The reporting of anal cytology and histology samples: establishing terminology and criteria

Sexual Health ◽  
2012 ◽  
Vol 9 (6) ◽  
pp. 562 ◽  
Author(s):  
Jennifer Margaret Roberts ◽  
Deborah Ekman
Keyword(s):  
Reporting System ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Classification Systems ◽  
Low Grade ◽  
Evidence Based ◽  
High Grade ◽  
Anal Neoplasia ◽  
Anal Cytology ◽  
Bethesda System

Our understanding of the human papillomavirus (HPV) related cytomorphology and histopathology of the anal canal is underpinned by our knowledge of HPV infection in the cervix. In this review, we utilise cervical reporting of cytological and histological specimens as a foundation for the development of standardised and evidence-based terminology and criteria for reporting of anal specimens. We advocate use of the Australian Modified Bethesda System 2004 for reporting anal cytology. We propose the use of a two-tiered histological reporting system for noninvasive disease – low-grade and high-grade anal intraepithelial neoplasia. These classification systems reflect current understanding of the biology of HPV and enhance diagnostic reproducibility. Biomarkers such as p16INK4A may prove useful in further improving diagnostic accuracy. Standardisation is important because it will increase the value of the data collected as Australian centres develop programs for screening for anal neoplasia.

The Role of Early Colposcopy in the Management of Females with First Episode Anogenital Warts

1994 ◽  
Vol 5 (5) ◽  
pp. 343-345 ◽  
Author(s):  
K A Ward ◽  
J R Houston ◽  
B E Lowry ◽  
R D Maw ◽  
W W Dinsmore
Keyword(s):  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Cervical Cytology ◽  
First Episode ◽  
Low Grade ◽  
High Grade ◽  
Anogenital Warts ◽  
Cervical Smear ◽  
Cervical Lesions ◽  
Increased Risk

212 females attending a genitourinary medicine (GUM) clinic with first episode anogenital warts were screened by cervical cytology and colposcopy/histology for the presence of cervical epithelial abnormalities in keeping with infection by the human papillomavirus (HPV infection) and/or cervical intraepithelial neoplasia (CIN). The prevalence of cervical epithelial abnormalities detected by cervical cytology alone was 32%, rising to 56% after colposcopic examination. However, the majority of cervical lesions detected by colposcopy alone were of low grade (HPV infection and/or CIN I). Histologically confirmed high grade cervical lesions (CIN II or CIN III) were detected more frequently in those females in whom cervical cytological examination indicated dyskaryosis in keeping with any grade of CIN, compared to females without dyskaryotic changes on cervical smear ( P<0.05, chi-squared test with Yates' correction). Early colposcopy is indicated for females with anogenital warts in the presence of a cervical smear showing dyskaryosis in keeping with any grade of CIN, because of the statistically significant increased risk of detecting a potentially progressive high grade cervical lesion. In females without dyskaryotic changes on cervical smear, the value of early colposcopy is uncertain and warrants larger more long-term trials.

scholarly journals Triage of human papillomavirus infected women by methylation analysis in first-void urine

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Severien Van Keer ◽  
Annina P. van Splunter ◽  
Jade Pattyn ◽  
Annemie De Smet ◽  
Sereina A. Herzog ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Host Cell ◽  
Intraepithelial Neoplasia ◽  
Underlying Disease ◽  
Hpv Infection ◽  
Molecular Testing ◽  
High Grade ◽  
Methylation Analysis ◽  
Hpv Dna ◽  
Screening Attendance

AbstractHost cell DNA methylation analysis in urine provides promising triage markers for women diagnosed with a high-risk (HR) human papillomavirus (HPV) infection. In this study, we have investigated a panel of six host cell methylation markers (GHSR, SST, ZIC1, ASCL1, LHX8, ST6GALNAC5) in cervicovaginal secretions collected within the first part of the urine void (FVU) from a referral population. Cytology, histology, and HPV DNA genotyping results on paired FVU and cervical samples were available. Urinary median methylation levels from HR-HPV (n = 93) positive women were found to increase for all markers with severity of underlying disease. Significantly elevated levels were observed for GHSR and LHX8 in relation to high-grade cervical intraepithelial neoplasia (CIN2 +; n = 33), with area under de curve values of 0.80 (95% Confidence Interval (CI) 0.59–0.92) and 0.76 (95% CI 0.58–0.89), respectively. These findings are the first to support the assertion that methylation analysis of host cell genes is feasible in FVU and holds promise as molecular, triage strategy to discern low- from high-grade cervical disease in HR-HPV positive women. Molecular testing on FVU may serve to increase cervical cancer screening attendance in hard-to-reach populations whilst reducing loss to follow-up and await further optimization and validation studies.

Vroegtijdige opsporing van voorstadia van een anaal carcinoom bij hiv-seropositieve patiënten

2021 ◽  
Author(s):  
E. GÖKCE ◽  
J. GELDOF ◽  
P. ROELANDT ◽  
J. VAN DORPE ◽  
S. CALLENS ◽  
...  
Keyword(s):  
Anal Cancer ◽  
Digital Rectal Examination ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
High Grade ◽  
Anal Squamous Cell Carcinoma ◽  
Increased Risk ◽  
High Prevalence ◽  
Risk Patients ◽  
Hiv Seropositive

Early detection of precursor lesions of anal cancer in HIV-seropositive patients Although anal cancer is rare in the overall population, its incidence is increasing in the last decades. Especially HIV-seropositive patients have an increased risk of developing anal squamous cell carcinoma (SCC), mainly because of the high prevalence of high-grade anal intraepithelial neoplasia (AIN) among these patients. High-grade AIN is a precursor lesion for anal SCC associated with human papillomavirus (HPV) infection. Despite the lack of direct evidence demonstrating that AIN identification reduces the risk of anal cancer, experts think that screening and treatment of high-risk patients will prevent the disease. This article aims to review the current literature about AIN and discusses the screening options, including digital rectal examination, anal cytology and high-resolution anoscopy.

scholarly journals HPV-16 E7-Specific Cellular Immune Response in Women With Cervical Intraepithelial Lesion Contributes to Viral Clearance: A Cross-Sectional and Longitudinal Clinical Study

2022 ◽  
Vol 12 ◽  
Author(s):  
Lina Zhang ◽  
Xinyi Shi ◽  
Qing Zhang ◽  
Zhilei Mao ◽  
Xiaoyu Shi ◽  
...  
Keyword(s):  
T Cell ◽  
Cell Response ◽  
Hpv Infection ◽  
T Cell Response ◽  
Viral Clearance ◽  
Low Grade ◽  
High Grade ◽  
Cross Sectional ◽  
Intraepithelial Lesion ◽  
Longitudinal Clinical Study

High-risk human papillomavirus (HPV) infection is the cause of almost all cervical cancers. HPV16 is one of the main risk subtypes. Although screening programs have greatly reduced the prevalence of cervical cancer in developed countries, current diagnostic tests cannot predict if mild lesions may progress into invasive lesions or not. In the current cross-sectional and longitudinal clinical study, we found that the HPV16 E7-specific T cell response in peripheral blood mononuclear cells of HPV16-infected patients is related to HPV16 clearance. It contributes to protecting the squamous interaepithelial lesion (SIL) from further malignant development. Of the HPV16 infected women enrolled (n = 131), 42 had neither intraepithelial lesion nor malignancy (NILM), 33 had low-grade SIL, 39 had high-grade SIL, and 17 had cervical cancer. Only one of 17 (5.9%) cancer patients had a positive HPV16 E7-specific T cell response, dramatically lower than the groups of precancer patients. After one year of follow-up, most women (28/33, 84.8%) with persistent HPV infection did not exhibit a HPV16 E7-specific T cell response. Furthermore, 3 malignantly progressed women, one progressed to high-grade SIL and two progressed to low-grade SIL, were negative to the HPV16 E7-specific T cell response. None of the patients with a positive HPV16 E7-specific T cell response progressed to further deterioration. Our observation suggests that HPV16 E7-specific T cell immunity is significant in viral clearance and contributes in protection against progression to malignancy.

scholarly journals INCIDENCE AND CLINICAL SIGNIFICANCE OF HIGH GRADE PROSTATIC INTRAEPITHELIAL NEOPLASIA IN TURP SPECIFIMENS

2020 ◽  
pp. 1-5
Author(s):  
B. Pavan Kumar ◽  
Imran Ali ◽  
Anwar Miya ◽  
Kishan Kishan
Keyword(s):  
Diagnostic Criteria ◽  
Prostatic Carcinoma ◽  
Invasive Carcinoma ◽  
Clinical Presentation ◽  
Intraepithelial Neoplasia ◽  
Diagnostic Techniques ◽  
Transurethral Resection Of Prostate ◽  
Low Grade ◽  
High Grade ◽  
Precancerous Condition

BACKGROUND : PIN is a well known precancerous condition of prostatic carcinoma. Transurethral resection of prostate has become the most prominent and the easiest way, to morphologically evaluate lesions of PIN. But clinicians are sometimes confused by the grading that is given in the report. So there is a need to define the diagnostic criteria and differential diagnosis of PIN using newer diagnostic techniques to assist in the better diagnosis and grading. AIMS AND OBJECTIVES: To evaluate whether the diagnostic criteria can be defined PIN and using newer techniques for PIN grading to improve the clinical management of patients with prostatic lesions. MATERIALS AND METHODS: This study will be done in the Department of Pathology MGM Hospitals, Warangal for a period of 2 years and includes consecutive cases of TURP specimens from the patients who present with obstructive symptoms as a major clinical presentation and correlated with PSA levels. INCLULSION CRITERIA: Patients who present with obstructive symptoms as a major clinical presentation. RESULTS: 1.160 cases of TURP specimens were studied out of which 53 (33.12%) cases are PIN. BPH -78 (48/74%), PC-15 (9.37%), SM-14 (8.75%) 2. Majority cases are low grade PIN 34 out of 53 cases (21.25%) High Grade PIN 19 out of 53cases. (11.87%) 3. High Grade PIN and prostatic Carcinoma shared increased incidence and severity with advancing age in the study. Majority of HG PIN cases in our study noted in (70-79 years of age) 4. The risk of carcinoma is more in cases of High Grade PIN (68.42%) than in low grade PIN (17.64%) 5. This warrants are need for repeat prostatic biopsies to diagnose the invasive carcinoma in patient with High grade PIN.

scholarly journals Photodynamic Therapy for Low-grade Cervical Intraepithelial Neoplasia (CIN1): A Case Report

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Yinyin Zhang ◽  
Hong Lin ◽  
Huizhen Fan
Keyword(s):  
Photodynamic Therapy ◽  
Cervical Intraepithelial Neoplasia ◽  
Persistent Infection ◽  
Precancerous Lesions ◽  
Irradiation Time ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Cervical Canal ◽  
Low Grade ◽  
Oxygen Inhalation

As a drug-mechanical combination technology, photodynamic (PDT) can achieve accurate and targeted therapy for malignant tumors and benign diseases through the production of reactive oxygen species, oxygen free radicals or singlet oxygen by photosensitizers at specific wavelengths. Compared with traditional surgery, it has the advantages of selective killing, repeatable treatment, preserving target organ function and so on. The purpose of this study was to explore the clinical value of photodynamic therapy in cervical precancerous lesions by taking the patients with low-grade cervical intraepithelial neoplasia (CIN1) with high-risk human papillomavirus (HR-HPV) persistent infection diagnosed by "three-step diagnosis and treatment procedure" as an example. Using HiPorfin as a photosensitizer, photodynamic therapy was performed 48 hours after intravenous drip. Set laser wavelength 630nm, light dose density 137.58J/cm2, transmission efficiency 1.42, output power 2w. 3cm columnar optical fiber was placed around the 2cm in the cervical canal to cover all the lesions, and the irradiation time was 900s (600s in the cervical canal and 300s outside the cervical canal). The patients were given oxygen inhalation for 6 hours after operation, and the patients were observed for itching and other discomfort, and paid attention to avoid light. Photodynamic therapy was performed again in the same way on the second day. After two months of treatment, pathological biopsy showed chronic cervicitis, indicating that the disease had been effectively controlled. Theoretically, although the patient is not the absolute indication of photodynamic therapy (that is, meeting CIN ? or CIN ?, having fertility requirements and not undergoing surgery), this therapy can remove not only the superficial lesions inside and outside the cervix, but also the potential lesions not found under colposcopy. It can also block the persistent infection of HPV by inhibiting the expression of HPV18, E6 and E7mRNA in Hela cells. In combination with Baofukang suppository, it can block HPV infection. Increase the negative conversion rate of cervical HPV and reduce the probability of recurrence after CIN1 cure. For young female patients with persistent HR-HPV infection and fertility requirements, photodynamic therapy is an effective choice for clinical treatment of CIN1.

scholarly journals Abnormal colposcopic images in patients with preinvasive cervical lesions

2013 ◽  
Vol 3 (2) ◽  
pp. 98-102
Author(s):  
Adnan Babović ◽  
Dženita Ljuca ◽  
Gordana Bogdanović ◽  
Lejla Muminhodžić
Keyword(s):  
Intraepithelial Neoplasia ◽  
Control Group ◽  
Low Grade ◽  
High Grade ◽  
Cervical Lesions ◽  
Cytological Examination ◽  
Chi Square ◽  
Chi Square Test ◽  
Intraepithelial Lesion ◽  
Experimental Group

Introduction: The objective of the study was to determine frequency and to compare frequency of the abnormal colposcopic images in patients with low and high grade pre-invasive lesions of cervix.Methods: Study includes 259 patients, whom colposcopic and cytological examination of cervix was done. The experimental group of patients consisted of patents with pre-invasive low grade squamousintraepithelial lesion (LSIL) and high grade squamous intraepithelial lesion (HSIL), and the control group consisted of patients without cervical intraepithelial neoplasia (CIN).Results: In comparison to the total number of satisfactory fi ndings (N=259), pathological findings were registered in N=113 (43.6 %) and abnormal colposcopic fi ndings in N=128 (49.4%). The study did notinclude patients with unsatisfactory fi nding N=22 (8.5%). Abnormal colposcopic image is present most frequently in older patients but there are no statistically important difference between age categories(Pearson Chi-Square 0.47, df -3, p=0.923). Frequency of abnormal colposcopic fi ndings (N=128) is the biggest in pathological cytological (N=113) and HSIL 58 (45.3%), LSIL 36 (28.1%). There is statisticallysignifi cant difference in frequency of abnormal colposcopic images in patients with low-grade in comparison to patients with high-grade pre-invasive cervix lesions (Chi-Square test, Pearson Chi-Square 117.14,df-12 p<0.0001).Conclusion: Thanks to characteristic colposcopic images, abnormal epithelium is successfully recognized, but the severity grade of intraepithelial lesion cannot be determined.

scholarly journals Comparison of 2 Anal Cytology Protocols to Predict High-Grade Anal Intraepithelial Neoplasia

2013 ◽  
Vol 17 (4) ◽  
pp. 414-424 ◽  
Author(s):  
Dorothy JoAnn Wiley ◽  
Hilary Hsu ◽  
Robert Bolan ◽  
Alen Voskanian ◽  
David Elashoff ◽  
...  
Keyword(s):  
Intraepithelial Neoplasia ◽  
Anal Intraepithelial Neoplasia ◽  
High Grade ◽  
Anal Cytology
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