Clinical application of the 2011 IFCPC colposcope terminology

Abstract Background Colposcopy offers an accurate way to the diagnose of cervical precancerous lesions. However, the diagnostic accuracy of colposcopy is unsatisfied. This study was to evaluate colposcopic accuracy according to the 2011 International Federation of Cervical Pathology and Colposcopy (IFCPC) terminology. Methods A retrospective cohort study was performed in 1,838 patients who underwent colposcopy in Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University from October 2013 to April 2018. Using conization or cervical biopsy pathology as the gold standard, the agreement between colposcopic diagnosis and pathologic diagnosis was calculated, and correlations between variables were analyzed. Results As an authoritative and widely used terminology for colposcopy diagnosis, the 2011 IFCPC terminology has certain clinical practicality and diagnostic accuracy. However, some signs such as mosaic, punctation, sharp border, inner border sign and ridge sign had high specificity but unsatisfactory sensitivity, which limited the diagnostic value. Therefore, we discussed the Lugol’s staining, a very common sign in colposcopy, and analyzed the diagnostic significance of bright yellow staining in low-grade squamous intraepithelial lesion (LSIL) and mustard yellow staining in high-grade squamous intraepithelial lesion (HSIL). The results showed that mustard yellow may be a valuable indicator in the diagnosis of HSIL. Conclusion The 2011 IFCPC colposcope terminology has standardized interpretations of the colposcopic findings and improved the accuracy of colposcopy diagnosis. The aceto-white epithelium still has important diagnostic value; however, the value of a few signs is needed to be discussed and new signs are expected to be discovered. Although the significance of Lugol’s staining was diminishing, mustard yellow might be a valuable indicator for the diagnosis of HSIL.

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Clinical application of the 2011 IFCPC colposcope terminology in the era of HPV vaccines

10.21203/rs.3.rs-131820/v1 ◽

2020 ◽

Author(s):

Bei Zhang ◽

Shuhui Hong ◽

Guihui Zhang ◽

Fengnian Rong

Keyword(s):

Diagnostic Accuracy ◽

Precancerous Lesions ◽

High Specificity ◽

Diagnostic Value ◽

World Health ◽

Low Grade ◽

Hpv Vaccines ◽

Squamous Intraepithelial Lesion ◽

Diagnostic Significance ◽

Intraepithelial Lesion

Abstract Background Colposcopy is the conjunction with screening and diagnosis of cervical precancerous lesions. However the diagnostic accuracy of colposcopy is unsatisfied. This study was to evaluate colposcopic accuracy according to the 2011 International Federation of Cervical Pathology and Colposcopy (IFCPC) terminology.Methods A retrospective cohort study was performed in 1,838 patients who underwent colposcopy in Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University from October 2013 to April 2018. Using conization or cervical biopsy pathology as the gold standard, the agreement between colposcopic diagnosis and pathologic diagnosis was calculated, and correlations between variables were analyzed. Results As an authoritative and widely used terminology for colposcopy diagnosis, the 2011 IFCPC terminology has certain clinical practicality and diagnostic accuracy. However, some signs such as mosaic, punctuation, sharp border, inner border sign and ridge sign had high specificity but unsatisfactory sensitivity, which limited the diagnostic value. Therefore, we discussed the Lugol’s staining, a very common sign in colposcopy, and analyzed the diagnostic significance of bright yellow staining in low-grade squamous intraepithelial lesion (LSIL) and mustard yellow staining in high-grade squamous intraepithelial lesion (HSIL). The results showed that mustard yellow may be a valuable indicator in the diagnosis of HSIL. Conclusion With the wide acceptance of human papilloma virus (HPV) vaccines and HPV-based screening, there will be new challenges to accurately identify the signs of non-HPV16 and non-HPV18 infections and of minor lesions using colposcopy. In this study, we provide some recommendations in dealing with these challenges. More clinical research will be needed to further refine colposcopy terminology, improve diagnostic accuracy, and ensure that the World Health Organization’s goal of eliminating cervical cancer worldwide by 2030 is achieved.

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Evaluation of the LC-1000 Flow Cytometry Screening System for Cervical Cancer Screening in Routine Health Checkups

Acta Cytologica ◽

10.1159/000489079 ◽

2018 ◽

Vol 62 (4) ◽

pp. 279-287

Author(s):

Ilyeong Heo ◽

Hyoung-Jung Kwak ◽

Eun-Hee Nah ◽

Seon Cho ◽

Suyoung Kim ◽

...

Keyword(s):

Flow Cytometry ◽

Precancerous Lesions ◽

Cervical Cytology ◽

Proliferation Index ◽

Low Grade ◽

Squamous Intraepithelial Lesion ◽

Normal Cytology ◽

Cervical Precancerous Lesions ◽

Intraepithelial Lesion ◽

Sensitivity Specificity

Objective: This study evaluated the performance of a flow cytometry system (LC-1000) in screening cervical precancerous lesions at routine health checkups. Study design: In total, 928 health examinees were enrolled at 16 health promotion centers in 13 Korean cities between 2016 and 2017. All participants underwent liquid-based cervical cytology and flow cytometry testing to determine the cell proliferation index (CPIx). Results: The positivity rate of the LC-1000 system increased with the severity of the cervical cytology findings (p for trend < 0.001). When low-grade squamous intraepithelial lesion (LSIL) or higher (including LSIL, high-grade squamous intraepithelial lesion [HSIL], and atypical squamous cells without excluding HSIL [ASC-H]) was defined as gold-standard positivity, the sensitivity, specificity, PPV, and NPV of LC-1000 were 75.3% (95% confidence interval [CI], 66.8–83.7), 58.5% (95% CI, 55.2–61.9), 18.1% (95% CI, 14.5–21.8), and 95.1% [95% CI, 93.2–97.0], respectively. The median CPIx increased significantly from normal cytology to HSIL (p < 0.001). The median CPIx was higher in high-risk human papillomavirus (HR-HPV)-positive cases than in HR-HPV-negative cases (0.23 vs. 0.17, p < 0.001), while it did not differ between HR-HPV-positive and HR-HPV-negative cases with normal cytology findings (0.16 vs. 0.16, p = 0.700). Conclusion: The LC-1000 system is potentially useful for screening cervical precancer and cancer, especially when excluding normal or ASC of undetermined significance cases in routinely screened populations.

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PREVALENCE OF HUMAN PAPILLOMAVIRUS GENOTYPES IN LOW AND HIGH GRADE SQUAMOUS INTRAEPITHELIAL LESIONS AT CERVICAL TISSUE

Folia Medica Indonesiana ◽

10.20473/fmi.v53i4.7157 ◽

2017 ◽

Vol 53 (4) ◽

pp. 258

Author(s):

Rizki Eko Prasetyo ◽

Gondo Mastutik ◽

Sjahjenny Mustokoweni

Keyword(s):

Precancerous Lesions ◽

Hpv Infection ◽

Multiple Infection ◽

Single Infection ◽

Low Grade ◽

High Grade ◽

Squamous Intraepithelial Lesion ◽

Cervical Precancerous Lesions ◽

Intraepithelial Lesion ◽

Intraepithelial Lesions

HPV infection is known to cause cervical cancer. This study aimed to identify the variant of HPV genotypes of cervical precancerous lesions from low grade squamous intraepithelial lesion (LSIL) and high grade squamous intraepithelial lesion (HSIL). This was an explorative study using formalin fix paraffin embedded (FFPE) from cervical precancerous lesions at Dr. Soetomo Hospital, Surabaya. DNA was extracted from FFPE and hybridized for HPV genotyping using Ampliquality HPV Type Express kit (AB ANALITICA) by reverse line blot techniques. The results showed that there were variants of HPV genotype in LSIL. The variants were HPV16 (8/15), HPV18 (3/15), HPV52 (1/15), HPV6+31 (1/15), HPV6+18 (1/15), and HPV72+68 (1/15), and in HSIL which were HPV16 (4/10), HPV18 (2/10), HPV59 (1/10), HPV6+45 (1/10), HPV61+26 (1/10), and HPV16+31 (1/10). The characteristics of infection in LSIL were single infection of high-risk (hr) HPV and multiple infection of low-risk (lr)+hr HPV, and in HSIL were single infection of HPVhr, multiple infection of HPVhr+hr and HPVlr+hr. In conclusion, HPV prevalence in cervical precancerous lesions is single infection by HPV16 (48%), HPV18 (20%), HPV52 (4%), HPV59 (4%), and multiple infection by HPV6+31, HPV6+18, HPV6+45, HPV16+31, HPV61+26, HPV72+68 is 4%.

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Separation of Normal and Premalignant Cervical Epithelial Cells Using Confocal Light Absorption and Scattering Spectroscopic MicroscopyEx Vivo

Journal of Biomedicine and Biotechnology ◽

10.1155/2011/214781 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Ling Yang ◽

Wen-Tao Liu ◽

Hao Wu ◽

Cheng Wang ◽

Bo Ping ◽

...

Keyword(s):

Light Absorption ◽

Pap Smear ◽

Precancerous Lesions ◽

Scattered Light ◽

Low Grade ◽

Squamous Intraepithelial Lesion ◽

Cervical Lesions ◽

Pap Smear Test ◽

Intraepithelial Lesion ◽

Cervical Squamous Intraepithelial Lesion

Confocal light absorption and scattering spectroscopic (CLASS) microscopy can detect changes in biochemicals and the morphology of cells. It is therefore used to detect high-grade cervical squamous intraepithelial lesion (HSIL) cells in the diagnosis of premalignant cervical lesions. Forty cervical samples from women with abnormal Pap smear test results were collected, and twenty cases were diagnosed as HSIL; the rest were normal or low-grade cervical squamous intraepithelial lesion (LSIL). The enlarged and condensed nuclei of HSIL cells as viewed under CLASS microscopy were much brighter and bigger than those of non-HSIL cells. Cytological elastic scattered light data was then collected at wavelengths between 400 and 1000 nm. Between 600 nm to 800 nm, the relative elastic scattered light intensity of HSIL cells was higher than that of the non-HSIL. Relative intensity peaks occurred at 700 nm and 800 nm. CLASS sensitivity and specificity results for HSIL and non-HSIL compared to cytology diagnoses were 80% and 90%, respectively. This study demonstrated that CLASS microscopy could effectively detect cervical precancerous lesions. Further study will verify this conclusion before the method is used in clinic for early detection of cervical cancer.

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Clinical study on primary screening of oral cancer and precancerous lesions by oral cytology

Diagnostic Pathology ◽

10.1186/s13000-020-01027-6 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Shintaro Sukegawa ◽

Sawako Ono ◽

Keisuke Nakano ◽

Kiyofumi Takabatake ◽

Hotaka Kawai ◽

...

Keyword(s):

False Positive ◽

Precancerous Lesions ◽

False Positive Rate ◽

False Negative ◽

False Negative Rate ◽

Clinical Findings ◽

Low Grade ◽

Severe Dysplasia ◽

Squamous Intraepithelial Lesion ◽

Intraepithelial Lesion

Abstract Background This study was conducted to compare the histological diagnostic accuracy of conventional oral-based cytology and liquid-based cytology (LBC) methods. Methods Histological diagnoses of 251 cases were classified as negative (no malignancy lesion, inflammation, or mild/moderate dysplasia) and positive [severe dysplasia/carcinoma in situ (CIS) and squamous cell carcinoma (SCC)]. Cytological diagnoses were classified as negative for intraepithelial lesion or malignancy (NILM), oral low-grade squamous intraepithelial lesion (OLSIL), oral high-grade squamous intraepithelial lesion (OHSIL), or SCC. Cytological diagnostic results were compared with histology results. Results Of NILM cytology cases, the most frequent case was negative [LBC n = 50 (90.9%), conventional n = 22 (95.7%)]. Among OLSIL cytodiagnoses, the most common was negative (LBC n = 34; 75.6%, conventional n = 14; 70.0%). Among OHSIL cytodiagnoses (LBC n = 51, conventional n = 23), SCC was the most frequent (LBC n = 31; 60.8%, conventional n = 7; 30.4%). Negative cases were common (LBC n = 13; 25.5%, conventional n = 14; 60.9%). Among SCC cytodiagnoses SCC was the most common (LBC n = 16; 88.9%, conventional n = 14; 87.5%). Regarding the diagnostic results of cytology, assuming OHSIL and SCC as cytologically positive, the LBC method/conventional method showed a sensitivity of 79.4%/76.7%, specificity of 85.1%/69.2%, false-positive rate of 14.9%/30.7%, and false-negative rate of 20.6%/23.3%. Conclusions LBC method was superior to conventional cytodiagnosis methods. It was especially superior for OLSIL and OHSIL. Because of the false-positive and false-negative cytodiagnoses, it is necessary to make a comprehensive diagnosis considering the clinical findings.

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Clinical study on primary screening of oral cancer and precancerous lesions by oral cytology

10.21203/rs.3.rs-34875/v2 ◽

2020 ◽

Author(s):

Shintaro Sukegawa ◽

Sawako Ono ◽

Keisuke Nakano ◽

Kiyofumi Takabatake ◽

Hotaka Kawai ◽

...

Keyword(s):

False Positive ◽

Precancerous Lesions ◽

False Positive Rate ◽

False Negative ◽

False Negative Rate ◽

Clinical Findings ◽

Low Grade ◽

Severe Dysplasia ◽

Squamous Intraepithelial Lesion ◽

Intraepithelial Lesion

Abstract BackgroundThis study was conducted to compare the histological diagnostic accuracy of conventional oral-based cytology and liquid-based cytology (LBC) methods.MethodsHistological diagnoses of 251 cases were classified as negative (no malignancy lesion, inflammation, or mild/moderate dysplasia) and positive [severe dysplasia/carcinoma in situ (CIS) and squamous cell carcinoma (SCC)]. Cytological diagnoses were classified as negative for intraepithelial lesion or malignancy (NILM), oral low-grade squamous intraepithelial lesion (OLSIL), oral high-grade squamous intraepithelial lesion (OHSIL), or SCC. Cytological diagnostic results were compared with histology results.ResultsOf NILM cytology cases, the most frequent case was negative [LBC n = 50 (90.9%), conventional n = 22 (95.7%)]. Among OLSIL cytodiagnoses, the most common was negative (LBC n = 34; 75.6%, conventional n = 14; 70.0%). Among OHSIL cytodiagnoses (LBC n = 51, conventional n = 23), SCC was the most frequent (LBC n = 31; 60.8%, conventional n = 7; 30.4%). Negative cases were common (LBC n = 13; 25.5%, conventional n = 14; 60.9%). Among SCC cytodiagnoses SCC was the most common (LBC n = 16; 88.9%, conventional n = 14; 87.5%). Regarding the diagnostic results of cytology, assuming OHSIL and SCC as cytologically positive, the LBC method/conventional method showed a sensitivity of 79.4%/76.7%, specificity of 85.1%/69.2%, false-positive rate of 14.9%/30.7%, and false-negative rate of 20.6%/23.3%.ConclusionsLBC method was superior to conventional cytodiagnosis methods. It was especially superior for OLSIL and OHSIL. Because of the false-positive and false-negative cytodiagnoses, it is necessary to make a comprehensive diagnosis considering the clinical findings.

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Clinical study on primary screening of oral cancer and precancerous lesions by oral cytology

10.21203/rs.3.rs-34875/v1 ◽

2020 ◽

Author(s):

Shintaro Sukegawa ◽

Sawako Ono ◽

Keisuke Nakano ◽

Kiyofumi Takabatake ◽

Hotaka Kawai ◽

...

Keyword(s):

Conventional Method ◽

False Positive ◽

Precancerous Lesions ◽

False Positive Rate ◽

False Negative ◽

False Negative Rate ◽

Intraepithelial Neoplasia ◽

Low Grade ◽

Squamous Intraepithelial Lesion ◽

Intraepithelial Lesion

Abstract Background This study was conducted to compare histological diagnostic accuracy between conventional method and liquid-based cytology (LBC) method and to clarify the effectiveness of cytology. Methods Histological diagnoses of 251 cases were classified as negative (no malignancy lesion, inflammation, and mild/moderate dysplasia) and positive [oral intraepithelial neoplasia/carcinoma in situ (OIN/CIS) and squamous cell carcinoma (SCC)]. Cytological diagnoses were classified as negative for intraepithelial lesion or malignancy (NILM), oral low-grade squamous intraepithelial lesion (OLSIL), oral high-grade squamous intraepithelial lesion (OHSIL), or SCC. Cytological diagnostic results were compared with histology results. Results Of NILM cytology cases, the most frequent case was negative [LBC n = 50 (90.9%), conventional n = 22 (95.7%)]. Among OLSIL cytodiagnoses, the most common was negative (LBC n = 34; 75.6%, conventional n = 14; 70.0%). Among OHSIL cytodiagnoses (LBC n = 51, conventional n = 23), SCC was the most frequent (LBC n = 31; 60.8%, conventional n = 7; 30.4%). Negative cases were common (LBC n = 13; 25.5%, conventional n = 14; 60.9%). Among SCC cytodiagnoses SCC was the most common (LBC n = 16; 88.9%, conventional n = 14; 87.5%). Regarding the diagnostic results of cytology, assuming HSIL and SCC as cytologically positive, the LBC method/conventional method showed a sensitivity of 79.4%/76.7%, specificity of 85.1%/69.2%, false positive rate of 14.9%/30.7%, and false negative rate of 20.6%/23.3%. Conclusions LBC method was superior to conventional method in cytodiagnosis. It was especially superior for LSIL and HSIL. Because of the false positive and false negative cytodiagnoses, it is necessary to make a comprehensive diagnosis considering the clinical findings.

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Value of Nucleolar Organizer Regions count in cervical pathology

Journal of Pathology of Nepal ◽

10.3126/jpn.v2i3.6017 ◽

1970 ◽

Vol 2 (3) ◽

pp. 180-185

Author(s):

Shiva Raj KC ◽

OP Talwar

Keyword(s):

Precancerous Lesions ◽

Squamous Metaplasia ◽

Nucleolar Organizer Regions ◽

Pap Smears ◽

Low Grade ◽

High Grade ◽

Squamous Intraepithelial Lesion ◽

Significant Difference ◽

Intraepithelial Lesion ◽

Intraepithelial Lesions

Background: ‘AgNOR’ represents Nucleolar Organiser Regions stained with silver which are related to cell proliferation rate and tumor malignant potential. The objective of this study was to evaluate the role of AgNOR in differentiating benign and precancerous lesions from cancerous lesions in both cervical smears and histology. Materials and Methods: This was a prospective study conducted at Manipal Teaching Hospital, from July 2005 to June 2007. Women of suspected cervical pathology and who underwent pap smears test followed by subsequent biopsy were included. There were 53 cases were included out of which 11 cases were of high grade squamous intraepithelial lesion and 12 cases of low grade squamous intraepithelial lesion, and 10 cases each of carcinoma, chronic cervicitis with and without squamous metaplasia. Results: In Low grade squamous intraepithelial lesion meanAgNOR dots was < (2.9 in pap smears and 1.9 in histology) in high grade lesion (3.45 in pap smears and 3.00 in histology). In carcinoma meanAgNOR dots was 5.18 and 4.05 in pap smears and histology respectively. Subjective AgNOR Pattern Assessment in pap smears and in histology was increasing with significant difference from intraepithelial lesions to carcinoma. Conclusion: In cervical pathology, the number and shape of AgNOR dots change from benign to precancerous to malignant tumors. Similarly, AgNOR Pattern Assessment is useful in differentiating benign to intraepithelial lesions to carcinoma cases. DOI: http://dx.doi.org/10.3126/jpn.v2i3.6017 JPN 2012; 2(3): 180-185

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A retrospective analysis of cervical smears for detection of precancerous lesions

Journal of Pathology of Nepal ◽

10.3126/jpn.v5i10.15641 ◽

2015 ◽

Vol 5 (10) ◽

pp. 847-849

Author(s):

A Jha ◽

AK Chaurasia

Keyword(s):

Squamous Cell Carcinoma ◽

Epithelial Cell ◽

Cell Carcinoma ◽

Squamous Cell ◽

Precancerous Lesions ◽

Low Grade ◽

Squamous Intraepithelial Lesion ◽

Cervical Smears ◽

Neoplastic Lesions ◽

Intraepithelial Lesion

Background: Diseases of the cervix are common in women. Detection of neoplastic lesions is of prime importance in the evaluation of cervical smears although their frequency is less than the non-neoplastic conditions. Reactive and inflammatory conditions, however, may mimic or obscure the dysplastic changes. The aim of this study was to evaluate the frequencies of various inflammatory, reactive and neoplastic lesions in the cervical smears.Materials and Methods: This was a retrospective study of 150 cases of cervical smears collected from medical record section of the hospital and Department of Pathology at National Medical College from April 2013 to April 2015.Results: Of 150 patients who underwent cervical cytology, only 15 cases (10%) had epithelial cell abnormalities. This was followed by reactive cellular changes associated with inflammation (16.7%), infections (5.3%) and atrophy (1.3%). Low grade squamous intraepithelial lesion (6%) was the most common epithelial cell abnormality followed by high grade squamous intraepithelial lesion (2%), atypical glandular cells (1.3%) and squamous cell carcinoma (0.7%).Conclusion: Reactive changes including atrophy were the commonest finding. Squamous intraepithelial lesion was commonest finding among epithelial abnormalities. Glandular intraepithelial lesions and squamous cell carcinoma were also identified. Among infections Trichomoniasis and candidiasis were seen.

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