scholarly journals Impact of the more restrictive definition of atypical squamous cells introduced by the 2001 Bethesda System on the sensitivity and specificity of the Papanicolaou test

Cancer ◽  
2008 ◽  
Vol 114 (3) ◽  
pp. 171-179 ◽  
Author(s):  
Michael J. Thrall ◽  
Stefan E. Pambuccian ◽  
Edward B. Stelow ◽  
Dan M. McKeon ◽  
Lizette Miller ◽  
...  
2020 ◽  
Vol 3 (1) ◽  
pp. 21-29
Author(s):  
Alphonse Niyodusenga ◽  
Emile Musoni ◽  
Sarah Niyonsaba

Objective To compare the performance of VIA and Pap smear tests as screening tools in cervical carcinoma detection in women. Methods The prospective and retrospective study was conducted on 198 women. Cervical smears were collected with Ayres’s spatula. Acetic acid was used and the results were categorized as VIA positive and VIA negative. The Pap smear was reported according to the Bethesda system 2001. Cervical biopsy was done for all the cases. Results VIA was positive in 47.47% of the cases and Pap smear was positive in 39.89% of the cases. Among 198 cases, 61 (30, 8%) cases had cervical carcinoma. When we compared VIA and Pap smear tests, 94 cases were positive to VIA, and 61cases were confirmed positive with Pap smear. The sensitivity and specificity for VIA were 88.5% and 84.68%, respectively. The sensitivity and specificity for Pap smear were 80.45% and 91.89%, respectively. The sensitivity of VIA was higher than that of Pap smear. However, the specificity of VIA was low as compared to Pap smear. Conclusion VIA is a cost effective test and could be alternatively used with Pap smear in screening of cervical carcinoma but the Papanicolaou test is the most effective test for early detection of cervical carcinoma. Keywords: Pap smear test; VIA test; cervical carcinoma; women


2008 ◽  
Vol 132 (8) ◽  
pp. 1290-1294 ◽  
Author(s):  
Ann T. Moriarty ◽  
Mary R. Schwartz ◽  
Galen Eversole ◽  
Marilee Means ◽  
Amy Clayton ◽  
...  

Abstract Context.—Oncogenic, high-risk human papillomavirus (HR-HPV) testing is used to evaluate women who are older than 20 years with atypical squamous cells of undetermined significance (ASC-US) and in conjunction with a screening Papanicolaou test in women older than 30 years. Objectives.—To evaluate the 2006 laboratory practice data from laboratories incorporating human papillomavirus (HPV) testing with the Papanicolaou test. Design.—To use the College of American Pathologists (CAP) Supplemental Questionnaire Survey for 2006 to determine laboratory practices of participants in the CAP Interlaboratory Comparison Program in Cervicovaginal Cytology. Results.—A total of 679 laboratories responded to the questionnaire. Most (73%) refer HPV testing to reference laboratories. Nine percent perform HPV testing in cytology. Forty-five percent offer low-risk HPV (LR-HPV) testing. The most common reflex is ASC-US, although HR-HPV is also offered with low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), or any other Papanicolaou test result. Digene Hybrid Capture II is the most common method. Human papilloma virus median test volumes are 55 monthly. Frequency distributions of HPV test volumes are significantly different from those found in 2003. Laboratories performing in-house testing reported significantly higher monthly HPV volumes (P < .001). Median rates for HR-HPV positivity are 36.6% for ASC-US, 50.0% for atypical squamous cells, cannot exclude HSIL (ASC-H), and 4% for women 30 years of age and older in conjunction with a screening Papanicolaou test. Conclusions.—Reference HPV testing remains the most common pattern. The most common reflex indication is for ASC-US, but HPV testing is modified locally to include a variety of scenarios. LR-HPV testing is commonly offered despite its lack of clinical significance. These data form a baseline for ongoing monitoring of HPV testing practice trends.


2018 ◽  
Vol 11 (5) ◽  
pp. 450-454 ◽  
Author(s):  
Sebastien Soize ◽  
Guillaume Fabre ◽  
Matthias Gawlitza ◽  
Isabelle Serre ◽  
Serge Bakchine ◽  
...  

Background and purposeWe aimed to identify the best definition of early neurological improvement (ENI) at 2 and 24 hours after mechanical thrombectomy (MT) and determine its ability to predict a good functional outcome at 3 months.MethodsThis retrospective analysis was based on a prospectively collected registry of patients treated by MT for ischemic stroke from May 2010 to March 2017. We included patients treated with stent-retrievers with National Institute of Health Stroke Scale (NIHSS) score before treatment and at 2 and/or 24 hours after treatment and modified Rankin Score (mRS) at 3 months. Receiver operating characteristic curve analysis was performed to estimate optimal thresholds for ENI at 2 and 24 hours. The relationship between optimal ENI definitions and good outcome at 3 months (mRS 0–2) was assessed by logistic regression.ResultsThe analysis included 246 patients. At 2 hours, the optimal threshold to predict a good outcome at 3 months was improvementin the NIHSS score of >1 point (AUC 0.83,95% CI 0.77 to 0.87), with sensitivity and specificity 78.3% (62.2–85.7%) and 84.6% (77.2–90.3%), respectively, and OR 12.67 (95% CI 4.69 to 31.10, p<0.0001). At 24 hours, the optimal threshold was an improvementin the NIHSS score of >4 points (AUC 0.93, 95% CI 0.89 to 0.96), with sensitivity and specificity 93.8% (87.7–97.5%) and 83.2% (75.7–89.2%), respectively, and OR 391.32 (95% CI 44.43 to 3448.35, p<0.0001).ConclusionsENI 24 hours after thrombectomy appears to be a straightforward surrogate of long-term endpoints and may have value in future research.


2009 ◽  
Vol 127 (5) ◽  
pp. 283-287 ◽  
Author(s):  
Andréa Cytryn ◽  
Fábio Bastos Russomano ◽  
Maria José de Camargo ◽  
Lucília Maria Gama Zardo ◽  
Nilza Maria Sobral Rebelo Horta ◽  
...  

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.


1998 ◽  
Vol 2 (3) ◽  
pp. 267-273 ◽  
Author(s):  
Robert A. Simons

How many brownfield sites are there in the United States? Although numerous federal and state lists of contaminated lands are known—totaling more than 380,000 sites—there is no comprehensive estimate of unlisted or total brownfield sites. This article uses economic base contraction analysis to provide an estimate of the number and acreage of brownfield sites, by type and as a percentage of the land, in 31 large cities in the United States. This approach recognizes that brownfields are the outcome of years of decline in central-city manufacturing, trade, transportation, and residential uses. Using a moderately restrictive definition of brownfield, there are an estimated 75,000 formerly industrial brownfield sites in these U.S. central cities, on 93,000 acres. This is about 5% of the land area in these communities. Another 20,000 acres are present in these same cities in the form of residential brownfields. These findings imply that the overall number of nonresidential brownfields sites in the United States is at least 500,000 to 600,000 or more.


2007 ◽  
Vol 46 (4) ◽  
pp. 211-215 ◽  
Author(s):  
Miyuki SHIBATA ◽  
Yuji ARAI ◽  
Noriyuki FURUTA ◽  
Masafumi TSUZUKU ◽  
Ken TAKIZAWA ◽  
...  

2011 ◽  
Vol 21 (6) ◽  
pp. 1339-1362 ◽  
Author(s):  
SEBASTIAN DANICIC ◽  
ROBERT. M. HIERONS ◽  
MICHAEL R. LAURENCE

Given a program, a quotient can be obtained from it by deleting zero or more statements. The field of program slicing is concerned with computing a quotient of a program that preserves part of the behaviour of the original program. All program slicing algorithms take account of the structural properties of a program, such as control dependence and data dependence, rather than the semantics of its functions and predicates, and thus work, in effect, with program schemas. The dynamic slicing criterion of Korel and Laski requires only that program behaviour is preserved in cases where the original program follows a particular path, and that the slice/quotient follows this path. In this paper we formalise Korel and Laski's definition of a dynamic slice as applied to linear schemas, and also formulate a less restrictive definition in which the path through the original program need not be preserved by the slice. The less restrictive definition has the benefit of leading to smaller slices. For both definitions, we compute complexity bounds for the problems of establishing whether a given slice of a linear schema is a dynamic slice and whether a linear schema has a non-trivial dynamic slice, and prove that the latter problem is NP-hard in both cases. We also give an example to prove that minimal dynamic slices (whether or not they preserve the original path) need not be unique.


2015 ◽  
Vol 139 (3) ◽  
pp. 373-377 ◽  
Author(s):  
Baowen Zheng ◽  
R. Marshall Austin ◽  
Xiaoman Liang ◽  
Zaibo Li ◽  
Congde Chen ◽  
...  

Context Reports that use the Bethesda System categories for Chinese Papanicolaou test results are rare. Objective 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. Design 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 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 &lt; .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). Conclusion Participation in the international College of American Pathologists Laboratory Accreditation Program provides laboratory quality standards not otherwise available in many international settings.


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