Correlation of endocervical curettage with subsequent cone biopsy in the investigation of abnormal cervical cytology

1991 ◽  
Vol 1 (3) ◽  
pp. 97-103
Author(s):  
C. Y. Takami ◽  
R. K. Nieberg ◽  
J. S. Berek
Keyword(s):  
Medical Center ◽  
Premenopausal Women ◽  
Diagnostic Value ◽  
Cervical Cytology ◽  
Low Grade ◽  
High Grade ◽  
Abnormal Cytology ◽  
Abnormal Cervical Cytology ◽  
Cone Biopsy ◽  
Premenopausal Patients

Endocervical curettage and cone biopsy found no high-grade intraepithelial lesions in premenopausal women who had a satisfactory colposcopic evaluation with low-grade cytology and exocervical biopsies.A retrospective analysis was performed of patients who underwent cervical cone biopsy to investigate an abnormal cytology. The histology of the cone was compared with the cervical cytology and the ectocervical biopsies. Over a 6-year period, 346 cone biopsies were performed at the UCLA Medical Center. Of these, 338 cone specimens were available for review, 279 had complete colposcopic records, and 227 had both an endocervical curettage and ectocervical biopsy. No premenopausal patients with low-grade cytology, satisfactory colposcopy and a low grade lesion on ectocervical biopsy subsequently had a high-grade lesion or invasive cancer on the cervical cone biopsy. Thus, in these patients the endocervical curettage did not prove to be of diagnostic value. In contrast, five patients with high-grade cytology, satisfactory colposcopy and low-grade ectocervical lesions had positive endocervical curettages and high-grade lesions on cone biopsy. These data suggest that selective use of endocervical curettage in premenopausal patients with satisfactory colposcopy can be based on whether the cytology is low grade or high grade. In premenopausal patients with low-grade cytology and satisfactory colposcopy, endocervical curettage can be omitted, while any patient who has a high-grade cytology should have an endocervical curettage.

scholarly journals Management of Abnormal Cervical Cytology: Atypical Squamous Cells of Undetermined Significance (ASC-US) and Atypical Squamous Cells cannot exclude High Grade Intraepithelial Lesion (ASC-H)

2016 ◽  
pp. 166-170
Author(s):  
Fitriyadi Kusuma ◽  
Mediana S. Liedapraja
Keyword(s):  
Cervical Cytology ◽  
Low Grade ◽  
High Grade ◽  
Cervical Lesions ◽  
Squamous Cells ◽  
Abnormal Cervical Cytology ◽  
Definitive Therapy ◽  
Intraepithelial Lesion ◽  
Precancerous Cervical Lesions ◽  
Undetermined Significance

Objective: To review for the management of abnormal cervical cytology: atypical squamous cells of undetermined significance (ASCUS) and atypical squamous cells cannot exclude high-grade intraepithelial lesion (ASC-H) as a treatment of cervical precancerous lesions in order to avoidexcessive treatment, reduce of unnecessary examinations and to provide cost effectively. Method: Literature study on published literatures and studies about the management of cervical cytology. Conclusion: The results of ASC-US cervical cytology and ASC-H is aninitial screening to detect precancerous cervical lesions. Definitive therapy should be done when finding a low-grade lesions (LSIL) and high degree of lesion(HSIL) squamous intraepithelial. A clinician expected to understand the natural history of HPV infection and the management of precancerous cervical lesions properly. [Indones J Obstet Gynecol 2013; 37-3: 166-170] Keywords: ASC-H, ASC-US, cervical cytology abnormalities, cervical precancerous lesion.

scholarly journals The PapilloCheck Assay for Detection of High-Grade Cervical Intraepithelial Neoplasia

2015 ◽  
Vol 53 (11) ◽  
pp. 3553-3559 ◽  
Author(s):  
Emma J. Crosbie ◽  
Andrew Bailey ◽  
Alex Sargent ◽  
Clare Gilham ◽  
Julian Peto ◽  
...  
Keyword(s):  
Cervical Intraepithelial Neoplasia ◽  
Cervical Screening ◽  
Intraepithelial Neoplasia ◽  
Relative Sensitivity ◽  
Population Based ◽  
Cervical Cytology ◽  
Low Grade ◽  
High Grade ◽  
Abnormal Cytology ◽  
Normal Cytology

Human papillomavirus (HPV) testing is used in primary cervical screening, as an adjunct to cervical cytology for the management of low grade abnormal cytology, and in a test of cure. PapilloCheck (Greiner Bio-One) is a PCR-based DNA microarray system that can individually identify 24 HPV types, including the 13 high-risk (HR) types identified by Hybrid Capture 2 (HC2). Here, we compare PapilloCheck with HC2 for the detection of high-grade cervical intraepithelial neoplasia (CIN2+) in a total of 8,610 cervical cytology samples from the ARTISTIC population-based cervical screening study. We performed a retrospective analysis of 3,518 cytology samples from round 1 ARTISTIC enriched for underlying CIN2+ (n= 723) and a prospective analysis of 5,092 samples from round 3 ARTISTIC. Discrepant results were tested using the Roche reverse line blot (RLB) or Linear Array (LA) assay. The relative sensitivity and specificity of HR PapilloCheck compared with that of HC2 for the detection of CIN2+ in women aged over 30 years were 0.94 (95% confidence interval [CI], 0.91, 0.97) and 1.05 (95% CI, 1.04, 1.05), respectively. HC2 missed 44/672 (7%) CIN2+ lesions, while HR PapilloCheck missed 74/672 (11%) CIN2+ lesions. Thirty-six percent of HC2-positive normal cytology samples were HR HPV negative by both PapilloCheck and RLB/LA, indicating that the use of HR PapilloCheck rather than HC2 in population-based primary screening would reduce the number of additional tests required (e.g., reflex cytology) in women where underlying CIN2+ is extremely unlikely. HR PapilloCheck could be a suitable HPV detection assay for use in the cervical screening setting.

Cervical cytologic abnormalities and negative colposcopy: histologic assessment

1994 ◽  
Vol 4 (5) ◽  
pp. 348-351 ◽  
Author(s):  
R. Chenoy ◽  
S. Manohar ◽  
C. W.E. Redman ◽  
D. M. Luesley
Keyword(s):  
Cervical Cytology ◽  
Histologic Diagnosis ◽  
Abnormal Cervical Cytology ◽  
Accurate Definition ◽  
Cone Biopsy ◽  
Histologic Evaluation ◽  
Simple Regression Analysis ◽  
Definition Of ◽  
Cytologic Abnormalities ◽  
Intraepithelial Lesions

Colposcopic assessment may be normal in the presence of severe or persistent minor cytologic abnormality. To assess the significance of negative satisfactory colposcopy in patients with abnormal cervical smears, a retrospective review was carried out on 1170 patients who had undergone out-patient loop diathermy excision for abnormal cervical cytology. Of these, 69 patients were treated for abnormal cervical cytology, despite normal colposcopic findings. Cytologic abnormalities ranged from persistent borderline changes to severe dyskariosis. Histologic assessment of the excision specimens revealed cervical intraepithalial neoplasia (CIN) in 43 (62.3%) cases, of which high-grade CIN accounted for 24 (34.8%) cases. There was good correlation between cytologic and histologic diagnosis. Simple regression analysis showedr= 0.46,P< 0.0001. The cytologic abnormality was highly predictive of the corresponding histologic diagnosis. This analysis has shown that significant intraepithelial lesions may exist despite negative colposcopic examination and highlights the need for histologic evaluation in such cases. In these circumstances, loop cone biopsy permits accurate definition of lesion severity, avoids potential undertreatment of significant lesions and causes less morbidity than conventional cone biopsy.

scholarly journals Prevalence of abnormal cervical cytology and HPV DNA positivity among HIV positive women

2019 ◽  
Vol 8 (9) ◽  
pp. 3649
Author(s):  
Sunita Malik ◽  
Supriti Kumari ◽  
Harsha S. Gaikwad ◽  
Archana Mishra ◽  
Mausumi Bharadwaj
Keyword(s):  
Hpv Infection ◽  
Cervical Cytology ◽  
Hiv Positive ◽  
Abnormal Cytology ◽  
Cross Sectional ◽  
Hpv Dna ◽  
Hpv Dna Testing ◽  
Abnormal Cervical Cytology ◽  
Hiv Positive Women ◽  
Relationship Of

Background: The relationship among HIV, HPV, and development of CIN is complex and incompletely understood. Present study is undertaken to find out the prevalence and relationship of abnormal cervical cytology and HPV infection in HIV positive women.Methods: This was a cross-sectional, case control study conducted on 95 HIV seropositive and 95 seronegative women. Specimen was collected from the cervix for HPV DNA testing, subtyping and cytology.Results: HPV DNA positivity was higher in seropositive group (18.6% vs. 7.4%). Premalignant conditions were found only in seropositive group. At CD4 count <249 HPV DNA positivity was 53%, at 250-499 the percentage of HPV DNA positivity was 31% and at >500 HPV DNA positivity was 19%.Conclusions: Prevalence of abnormal cytology and HPV DNA positivity is higher amongst HIV positive women and there is an association between HPV DNA positivity with lower CD4 counts. 

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.

Role of magnetic resonance imaging in prediction of chondrosarcoma of bone grade

2021 ◽  
pp. 21-24
Author(s):  
A. V. Fedorova ◽  
N. V. Kochergina ◽  
A. B. Bludov ◽  
I. V. Boulycheva ◽  
E. A. Sushentsov ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Diagnostic Value ◽  
Low Grade ◽  
High Grade ◽  
Resonance Imaging ◽  
Accurate Definition ◽  
Definition Of ◽  
Decisive Rule

Purpose. Determining the diagnostic value of magnetic resonance imaging in the accurate definition of chondrosarcoma of bone grade at the pre-surgery examination. Material and methods. We analyzed examination data (magnetic resonance imaging with no contrast enhancement) of 70 patients with chondrosarcoma (35 patients with low-grade chondrosarcoma and 35 patients with high grade chondrosarcoma). Informative weighted coefficients were determined separately for ‘learning’ and ‘examination’ samples. On the basis of weighted coefficients, the decisive rule was created for differentiation between low-grade and high-grade chondrosarcoma. Results. The sensitivity of the method was 87.0%, specificity was 95.6%, total correct classification was 91.03%. Conclusion. Magnetic resonance imaging is a highly informative method for prediction of chondrosarcoma grade at the pre-surgery examination.

Characteristics of high-risk human papillomavirus infection in women with abnormal cervical cytology: a population-based study in Shanxi Province, China

2019 ◽  
Author(s):  
Li Song ◽  
Yuanjing Lyu ◽  
Ling Ding ◽  
Xiaoxue Li ◽  
Wen Gao ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
High Risk ◽  
Hpv Infection ◽  
Cervical Cytology ◽  
Shanxi Province ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Abnormal Cervical Cytology ◽  
Intraepithelial Lesion

Abstract Background: High-risk human papillomavirus (HR-HPV) infection is widely known as the major cause of cervical intraepithelial neoplasia (CIN) and cervical cancer and it’s characteristics vary greatly in different population. Women with abnormal cervical cytology could increase the risk of cervical cancer, however, HR-HPV infection characteristics in women with abnormal cervical cytology remains unclear. Methods: This study was based on baseline survey of the CIN Cohort established in Shanxi Province, China. A total number of 2300 women with cervical abnormalities were enrolled in this study. All participants gave informed consent and agreed to HPV and thinprepcytologic test (TCT). Each individual completed a questionnaire about characteristics related to HPV infection. Results: The overall prevalence of HR-HPV in 2300 women was 32.0%, and the proportion of single and multiple HR-HPV infections were 70.2% and 29.8% in HR-HPV infection women, respectively. The top five HR-HPV genotypes were ranked as HPV16, HPV58, HPV52, HPV53 and HPV51. The prevalence of HR-HPV in atypical squamous cells of undetermined significance (ASC-US), low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion and above(HSIL+) were 30.8%, 36.5% and 54.9%, respectively, showing an increasing trend with the severity of cervical cytology ( χ 2 trend =13.952; p <0.001). The women aged 35~45 years, with lower education level, less frequency of bathing, multiple gravidity, multiple parity, history of gynecological diseases and premenopausal women were prone to HR-HPV infection. Conclusions: We defined the characteristics related to HR-HPV infection in abnormal cervical cytology women, and provided an insight for the development and deeply research of HPV vaccine.

scholarly journals Prevalence of Chlamydia trachomatis Infection, Serovar Distribution and Co-Infections with Seven High-Risk HPV Types among Italian Women with a Recent History of Abnormal Cervical Cytology

2019 ◽  
Vol 16 (18) ◽  
pp. 3354 ◽  
Author(s):  
Marianna Martinelli ◽  
Rosario Musumeci ◽  
Alberto Rizzo ◽  
Narcisa Muresu ◽  
Andrea Piana ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Screening Program ◽  
Hpv Infection ◽  
Cervical Cytology ◽  
Recent History ◽  
Abnormal Cytology ◽  
Chlamydia Trachomatis Infection ◽  
Hpv Dna ◽  
Abnormal Cervical Cytology ◽  
History Of

Chlamydia trachomatis (Ct) and human papillomavirus (HPV) are the most prevalent sexually transmitted infections throughout the world. Despite the serious complications associated with chronic Ct infections in sexually active women, a screening program is not yet available in Italy. Moreover, HPV/Ct co-infections are also known to occur frequently, increasing the risk of HPV-induced carcinogenesis. The aim of this study was to evaluate the prevalence of Ct infections, the distribution of Ct serovars, and the incidences of Ct/HPV co-infections among women with a recent history of abnormal cervical cytology. Cervical samples were collected from 199 women referred for a gynecological visit following an abnormal Pap test results. All samples were tested for the presence of Ct and HPV DNA using real-time PCR assays; Ct typing of positive samples was performed by PCR–RFLP (restriction fragment length polymorphism) targeting the ompA gene. A high percentage of these women (12.8% and 21.7% with or without abnormal cytology on “retesting”, respectively) were found to be Ct positive. Serovar F was the most prevalent type in Ct positive women, followed by E and K. Ct/HPV co-infections were detected in 7% (14/199) of enrolled women, with HPV-16, HPV-51, and HPV-52 being most frequently identified in co-infections. This study provides new epidemiological data on the prevalence of Ct and associated HPV infection in women with a recent history of abnormal cervical cytology in Italy, where notification of cases is not mandatory.

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