancer clinics charity, Babol, Iran. Papanicolaou test and clinical examinations were performed for each woman. In addition to Papanicolaou test results, demographic data were collected. The data were analyzed with X 2 test using SPSS software, version 18. Results: In total, 2511 out of 33600 (7.5% cases had vaginal infections. A total of 71 (0.2%, 2248 (6.7%, and 192 (0.6% of subjects were infected by T. vaginalis, Candida sp, and Gardnerella, respectively. The highest rate of infection was seen in 20-30 and 30-40 years age group. The frequency of vaginal ulcers was higher in trichomoniasis (14.1%. Conclusion: This study demonstrated that the prevalence of T. vaginalis, Candida sp, and Gardnerella was low among the studied population. Moreover, malignant cytological alternations were not seen in any infected women.

  3. 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

  4. 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

  5. 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

  6. Diagnostic accuracy and pitfalls of fine needle aspiration cytology and scrape cytology in oral cavity lesions

    Directory of Open Access Journals (Sweden)

    Nesreen H. Hafez

    2014-10-01

    Full Text Available Background — The oral cavity can be home for a wide variety of lesions. To date, biopsy has remained the gold standard for diagnosing these lesions. Purpose — This study was carried out to assess the diagnostic accuracy of cytology in the oral lesions and to address the cytologic-histologic correlation. Patients and Methods — This prospective study included 72 patients with intraoral lesions. Fine needle aspiration cytology (FNAC or scrap cytology was performed. The smears were immediately fixed in 95% alcohol for Papanicolaou staining. If there was sufficient material, cell block was prepared. When indicated immunocytochemical study was ordered. Final cytologic results were then compared with the definitive histopathological diagnoses which were considered the gold standard. Results — Cytologically, 28 patients (38.9% were diagnosed as benign/atypical and 44 (61.1% as malignant/suspicious. The most common benign cytologic diagnosis was inflammation (42.9% of benign cases. The most common malignant cytologic diagnosis was squamous cell carcinoma (36.4%. Cytologic diagnoses were compared with histopathologic ones. There were 3 false negative cases and one false positive case. The sensitivity was 93.5%; specificity was 96.2%; positive predictive value (PPV was 97.7%; negative predictive value (NPV was 89.3% with a diagnostic accuracy of 94.4%. P-value was <0.001. Kappa was 0.882. Conclusion — FNAC was found to be highly accurate in the diagnosis of oral lesions. Detailed cytomorphologic examination coupled with clinical data and appropriate immunocytochemical study, in some cases, can lead to an accurate diagnosis. Overlapping features of some tumors, especially in minor salivary gland, as well as limitation of sampling, were responsible for the inaccurate diagnoses.

  7. 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.

  8. 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

  9. 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。

  10. 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.

  11. Conhecimento de mulheres sobre o exame de Papanicolaou Conocimiento de mujeres sobre el examen de Papanicolaou Women's knowledge about the Papanicolaou exam

    OpenAIRE

    Carolina Amancio Valente; Viviane Andrade; Maurícia Brochado Oliveira Soares; Sueli Riul da Silva

    2009-01-01

    Estudo epidemiológico, quantitativo, descritivo, transversal. Realizado com mulheres, estudantes do ensino médio noturno em escolas públicas para identificar conhecimentos sobre o exame de Papanicolaou. Participaram 1035 mulheres sendo 476 maiores de 18 anos, que compuseram o grupo de sujeitos. Após consentimento foi aplicado questionário com questões objetivas, capazes de identificar conhecimentos a respeito do exame de Papanicolaou, bem como perfil sócio-epidemiológico do grupo; foi realiza...

  12. Immunocytoexpression profile of ProExC in smears interpreted as ASC-US, ASC-H, and cervical intraepithelial lesion

    Directory of Open Access Journals (Sweden)

    Zeynep Tosuner

    2017-01-01

    Full Text Available Aims: We aimed to investigate the immunocytoexpression profiles of a novel assay ProEx C for topoisomerase II alpha (TOP2A and minichromosome maintenance protein 2 (MCM2 in abnormal interpreted smears. Settings and Design: Screening programs with Papanicolaou smear and high risk group human papilloma virus testing have yielded a dramatic reduction of cervical cancer incidence. However, both of these tests have limited specificity for the detection of clinically significant cervical high grade lesions. ProEx C for topoisomerase II alpha (TOP2A and minichromosome maintenance protein 2 (MCM2 has been considered to have tight association with high grade intraepithelial lesions. Materials and Methods: A total number of 54 SurePath cervical cytology specimens of patients previously interpreted as atypical squamous cells-undetermined significance (ASC-US, atypical squamous cells-cannot exclude high grade squamous intraepithelial lesion (ASC-H, low grade squamous intraepithelial lesion (LSIL, and high grade squamous intraepithelial lesion (HSIL were included in our study. Results and Conclusions: ProEx C was positive in 14 of HSILs (100%, 3 of 19 LSILs (16%, 2 of 4 ASC-Hs, and none of ASC-USs (0%. The ProEx C test showed very intense nuclear staining in all cytologically abnormal cells. Further studies are indicated to evaluate the diagnostic role of ProEx C.

  13. 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

  14. 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.

  15. Cytological artifacts masquerading interpretation

    Science.gov (United States)

    Sahay, Khushboo; Mehendiratta, Monica; Rehani, Shweta; Kumra, Madhumani; Sharma, Rashi; Kardam, Priyanka

    2013-01-01

    Background: Cytological artifacts are important to learn because an error in routine laboratory practice can bring out an erroneous result. Aims: The aim of this study was to analyze the effects of delayed fixation and morphological discrepancies created by deliberate addition of extraneous factors on the interpretation and/or diagnosis of an oral cytosmear. Materials and Methods: A prospective study was carried out using papanicolaou and hematoxylin and eosin-stained oral smears, 6 each from 66 volunteer dental students with deliberate variation in fixation delay timings, with and without changes in temperature, undue pressure while smear making and intentional addition of contaminants. The fixation delay at room temperature was carried out at an interval of every 30 minutes, 1 day and 1 week and was continued till the end of 1 day, 1 week, and 1 month, respectively. The temperature variations included 60 to 70°C and 3 to 4°C. Results: Light microscopically, the effect of delayed fixation at room temperature appeared first on cytoplasm followed by nucleus within the first 2 hours and on the 4th day, respectively, till complete cytoplasmic degeneration on the 23rd day. However, delayed fixation at variable temperature brought faster degenerative changes at higher temperature than lower temperature. Effect of extraneous factors revealed some interesting facts. Conclusions: In order to justify a cytosmear interpretation, a cytologist must be well acquainted with delayed fixation-induced cellular changes and microscopic appearances of common contaminants so as to implicate better prognosis and therapy. PMID:24648667

  16. A comparative study of liquid based cytology examination and DNA quantitative analysis in 879 women%879例女性宫颈液基细胞学检查与DNA定量分析法的对比研究

    Institute of Scientific and Technical Information of China (English)

    范雪梅; 徐薇; 耿建祥; 张秀梅; 仲玉英; 蔡为民; 梅静; 徐海燕; 赵雪

    2014-01-01

    目的:比较液基细胞学检查和 DNA 定量分析法在女性宫颈病变中的应用及其临床意义。方法对参与对比的879例妇女用宫颈刷取材,进行液基薄层制片,分别进行巴氏染色和 DNA 染色。对巴氏染色片做液基细胞学检查,并对 DNA 染色片进行全自动扫描诊断。结果对液基细胞学检查结果显示病变程度在非典型鳞状上皮细胞(ASCUS)意义不明以上病例和全自动 DNA 倍体分析系统检测见异倍体细胞部分病例,建议进一步做阴道镜检查及宫颈活检。28例妇女做了病理活检。以细胞诊断结果为标准,计算出细胞 DNA 定量分析法在 ASCUS 以上宫颈病变的检出率。结论细胞 DNA 定量分析法与液基细胞学检查组合应用,能明显提高宫颈癌及癌前病变的阳性检出率,对我国女性宫颈癌的防治具有重要的意义。%Objective To compare the application and clinical significance of the liquid based cytology examination and the DNA quantitative analysis in female cervical lesions.Methods The cervical cell samples were collected from 879 women participating in the comparison by the cervical brush and performed the the liquid-based thin layer section preparation for conducting Papanicolaou staining and DNA staining respectively.The liquid based cytology examination was performed on the Papanicolaou staining section and the fully automatic scanning diagnosis was performed on the DNA staining section.Results The cases of above atypical squa-mous cells of undetermined significance(ASCUS)detected by the liquid based cytology examination and the partial cases of hetero-ploid cell detected by the fully automated DNA ploidy analysis system were recommended to further perform colposcopy and cervi-cal biopsy.28 women were performed the pathological biopsy.With the cytological examination result as the standard,the detection rate of above ASCUS cervical lesions detected by the cellular DNA

  17. 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.

  18. The Cervical Cancer Screening Technique of Application and Progression%子宫颈癌筛查方法的应用及研究进展

    Institute of Scientific and Technical Information of China (English)

    张文娟; 东燕; 孙绪兰; 王萍; 曾燕

    2012-01-01

    Cervical cancer is a common gynecologic tumor and it is the second-leading cause of death from cancer in women worldwide. It is critical to construct a sustainable, reasonable and efficient general survey method for the early detection of precancerosis of Cervical Cancer. At present, cervical cancer screening technique includes: (a) cervical cytological screening (papanicolaou smear, TCT and DNA quantification); (b) visual inspection with acetic acid (VIA) and visual inspection with Lugol'S iodine (VH.I) ; (c) vaginoscopy; (d) HPV detection. The article is to summarize the application and progression of technique for cervical cancer screening.%子宫颈癌是妇科常见恶性肿瘤之一,发病率居女性恶性肿瘤第二位.建立可持续、合理、有效的普查方法,早期发现癌前病变是防治宫颈癌的关键.目前宫颈癌筛查方法有宫颈细胞学筛查(巴氏涂片、液基薄层细胞学检测、细胞DNA定量分析技术)、肉眼观察辅以醋酸白和Lugol碘溶液检测法、阴道镜检查、病毒-HPV检测,本文就当前各种筛查方法的应用及研究进展进行概括.

  19. Post-brushing and fine-needle aspiration biopsy follow-up and treatment options for patients with pancreatobiliary lesions: The Papanicolaou Society of Cytopathology Guidelines

    Directory of Open Access Journals (Sweden)

    Daniel F. I. Kurtycz

    2014-01-01

    Full Text Available The Papanicolaou Society of Cytopathology (PSC has developed a set of guidelines for pancreatobiliary cytology including indications for endoscopic ultrasound (EUS guided fine-needle aspiration (FNA biopsy, techniques of EUS-FNA, terminology and nomenclature for pancreatobiliary cytology, ancillary testing and post-procedure management. All documents are based on the expertise of the authors, a review of the literature and discussions of the draft document at several national and international meetings over an 18 month period and synthesis of online comments of the draft document on the PSC web site (www.papsociety.org. This document selectively presents the results of these discussions and focuses on the follow-up and treatment options for patients after procedures performed for obtaining cytology samples for the evaluation of biliary strictures and solid and cystic masses in the pancreas. These recommendations follow the six-tiered terminology and nomenclature scheme proposed by committee III.

  20. Eumycetoma versus actinomycetoma: Diagnosis on cytology

    Directory of Open Access Journals (Sweden)

    Afroz Nishat

    2010-01-01

    Full Text Available Eumycetoma is a chronic cutaneous and subcutaneous infection caused by various genera of fungi producing specific colored granules known as grains. A 45-year-old farmer presented clinically with a left foot mass with multiple discharging sinuses existing for last 3 years. Clinical and radiological findings suggested a diagnosis of chronic osteomyelitis with suspicion of tuberculosis. Imprints plus fine needle aspiration cytology (FNAC smears exhibited distinct brown-black colonies of a fungus having branching and septate hyphae embedded in matrix like material against a mixed inflammatory background. Periodic acid Schiff (PAS stain gave positive staining and subsequent fungal culture confirmed the cytological diagnosis and aided in species identification as Madurella mycetomatis. Thus, eumycetoma can precisely be diagnosed and confidently differentiated from similar conditions such as actinomycetoma by simple and inexpensive cytological techniques such as FNAC and imprint smears, employing routine May-Grόnwald-Giemsa, Papanicolaou and simple PAS stains on cytological specimen, thus leading to rapid diagnosis for institution of correct treatment.

  1. 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

  2. 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

  3. 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

  4. 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%.

  5. 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.

  6. 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

  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. Predictors of Iranian women's intention to first papanicolaou test practice: An application of protection motivation theory.

    Science.gov (United States)

    Dehdari, T; Hassani, L; Shojaeizadeh, D; Hajizadeh, E; Nedjat, S; Abedini, M

    2016-01-01

    Given the importance of papanicolaou (Pap) test in the early detection and timely treatment of cervical cancer, present study was designed to determine predictors of a sample of Iranian women's intention to first Pap test practice based on the protection motivation theory (PMT) variables. In this cross-sectional study, a total of 240 women referral to the 30 primary health care clinics were selected. They completed a developed scale based on PMT variables including intention, perceived vulnerability and severity, fear, response costs, response efficacy and self-efficacy. Path analysis was used to determine the association between predictive factors and intention. The results showed that PMT had goodness of fit with a χ2/df = 2.37, df = 28, P= 0.001 and RMSEA = 0.076. PMT explained 42% of the variance in women's intention to get first Pap smear test. Self-efficacy (b = 0.55, Ptheory-based educational interventions associated with Pap testing among women.

  9. SEM observations of an IUD from a patient with Actinomyces-like organisms on papanicolaou smear.

    Science.gov (United States)

    Keith, L; Method, M; Bailey, R; Bockoff, C; Hidvegi, D; Puleo, M

    1986-01-01

    Scanning electron microscopy (SEM) was used to study an IUD from an asymptomatic patient with Actinomyces-like organisms on Papanicolaou smear and in whom Actinomyces israelii was determined to be present in cervical smears. The objective was to determine if there were any variations in surface morphology that might be correlated with the Actinomyces-like organisms. SEM revealed numerous areas of thick surface encrustation. The surface morphology of the IUD fragments showed basic similarities to the morphologies observed in other cases. Encrustations were attached to the arms and stem of the device. A unique finding was apparently biological material adherent to a fragment of encrusted material. Filamentous structures radiated perpendicularly from a central core. These filaments resembled Actinomyces-like organisms in the patient's Pap smear. Also of interest was a delicate network of hair-like structures at the bottom of a naturally occurring space in the surface encrustation.

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. The pathogenic microorganisms in papanicolaou vaginal smears and correlation with inflammation.

    Directory of Open Access Journals (Sweden)

    Esmat Barouti

    2013-03-01

    Full Text Available Non-specific cervicitis or inflammatory changes in a smear report are common which are usually unclear for clinical approaches. To investigate the frequency of inflammation and pathogenic vaginal microorganisms in cervical smears among an Iranian population sample.This cross-sectional study was carried out on Pap smear samples of women referred to gynecological clinic of Taleghani Hospital in Tehran, Iran, between October 2008 and March 2009. This study was conducted on 528 conventional Papanicolaou cervical smears. The frequency and severity of inflammation and prevalence of bacterial vaginosis (BV, Trichomonas vaginalis (TV, and vaginal candidiasis (VC was determined in the samples. Also co-infection of the microorganisms in Pap samples was evaluated. percentage, mean±standard deviation of the outcome parameters were calculated. The comparison between data was performed with the Pearson's chi square or Fisher's exact test.The prevalence of BV, VC, and TV in Pap samples was 17%, 11%, and 0.4% respectively. Overall, the prevalence of these microorganisms in women of reproductive age was higher than menopausal women. There was a significant association between VC and the presence of inflammation in our samples.Based on our results, inflammation in the Pap smears can suggest an infection of VC and the patients should be considered for proper VC treatment.

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

    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,

  16. 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

  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. 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

  19. Oral epithelial atypical changes in apparently healthy oral mucosa exposed to smoking, alcohol, peppers and hot meals, using the AgNOR and Papanicolaou staining techniques.

    Science.gov (United States)

    Ahmed, Hussain Gadelkarim; Ebnoof, Syda Omer M Ali; Hussein, Mohmmed Omer M; Gbreel, Afra Yousif A

    2010-07-01

    To evaluate cytological atypical changes in apparently healthy oral mucosa exposed to smoking, alcohol, hot meals, and peppers using the AgNOR and Papanicolaou methods. A total of 180 individuals were evaluated, of which 60 were smokers, 34 were alcohol users, 52 were habitual peppers and hot meal (exposed) consumers, 24 were non-exposed, and 10 were patients with Oral Squamous Cell Carcinoma (OSCC), as an internal control. Cytological materials were obtained by brushing of buccal mucosa, on the border of the tongue and on the floor of the mouth, and participants underwent the Papanicolaou test for cytological changes and AgNOR staining for evaluation of the mean number of AgNOR dots per nucleus. SPSS program was used to perform the Pearson chi-square test. The 95% confidence level, Odds Ratio (OR), and the 95% Confidence Intervals (CI) were used. The features of cytological atypia were verified among 10 individuals, including 5 smokers, 2 alcohol users, 2 hot meals and peppers consumers, and one non-exposed. For atypia among tobacco smokers, the adjusted Odds Ratio (OR) and the 95% CI were found to be 2 (0.246-16.24). Increased keratinization was detected among 27 (45%) of the smokers (P cytological atypia were identified with 6 +/- 2 AgNOR mean count. The increase of the variables suggests that the evaluation of epithelial atypical changes in individuals exposed to smoking and alcohol carcinogens may be a useful screening tool. While hot meals and peppers did not seem to be a risk for oral mucosal proliferation, they increased the potency of keratinization and infection.

  20. Cytohistological correlation and accuracy of the pap smear test in diagnosis of cervical lesions: a hospital based cross-sectional study from Odisha, India

    Directory of Open Access Journals (Sweden)

    Reena Naik

    2015-09-01

    Full Text Available Background Cervical carcinoma is one of the most common causes of mortality among women.Early detection can be done by Papanicolaou (Papsmear test - a simplest, safe, cost effective and non invasive procedure. The main objective of this study was to categorize Pap smears for cytohistologicalexamination as well as clinically correlate to analyze sensitivity, specificity and positive predictive value of Pap smear. Methods In this prospective study 417 Pap smears performed, cytohistological correlation was done in 104 cases because patients had undergone both Pap smear and cervical biopsy.Detailed history was taken and clinical examination was done. Pap smear sample was collected from cervix and reporting was made according to Bethesda 2001 classification.Cytological findings were correlated with histopathology. Results Overall concordance rate was 60.7%. Concordance rate for malignancy was 100%, for inflammatory lesions 70.8% and for cervical intraepithelial neoplasia (CIN 33.3%. Common age group presented for screening was40-50 years.Commonest clinical presentationwas bleeding per vaginum. Conclusion The study provides good cyto-histopathology correlation in detecting high grade lesions and malignancy. Although Pap smear sensitivity was low but can be increased by adequate sampling and avoiding technical errors.Bethesda system is strongly recommended for adequacy of sampling to minimize inconsistency.Regular screening should be advised to the patients for the early detection of cervical carcinoma.

  1. The present situation and defects of cytology screening technique in China mainland%中国大陆宫颈细胞学筛查技术实施的现状及缺憾

    Institute of Scientific and Technical Information of China (English)

    黄恩杰; 罗新

    2016-01-01

    细胞学筛查技术在宫颈病变及宫颈癌的防治中起着举足轻重的作用。从传统的巴氏涂片发展到现今以液基细胞学( liquid-based cytology, LBC)技术为基础的伯塞斯达诊断系统( the bethesda system, TBS),宫颈病变的检出率得到了明显的提高,宫颈癌的死亡率也大大降低。全球宫颈癌总体的发病率与死亡率虽然有所下降,但在欠发达国家和地区,由于资源、技术和人才的缺乏,其发病率与死亡率仍比发达国家高许多,少数地区甚至有上升趋势,以细胞学筛查技术为首的筛查模式遇到了发展的瓶颈期。细胞学筛查作为宫颈病变“三阶梯”筛查模式第一阶梯,仍然起着至关重要的作用。 LBC技术是目前最优化的细胞学筛查技术,但TBS技术在中国大陆的应用因细胞病理学医师奇缺,而仍存在“不确定性、不稳定性、不标准性”等缺憾,宫颈病变及宫颈癌的防治工作仍任重道远。本文将综述目前细胞学筛查技术在中国大陆应用现状及局限性,并对该技术未来的发展进行讨论。%Cytological screening plays an important role in the prevention and treatment of cervical lesions and cervical cancer. The application of the technique, which has developed from traditional Papanicolaou ( Pap) smear to liquid-based cervical cytology ( LBC) , has lead to a significant increase in detectable rate and decrease in death rate from cervical cancer. However, due to lack of technology and resources, although the global morbidity and death rates of cervical cancer have decrease, these two rates are still high in some developing and underdeveloped countries. Cytological screening technique is going through a bottleneck period. Cytological screening technique which is the first-step of the three-step screening model, plays an indispensable role for early detection of cervical cancer and its precursors. LBC is the most optimizing cytological screening technique, but

  2. The performance of multimodal hyperspectral spectroscopy in the detection of precancerous cervical lesions

    Science.gov (United States)

    Trahmono; Lusiana, N.; Indarti, J.

    2017-08-01

    The aim of this study was to compare the performance of multimodal hyperspectral spectroscopy (MHS), which combines fluorescence and reflectance spectroscopy, with that of conventional laboratory-based screening tests, such as the Papanicolaou (Pap) smear test and human papilloma virus (HPV) DNA test, for detecting precancerous lesions of the cervix. The study utilized a cross-sectional design, and the kappa test was used in the analytical assessment. MHS scans were obtained from a sample of 70 consecutive patients, followed by sample collection for Pap and HPV DNA analysis and colposcopy referral, if indicated. Of the 70 patients evaluated, the results of cervical spectroscopy were normal in 38 (54.3%) patients, and they were abnormal in 32 (45.7%) patients. Based on the cytology results, 45 (64.3%) samples were normal, and 25 (35.7%) samples were abnormal. According to the results of the HPV DNA test, 47 (67.14%) samples were normal, and 17 (24.28%) samples were abnormal. Based on the results of the kappa test, the agreement between MHS and cytology was 0.793 (p < 0.001). The agreement between MHS and the HPV DNA test was 0.195 (p = 0.086), and the agreement between MHS and colposcopy was 0.479 (p < 0.001).

  3. 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

  4. 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 and cervical cancer.Increasing awareness of ASC and attention to patients may avoid delay in diagnosis and treatment of cervical lesions.%目的:探讨薄层液基细胞学检测(Thinprep cytoligic test, TCT)在诊断非典型鳞状细胞的意义。方法回顾性分析某医院2012年7月至2014年7月期间 TCT 标本中诊断为非典型鳞状细胞患者的结局。结果349例宫颈非典型鳞状细胞中,152例患者 HPV 阳性,44.7%存在宫颈上皮内瘤变或宫颈癌;197例 HPV 阴性患者中,8例患者存在宫颈上皮内瘤变或宫颈癌。同时非典型鳞状细胞的诊断与年龄存在相关性,年龄在40岁以上的妇女被诊断为 ASC 的人数较多。结论宫颈 TCT 及 HPV 筛查对于宫颈癌前病变及宫颈癌的早期发现有重要价值。应提高对 ASC 认识及对患者重视,以免耽误宫颈病变的诊断和治疗。

  5. Endometrial aspiration cytology in gynecological disorders

    Directory of Open Access Journals (Sweden)

    Meenal V Jadhav

    2016-01-01

    Full Text Available Context: Endometrial aspiration is not a popular modality for the study of the endometrium despite its simplicity and potential utility. Aim: The present study was aimed at evaluating the utility of endometrial aspiration in various gynecological disorders. Materials and Methods: In this diagnostic accuracy study, 55 prospectively registered women with various gynecological disorders were evaluated clinically and subjected to endometrial aspiration cytology and study of endometrial histology. Endometrial aspiration was performed by infant feeding tube in 10 cases and intra cath cannula in 45 cases. The slides were stained with rapid Papanicolaou (PAP stain and Leishman stain. Results: Endometrial aspiration cytology showed 90% and 94.6% sampling adequacy with infant feeding tube and intra cath cannula, respectively. Intra cath cannula was very convenient to handle and superior to infant feeding tube in aspirating the endometrium. Of the two stains used, rapid PAP stain was less time-consuming and superior to Leishman stain in studying the nuclear details. Leishman stain was helpful in detecting cytoplasmic vacuoles of secretory endometrium. Overall diagnostic accuracy of endometrial cytology was 90.4% while that for morphological hormonal evaluation was 97.6%. It enjoyed a sensitivity of 91.66%, a specificity of 88.23%, positive predictive value of 94.28%, and negative predictive value of 83.33%. Conclusion: Intra cath cannula emerged as an inexpensive, effective, and convenient device for endometrial aspiration. Endometrial aspiration proved to be a fairly effective, simple, and informative diagnostic modality.

  6. The influence of probiotics on the cervical malignancy diagnostics quality

    Directory of Open Access Journals (Sweden)

    Perišić Živko

    2011-01-01

    Full Text Available Background/Aim. Probiotics help to provide an optimum balance in the intestines. Probiotics species competitive block toxic substances and growth of unwanted bacteria and yeast species while they compete for the space and food. Lactogyn® is the first oral probiotics on Serbian market dedicated to maintaining a normal vaginal flora. Lactogyn® contains two well studied probiotics strains - Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14. Both of them are considered as probiotic agents with therapeutic properties increase the population of beneficial lactobacillus organisms within the vagina. The aim of this study was to exam an influence of Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 on results of cervical smear cytological testing including detection of atypical cells, detection of false positive and false negative findings as well as on vaginal microflora content in patients with vaginal infection signs and symptoms. Methods. Totally 250 women with signs of vaginal infection were selected to participate in the study. The study group comprised 125 patients taking studied probiotic strains along with specific anti-infective therapy. The control group comprised, also, 125 patients taking anti-infective agents, only. Probiotic preparation (Lactogyn ® capsules was administered orally (one capsule daily during 4 weeks. Before and six weeks after beginning of the therapy a cervical smear cytological test (the Papanicolaou test, as well as microbiological examination of the vaginal smear were performed. Results. Number of cases of inflammation and atypical squamous cells of undeterminated significance (ASCUS in the study group were significantly higher before administration of the probiotic preparation. The number of lactobacilli was significantly higher, and the number of pathogenic microorganisms lower in the group treated with this preparation. Conclusion. The application of probiotic strains Lactobacillus rhamnosus

  7. Cervical cytological changes in HIV-infected patients attending care and treatment clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania

    Directory of Open Access Journals (Sweden)

    Mwakigonja Amos R

    2012-02-01

    Full Text Available Abstract Background Tanzania is among Sub-Saharan countries mostly affected by the HIV and AIDS pandemic, females being more vulnerable than males. HIV infected women appear to have a higher rate of persistent infection by high risk types of human papillomavirus (HPV strongly associated with high-grade squamous intraepithelial lesions (HSIL and invasive cervical carcinoma. Furthermore, although HIV infection and cervical cancer are major public health problems, the frequency and HIV/HPV association of cervical cancer and HSIL is not well documented in Tanzania, thus limiting the development of preventive and therapeutic strategies. Methods A prospective unmatched, case-control study of HIV-seropositive, ≥ 18 years of age and consenting non-pregnant patients attending the care and treatment center (CTC at Muhimbili National Hoospital (MNH as cases was done between 2005 and 2006. HIV seronegative, non-pregnant and consenting women recruited from the Cervical Cancer Screening unit (CCSU at ORCI were used as controls while those who did not consent to study participation and/or individuals under Results A total of 170 participants from the two centers were recruited including 50 HIV-seronegative controls were from the CCSU. Ages ranged from 20-66 years (mean 40.5 years for cases and 20-69 years (mean 41.6 years for controls. The age group 36-45 years was the most affected by HIV (39.2%, n = 47. Cervicitis, squamous intraepithelial lesions (SIL and carcinoma constituted 28.3% (n = 34, 38.3% (n = 46 and 5.8% (n = 7 respectively among cases, and 28% (n = 14, 34% (n = 17 and 2% (n = 1 for controls, although this was not statistically significant (P-value = 0.61. IHC showed that p53 was not detectable in HPV + Pap smears and cell blocks indicating possible degradation. Conclusions The frequency of SIL and carcinoma appeared to be higher among HIV-infected women on HAART compared to seronegative controls and as expected increased with age. HIV

  8. 液基薄层细胞学检查配合阴道镜检查对子宫颈病变的诊断价值%The diagnostic value of thinprep cytology combined with colposcopy for cervical lesions

    Institute of Scientific and Technical Information of China (English)

    白杰

    2014-01-01

    Objective To investigate the diagnostic value of ThinPrep cytology(TCT) combined with colposcopy for cervical lesions.Methods 980 patients with suspected cervical lesions were selected and received TCT combined with colposcopy examination.Among the 980 patients,102 patients with positive smear were referred for colposcopy and were diagnosed by colposcopy biopsy.Results Of 102 patients with positive smear,the detection rates of the atypical squamous cells (ASC),low-grade squamous intraepithelial lesions (LSIL),cervical intraepithelial neoplasia (HSIL) and atypical glandular cells (AGC) were 6.1%,0.6%,2.1% and 1.5%,respectively.Compared with the colposcopy biopsy for cytology samples,the test results were as follows:LSIL was 72.4% (21/29),HSIL was 93.8% (15/16).Conclusion The method of TCT could increase the screening rate of positive diagnosis of cervical lesions and for the highly suspected patients,the combination of vaginal colposcopy and biopsy could further improve the accuracy of diagnosis,in order to provide scientific solutions for clinical treatment.%目的 探讨液基薄层细胞学检查(TCT)联合阴道镜检查对子宫颈病变的临床诊断应用价值.方法 选取疑似为宫颈病变的患者980例,采用TCT联合阴道镜检查,其中,送检样本阳性涂片患者102例,均行阴道镜检查,于阴道镜下取组织活检.结果 980例患者的102例阳性患者中,不典型鳞状上皮细胞(ASC)、低度鳞状上皮内病变(LSIL)、宫颈癌前病变(HSIL)及不典型腺细胞(AGC)的检出率分别为6.1%、0.6%、2.1%和1.5%;对细胞学阳性样本进行阴道镜组织活检,两种检测结果比较:LSIL为72.4% (21/29),HSIL为93.8% (15/16).结论 TCT筛查可增加宫颈病变阳性诊断率,对于高度疑似患者配合阴道镜检查及阴道组织活检可以进一步提高诊断的准确度,以便为临床治疗提供科学的方案.

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

    OpenAIRE

    Cheng, Jiaoying; BIAN, MEILU; CONG, XIAO; SUN, AIPING; Li, Min; Ma, Li; Chen, Ying; Liu,Jun

    2012-01-01

    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 T...

  10. Clinical study of Colposcopy and liquid-based cytology Test in the cervical intraepithelial neoplasia%阴道镜联合液基细胞学检查在宫颈上皮内瘤变的临床研究

    Institute of Scientific and Technical Information of China (English)

    张丽英

    2012-01-01

    目的 探讨阴道镜联合液基细胞学(TCT)检查对宫颈上皮内瘤变(CIN)的诊断价值.方法 回顾性分析了2006年6月~2010年12月在我院妇科就诊行TCT涂片的已婚妇女436例,同时对阳性者行阴道镜下宫颈活检病理学检查,以病理结果为金标准,评价阴道镜检联合TCT对宫颈上皮内瘤变诊断的准确性.结果 细胞学检测阳性者143例,与病理诊断结果比较,CINI诊断符合率为61.0%,CIN Ⅱ、CINI Ⅱ诊断符合率为42.9%.通过TCT检测再行阴道镜检查,CINI诊断符合率为78.7%,CIN Ⅱ、CINI Ⅱ诊断符合率为69.6%.结论 TCT与阴道镜联合应用明显提高了宫颈上皮内瘤变的诊断符合率,具有较高的临床应用价值.%Objective To investigate the diagnostic value of colposcopy and liquid-bas ed cytology (TCT) in patients with cervical intraepithelial neoplasia (CIN).Methods A total of 436 females were suspected cervical intraepithelial neoplasia between June 2006 and December 2010 in the gynecological clinic of our hospital.All the patients with liquid-based cytology smears,while cytology positive line colposcopy and c ervical biopsy pathology multi-point inspection,the pathology results as the gold standard,to evaluated the diagnostic accuracy of colposcopy combined TCT for cervical intraepithelial neoplasia.Results 143 cases of patients with pos itive cyto logy,compared with the results of pathological diagnosis,cytology tests CINI diagnosis rate was 61.0%,C1NII,CINIII diagnosis rate was 42.9%; through the test with liquid-based cytology and colposcopy,CINI diagn osis rate was 78.7%,CINII,CINIII diagnosis rate was 69.6%.Conclusion TCT in combination with colposcopy was significantly improved the diagnosis rate of cervical intraepithelial neoplasia.as a diagnostic cervical intraepithelial neoplasia of the method with high clinical value.

  11. 液基细胞学联合人乳头瘤病毒检查在妊娠期宫颈病变筛查中的作用%Effect of liquid-based cytology combined with human papillomavirus test in screening of cervical lesions during pregnancy

    Institute of Scientific and Technical Information of China (English)

    关嵩青; 叶菲

    2012-01-01

    目的:探讨液基细胞学(TCT)联合人乳头瘤病毒(HPV)检查在妊娠期宫颈病变筛查中的价值.方法:采用TCT联合HPV检查的方法,对在深圳市第二人民医院行产前检查的500例妊娠期妇女进行宫颈病变筛查,以宫颈组织病理学检查结果作为确诊的金标准.结果:500例中,高危HPV阳性检出率为28.00%,TCT阳性检出率为8.40%,HPV与TCT同时阳性与阴道镜活检病理结果的阳性符合率为89.29%.结论:产前检查是进行宫颈病变筛查的良好时机,TCT联合HPV检查与阴道镜活检病理结果的阳性符合率高,用于妊娠期宫颈病变筛查是安全和有效的.%Objective: To explore the value of liquid — based cytology combined with human papillomavirus (HPV) test in screening of cervical lesions during pregnancy. Methods: Liquid-based cytology combined with HPV test was used to carry out screening of cervical lesions in 500 pregnant women in the hospital, the pathological result of cervical tissue was designed as gold standard of definite diagnosis. Results: Among 500 pregnant women, the detection rate of high risk HPV was 28. 00% , and the positive detection rate of liquid-based cytology was 8. 40% , the positive coincidence rate between positive HPV test, liquid-based cytology and pathological result after colposcopic biopsy was 89. 29%. Conclusion: Prenatal examination is a good opportunity for screening of cervical lesions; the positive coincidence rate between liquid-based cytology combined with HPV test and pathological result after colposcopic biopsy was high; the method is safe and effective for screening of cervical lesions during pregnancy.

  12. Cytokeratin-20 immunocytochemistry in voided urine cytology and its comparison with nuclear matrix protein-22 and urine cytology in the detection of urothelial carcinoma.

    Science.gov (United States)

    Srivastava, Ruchi; Arora, Vinod Kumar; Aggarwal, Seema; Bhatia, Arati; Singh, Navjeevan; Agrawal, Vivek

    2012-09-01

    This study was done on 59 subjects (42 urinary bladder carcinoma patients and 17 non-neoplastic controls). Urine cytology and bladder chek NMP22 test was done on all cases. CK20 immunostaining was performed on archived papanicolaou stained urine cytology smears in 34 cases (27 bladder carcinoma and 7 negative controls). Results of all three tests (cytology, NMP22, and CK20 immunostaining) were compared with histopathology to evaluate the accuracy of individual test. The combination of cytology and NMP22 was compared with combination of cytology and CK20 immunostaining for detection of bladder carcinoma. NMP22 had sensitivity of 92.9% and specificity of 70.6%, as compared with voided urine cytology (sensitivity of 76.2% and specificity of 76.5%) and CK20 immunostaining (sensitivity of 70.4% and specificity of 71.4%). Combination of cytology and NMP22 gave better results (sensitivity of 88.1% and specificity of 88.2%) than combination of cytology and CK20 immunostaining or any other test in isolation.

  13. Primary serous peritoneal carcinoma presenting first on a routine papanicolaou smear: a case report.

    Science.gov (United States)

    Wang, Hangjun; Chen, Patrick C

    2010-01-01

    Primary peritoneal carcinoma (PPC) is a relatively uncommon malignancy, and its presentation is similar to that of advanced ovarian serous carcinoma. There have been afew case reports in which the malignant cells from PPC were discovered from routine Papanicolaou (Pap) smears. In 2006 a 49-year-old, asymptomatic female participated in the Hospital Health Fair. High grade adenocarcinoma was found by Pap smear. After negative cervical and endometrial curetting and loop electrosurgical excision procedure cone, laparoscopy revealed widespread peritoneal carcinomatosis. The subsequent surgical specimens showed primary peritoneal serous carcinoma. Although the Pap smear was originally designed to detect premalignant cervical lesions and cancer, it became apparent that malignant cells from extrauterine primaries might appear in the smears. This case illustrated the value of the Pap smear in discovering unsuspected extrauterine malignancies, including PPC. Review of 9 cases showed tumor cells in the fallopian tube lumen in 4 out of 9 cases, indicating the likely route of efflux of tumor cells to appear in the Pap smear. The new concept of serous tubal intraepithelial carcinoma as the origin of PPC suggests another source of tumor cells in Pap smears.

  14. Cervical cancer control in Latin America: A call to action.

    Science.gov (United States)

    Bychkovsky, Brittany L; Ferreyra, Mayra E; Strasser-Weippl, Kathrin; Herold, Christina I; de Lima Lopes, Gilberto; Dizon, Don S; Schmeler, Kathleen M; Del Carmen, Marcela; Randall, Tom C; Nogueira-Rodrigues, Angelica; de Carvalho Calabrich, Aknar Freire; St Louis, Jessica; Vail, Caroline M; Goss, Paul E

    2016-02-15

    Cervical cancer (CC) is second most common cause of cancer in Latin America and is a leading cause of cancer mortality among women. In 2015, an estimated 74,488 women will be diagnosed with CC in Latin America and 31,303 will die of the disease. CC mortality is projected to increase by 45% by 2030 despite human papillomavirus (HPV) vaccination and screening efforts. In this setting, the goal was of the current study was to examine CC control efforts in Latin America and identify deficiencies in these efforts that could be addressed to reduce CC incidence and mortality. The authors found that HPV vaccination has been introduced in the majority of Latin American countries, and there is now a need to monitor the success (or shortcomings) of these programs and to ensure that these programs are sustainable. This topic was also reviewed in light of emerging data demonstrating that visual inspection with acetic acid and HPV DNA testing without Papanicolaou tests have efficacy from a screening perspective and are good alternatives to cytology-based screening programs. Overall, there is a need to build capacity for CC control in Latin America and the best strategy will depend on the country/region and must be tailored to meet the needs of the population as well as available resources.

  15. Clinical significance of detection of HPV feedback on patients with cervical cytology ASC-H%对宫颈细胞学ASC-H患者进行反馈性HPV检测的临床意义

    Institute of Scientific and Technical Information of China (English)

    林文毅; 陈颖; 王世凤; 胡志敏; 赖娜; 王敏

    2015-01-01

    Objective: To discuss the clinical significance of HPV (human papilloma virus)-detection in women with cervical ASC-H (atypical squamous cell cannotexclude high-grade squamous intraepithelial lesion). Methods: Retrospective analysis of the HPV-feedback test and histopathological findings in 197 cases of patients with ASC-H from June 2012 to June 2014. Results: Collected 197 cases of ASC-H patients diagnosed through cervical cytology in our hospital from June 2012 to June 2014. 124 cases gave the feedback tests of HPV and cervical tissue examination results, who were female, aged 25-63 years, with an average age of about 46 years old;clinical manifestations include cervical erosion,the real bleeding,physical examinations and others. 92 cases with the HPV positive, including histopathological findings as inflammation and 22 normal cases,accounting for about 23.91%, 15 cases with the low level of cervical intraepithelial neoplasia (CINI) ,accounting for about 16.3% , 45 cases with advanced differentiation of cervical intraepithelial neoplasia (cervical intraepithelial neopsia. CINII/CINIII), 10 cases with carcinoma, accounted for 59.78%, 32 cases of HPV negative, including histopathological findings as inflammation and 23 cases of normal, accounting for about 71.88%,8 cases with the low level of cervical intraepithelial neoplasia (CINI),accounting for about 25%,1 case with advanced differentiation of cervical intraepithelial neoplasia (CINII), accounting for about 3.12%, CINIII and squamous cell carcinoma were detected negatively. Thus the HPV detection has higher predictive value for lesions in high grade cervical intraepithelial cancer , risk of high-grade cervical intraepithelial lesion in HPV positive ASC-H patients were higher than the negative group (P< 0.05). Conclusion HPV feedback inspection in all ASC-H patients is very useful. Treatments could be provided more reasonable and personalized, while excessive examinations and treatments could be avoided and the

  16. A review of reporting systems and terminology for urine cytology.

    Science.gov (United States)

    Owens, Christopher L; Vandenbussche, Christopher J; Burroughs, Frances H; Rosenthal, Dorothy L

    2013-01-01

    Urine cytology continues to play an important role in the diagnosis and management of urothelial carcinoma, a common cancer of adults with significant morbidity and mortality. Because of its high sensitivity for high-grade urothelial tumors, including lesions that may be cystoscopically occult, urine cytology nicely compliments cystoscopic examination, a method that detects most low-grade tumors. Over the decades, several reporting schemes for urine cytology have been published in the literature, each of which has relative strengths and weaknesses. Unlike cervical cytology, there has not been widespread acceptance and use of any particular reporting scheme for urine cytology studies. Thus, terminology and criteria for urine cytology reporting are not uniform among pathologists, which can frustrate clinicians and hinders interlaboratory comparisons.

  17. Distribution of human papillomavirus types in ThinPrep Papanicolaou tests classified according to the Bethesda 2001 terminology and correlations with patient age and biopsy outcomes.

    Science.gov (United States)

    Evans, Mark F; Adamson, Christine S-C; Papillo, Jacalyn L; St John, Timothy L; Leiman, Gladwyn; Cooper, Kumarasen

    2006-03-01

    A survey of the distribution of human papillomavirus (HPV) types across the spectrum of cervical cytologic categories defined by the Bethesda 2001 guidelines was conducted with the objective of examining how HPV detection by polymerase chain reaction (PCR) analysis may benefit the management of patients who have abnormal Papanicolaou (Pap) test results. DNA samples from women with no intraepithelial lesion or malignancy (NLM) (n = 300 samples); atypical squamous cells of undetermined significance (ASC-US) (n = 200 samples); low-grade squamous intraepithelial lesion (LSIL) (n = 200 samples); atypical squamous cells, cannot rule out high-grade squamous intraepithelial lesion (ASC-H) (n = 200 samples); and high-grade squamous intraepithelial lesion (HSIL) (n = 200 samples) were tested for HPV using a modified general primer (GP)5+/GP6+ PCR assay and dot-blot hybridization with type-specific oligonucleotide probes (PCR assay analytical sensitivity: 1-100 copies of HPV, depending on the HPV type, in a background of 100 ng human DNA). HPV was detected in 27% of NLM samples, in 89.5% of ASC-US samples, in 97.5% of LSIL samples, in 93% of ASC-H samples, and in 96.5% of HSIL samples. Thirty-seven different HPV types were identified in total. One or more of 13 high-risk (HR) HPV types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68) were detected in 53% of samples that were diagnosed as ASC-US (59.0% of patients younger than age 30 yrs; 45.5% of patients age 30 yrs and older), in 55.5% of samples that were diagnosed as LSIL (60.0% of patients younger than age 30 yrs; 44.0% of patients age 30 yrs and older), in 80% of samples that were diagnosed as ASC-H, and in 87.5% of samples that were diagnosed as HSIL (P biopsy data were obtained for 359 patients. A "benign" biopsy result was recorded for 47 of 64 women (73.5%) with ASC-US, 30 of 66 women (45.5%) with LSIL, 39 of 87 women (45.0%) with ASC-H, and 26 of 142 women (18.0%) with HSIL and was most common in women age

  18. Role of scrape cytology in the intraoperative diagnosis of tumor

    Directory of Open Access Journals (Sweden)

    Kolte Sachin

    2010-01-01

    Full Text Available Background : Rapid diagnosis of surgically removed specimens has created many controversies and a single completely reliable method has not yet been developed. Histopathology of a paraffin section remains the ultimate gold standard in tissue diagnosis. Frozen section is routinely used by the surgical pathology laboratories for intraoperative diagnosis. The use of either frozen section or cytological examination alone has an acceptable rate (93-97% of correct diagnosis, with regard to interpretation of benign versus malignant. Aim : To evaluate the utility of scrape cytology for the rapid diagnosis of surgically removed tumors and its utilisation for learning cytopathology. Materials and Methods : 75 surgically removed specimens from various organs and systems were studied. Scrapings were taken from each specimen before formalin fixation and stained by modified rapid Papanicolaou staining. Results : Of the 75 cases studied, 73 could be correctly differentiated into benign and malignant tumors, with an accuracy rate of 97.3%. Conclusions : Intraoperative scrape cytology is useful for intraoperative diagnosis of tumor, where facilities for frozen section are not available. The skill and expertise developed by routinely practicing intraoperative cytology can be applied to the interpretation of fine needle aspirate smears. Thus, apart from its diagnostic role, intraoperative cytology can become a very useful learning tool in the field of cytopathology.

  19. Desmoplastic small round cell tumour: Cytological and immunocytochemical features

    Directory of Open Access Journals (Sweden)

    Filho Adhemar

    2005-01-01

    Full Text Available Abstract Background Desmoplastic small round cell tumor (DSRCT is a rare and highly aggressive neoplasm. The cytological diagnosis of these tumors can be difficult because they show morphological features quite similar to other small round blue cells tumors. We described four cases of DSRCT with cytological sampling: one obtained by fine needle aspiration biopsy (FNAB and three from serous effusions. The corresponding immunocytochemical panel was also reviewed. Methods Papanicolaou stained samples from FNAB and effusions were morphologically described. Immunoreaction with WT1 antibody was performed in all cytological samples. An immunohistochemical panel including the following antibodies was performed in the corresponding biopsies: 34BE12, AE1/AE3, Chromogranin A, CK20, CK7, CK8, Desmin, EMA, NSE, Vimentin and WT1. Results The smears showed high cellularity with minor size alteration. Nuclei were round to oval, some of them with inconspicuous nucleoli. Tumor cells are clustered, showing rosette-like feature. Tumor cells in effusions and FNA were positive to WT1 in 3 of 4 cytology specimens (2 out 3 effusions and one FNA. Immunohistochemical reactions for vimentin, NSE, AE1/AE3 and WT1 were positive in all cases in tissue sections. Conclusion The use of an adjunct immunocytochemical panel coupled with the cytomorphological characteristics allows the diagnosis of DSRCT in cytological specimens.

  20. 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.

  1. Diagnostic and prognostic validity of the human papillomavirus E6/E7 mRNA test in cervical cytological samples of HC2-positive patients.

    Science.gov (United States)

    Benevolo, Maria; Terrenato, Irene; Mottolese, Marcella; Marandino, Ferdinando; Carosi, Mariantonia; Rollo, Francesca; Ronchetti, Livia; Muti, Paola; Mariani, Luciano; Sindico, Stefano; Vocaturo, Giuseppe; Vocaturo, Amina

    2011-06-01

    The study aimed to assess the clinical utility in identifying CIN2 or worse (CIN2+), of the Pretect HPV-Proofer test for E6/E7 mRNA detection in Hybrid Capture 2 (HC2)-positive patients, who underwent colposcopy. In particular, the study analyzed the mRNA test perf