Colposcopic characteristics and Lugol׳s staining differentiate anal high-grade and low-grade squamous intraepithelial lesions during high resolution anoscopy

The aim of this study was to evaluate retrospectively cytologic screening for cancers and precancerous lesions of the cervix and to research whether biopsy is overused among women with a cytologic diagnosis of atypical squamous cells of undetermined significance (ASCUS). We examined 28 469 smears obtained over 5 years. The patients were referred when the result of the smear was abnormal for a colposcopic biopsy, endocervical curettage, or a repeat Papanicolaou smear. The results of the screening of 28 469 smears are as follows: 699 (2.45%) ASCUS, 67 (0.23%) low-grade squamous intraepithelial lesions (LGSIL), 43 (0.15%) high-grade squamous intraepithelial lesions (HGSIL), 1 epidermoid carcinoma, 31 (0.10%) atypical glandular cells, and 1 adenocarcinoma. Histologic examination of the cervix was done in 119 patients (17.0%) of ASCUS, 13 patients (10.9%) of LGSIL, and 15 patients (12.6%) of HGSIL and cervical carcinoma. In the 119 women with histological examination, histologic examination was generally performed in patients with ASCUS neoplastic Papanicolaou smear, and histologic diagnosis of low-grade, high-grade, or invasive lesion of the cervix was made in 23.5% of women with ASCUS; in these patients, 46.4% were cytologic LGSIL and 53.5 % were cytologic HGSIL and cervical carcinoma. In the aspect of these findings, we concluded that for patients with a cytologic diagnosis of ASCUS, more aggressive interventions should be performed

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Critical Analyses of the Introduction of Liquid-Based Cytology in a Public Health Service of the State of São Paulo, Brazil

Acta Cytologica ◽

10.1159/000435801 ◽

2015 ◽

Vol 59 (3) ◽

pp. 273-277 ◽

Cited By ~ 2

Author(s):

Adhemar Longatto-Filho ◽

José Eduardo Levi ◽

Toni Ricardo Martins ◽

Diane Cohen ◽

Lise Cury ◽

...

Keyword(s):

Public Health ◽

Sao Paulo ◽

The State ◽

Low Grade ◽

High Grade ◽

São Paulo ◽

Squamous Intraepithelial Lesions ◽

Squamous Cells ◽

Liquid Based Cytology ◽

Intraepithelial Lesions

Objective: The aim of this study was to compare the performance of the current conventional Pap smear with liquid-based cytology (LBC) preparations. Study Design: Women routinely undergoing their cytopathological and histopathological examinations at Fundação Oncocentro de São Paulo (FOSP) were recruited for LBC. Conventional smears were analyzed from women from other areas of the State of São Paulo with similar sociodemographic characteristics. Results: A total of 218,594 cases were analyzed, consisting of 206,999 conventional smears and 11,595 LBC. Among the conventional smears, 3.0% were of unsatisfactory preparation; conversely, unsatisfactory LBC preparations accounted for 0.3%. The ASC-H (atypical squamous cells - cannot exclude high-grade squamous intraepithelial lesion) frequency did not demonstrate any differences between the two methods. In contrast, the incidence of ASC-US (atypical squamous cells of undetermined significance) was almost twice as frequent between LBC and conventional smears, at 2.9 versus 1.6%, respectively. An equal percentage of high-grade squamous intraepithelial lesions were observed for the two methods, but not for low-grade squamous intraepithelial lesions, which were more significantly observed in LBC preparations than in conventional smears (2.2 vs. 0.7%). The index of positivity was importantly enhanced from 3.0% (conventional smears) to 5.7% (LBC). Conclusions: LBC performed better than conventional smears, and we are truly confident that LBC can improve public health strategies aimed at reducing cervical lesions through prevention programs.

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Early Age at First Sexual Intercourse is Associated with Higher Prevalence of High-grade Squamous Intraepithelial Lesions (HSIL)

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0036-1597973 ◽

2017 ◽

Vol 39 (02) ◽

pp. 080-085 ◽

Cited By ~ 3

Author(s):

José Xavier-Júnior ◽

Rozany Dufloth ◽

Diama Vale ◽

Marcelo Lima ◽

Luiz Zeferino

Keyword(s):

Sexual Intercourse ◽

Prevalence Ratio ◽

Low Grade ◽

High Grade ◽

Squamous Intraepithelial Lesions ◽

First Sexual Intercourse ◽

Squamous Cells ◽

Intraepithelial Lesion ◽

Prevalence Ratios ◽

Intraepithelial Lesions

Objective To evaluate the association of age at first sexual intercourse with the results of the cervicovaginal cytology. Study Design Observational analytical study about the prevalence of altered cervicovaginal cytology results in women aged between 18 and 34 years from a densely populated area in Brazil, during 10 years. The patients were stratified into 2 categories according to their age at first sexual intercourse (13–16 years and 17–24 years). Results From the total of 2,505,154 exams, 898,921 tests were in accordance with the inclusion criteria. Considering women with 4 years or less from the first sexual intercourse as a reference, those with 5 to 9 years and 10 years or more showed a higher prevalence of high-grade squamous intraepithelial lesions (HSILs). Women with an earlier onset of sexual intercourse (13–16 years) showed higher prevalence ratios for atypical squamous cells (ASC), low-grade squamous intraepithelial lesion (LSIL) and HSIL. The prevalence ratio for HSIL adjusted by age at diagnosis and by age at first sexual intercourse was higher only for women with an earlier onset of sexual intercourse. Conclusions The age of first sexual intercourse could be a variable that might qualify the selection among young women who are really at a higher risk for HSIL.

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High-Resolution Anoscopy Targeted Surgical Destruction of Anal High-Grade Squamous Intraepithelial Lesions: A Ten-Year Experience

Diseases of the Colon & Rectum ◽

10.1007/s10350-008-9233-4 ◽

2008 ◽

Vol 51 (6) ◽

pp. 829-837 ◽

Cited By ~ 118

Author(s):

Carlos E. Pineda ◽

J. Michael Berry ◽

Naomi Jay ◽

Joel M. Palefsky ◽

Mark L. Welton

Keyword(s):

High Resolution ◽

High Grade ◽

Squamous Intraepithelial Lesions ◽

Intraepithelial Lesions

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Epidemiological Approach and Precocious Diagnosis of Precancerous Cervical Lesion in Sidi Bel Abbes Region (North-West of Algeria)

Journal of Drug Delivery and Therapeutics ◽

10.22270/jddt.v10i1-s.3887 ◽

2020 ◽

Vol 10 (1-s) ◽

pp. 72-78

Author(s):

Samira Meziani ◽

Khadidja Haoud ◽

Hayet Mehida ◽

Norddine Menadi ◽

Fatima Zohra Chenni ◽

...

Keyword(s):

Cervical Cancer ◽

Pap Smear ◽

Precancerous Lesions ◽

Precancerous Lesion ◽

Public Health Problem ◽

Low Grade ◽

High Grade ◽

Squamous Intraepithelial Lesions ◽

Pathology Laboratory ◽

Intraepithelial Lesions

Object: Cervical cancer of the uterine (CCU) is the first cancer of the genital tract. In Algeria, this cancer remains a real public health problem. The diagnosis is still done often with advanced stages which makes the therapeutic results modest and the cost of the high care. Methodology: Our study aims to elucidate the reality of this type of pathology in the region of Sidi Bel Abbes, northwestern Algeria. This retrospective and descriptive study was devoted to the epidemiological and clinical analysis of cervical cancer cases over a period of 3 years. Results: This study shows that out of a total of 500 smears recorded between (2014-2016) at the Ana-pathology laboratory level in Sidi Bel Abbes, we found that 230 smears presented precancerous lesions according to a cytological study, atypical squamous cells of undetermined significance (ASC-US: were 18%; low-grade squamous intraepithelial lesions (LSIL) were 20%, while high-grade squamous intraepithelial lesions (HSIL) were 8%. The results obtained according to the distribution of the patients in relation to the various factors: the most affected age group is late 46-55 years with a total of 40%; precocious age of 1st report 18-20 years is (38.2%); gestation 4-5 pregnancies and parities 4-5 children with a rate of (38.70% and 32.6%) respectively ; the hormonal state in genital activity is estimated at 62.2%; patients on oral contraception (OC) have a rate of 48.9%. Finally, more than half of the patients (57.8%), were able to have a biopsy within three to four months of the last smear. In histology, the presence of a HPV (Human Papilloma Virus) low grade lesion does not predict the evolution of this lesion. Conclusion: HPV can be oncogenic or non-oncogenic. it is the oncogenic HPV infection that is the main risk factor for developing a high grade lesion and cervical cancers outside the associated cofactors. Keywords: Pap Smear, Precancerous lesion, Cancer, Cervix, Screening

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The CpG island methylator phenotype increases the risk of high-grade squamous intraepithelial lesions and cervical cancer

Clinical Epigenetics ◽

10.1186/s13148-021-01224-0 ◽

2022 ◽

Vol 14 (1) ◽

Author(s):

Jaqueline Loaeza-Loaeza ◽

Berenice Illades-Aguiar ◽

Oscar del Moral-Hernández ◽

Yaneth Castro-Coronel ◽

Marco A. Leyva-Vázquez ◽

...

Keyword(s):

Cervical Cancer ◽

Dna Methylation ◽

Cpg Island ◽

Hpv Infection ◽

Low Grade ◽

High Grade ◽

Squamous Intraepithelial Lesions ◽

Cpg Island Methylator Phenotype ◽

Methylator Phenotype ◽

Intraepithelial Lesions

Abstract Background High-risk human papillomavirus (HR-HPV) infection is the main cause of cervical cancer, but additional alterations are necessary for its development. Abnormal DNA methylation has an important role in the origin and dissemination of cervical cancer and other human tumors. In this work, we analyzed the methylation of eight genes (AJAP1, CDH1, CDH13, MAGI2, MGMT, MYOD1, RASSF1A and SOX17) that participate in several biological processes for the maintenance of cell normality. We analyzed DNA methylation by methylation-specific PCR (MSP) and HPV infection using the INNO‑LiPA genotyping kit in 59 samples diagnostic of normal cervical tissue (non-SIL), 107 low-grade squamous intraepithelial lesions (LSILs), 29 high-grade squamous intraepithelial lesions (HSILs) and 51 cervical cancers (CCs). Results We found that all samples of LSIL, HSIL, and CC were HPV-positive, and the genotypes with higher frequencies were 16, 18, 51 and 56. In general, the genes analyzed displayed a significant tendency toward an increase in methylation levels according to increasing cervical lesion severity, except for the CDH13 gene. High CpG island methylator phenotype (CIMP) was associated with a 50.6-fold (95% CI 4.72–2267.3)-increased risk of HSIL and a 122-fold risk of CC (95% CI 10.04–5349.7). Conclusions We found that CIMP high was significantly associated with HSIL and CC risk. These results could indicate that CIMP together with HR-HPV infection and other factors participates in the development of HSIL and CC.

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