scholarly journals Epidemiological and cytological aspects of the cervix in women from the Diourbel region (Senegal) cervical smear screening

2020 ◽  
Vol 9 (11) ◽  
pp. 4356
Author(s):  
Amadou Ndiade ◽  
Ibou Thiam ◽  
Abdou Karim Diallo ◽  
Ange Lucien Diatta ◽  
Fabrice Senghor ◽  
...  
Keyword(s):  
Effective Means ◽  
Epidemiological Data ◽  
Regional Hospital ◽  
Low Grade ◽  
High Grade ◽  
Age Group ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Smear ◽  
Intraepithelial Lesion ◽  
The Mean

Background: Objectives of the study were to record the results of uterine cervical smear tests of women in the Diourbel region to compare epidemiological data with the results of uterine cervical smear tests.Methods: This was a retrospective study of 201 satisfactory cervical smears performed in the period from 01 December 2018 to 01 December 2019 at the laboratory of the regional hospital Henrich Lubcke of Diourbel. All women with a satisfactory smear were included in our study, so we classified patients according to age and parity.Results: The mean age of the patients was 38.41 years with a standard deviation of 11.51 years. The extremes were 15 and 64 years. The age group (30-40 years) was in the majority at 32.34%. Multiparous patients were in the majority, accounting for 43.28%. The cervix was macroscopically healthy in 61.19% of patients and inflammatory in 12.94%. There was 18.41% low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL) accounted for 1% of smears. A statistically significant relationship existed between parity and smear result with p˂0.01.Conclusions: Cervical cancer is one of the most fatal cancers in women and the smear remains the safest and most effective means of prevention.

scholarly journals Comparison between Thin Prep® Preparation (Liquid Based Cytology) and Conventional Pap Smears of Cervical Smear Cytology Lesions – A Study from Kanyakumari, Tamilnadu, India

2021 ◽  
Vol 10 (21) ◽  
pp. 1611-1615
Author(s):  
Premalatha A. ◽  
Velayutham Sumathi
Keyword(s):  
Pap Smear ◽  
Cervical Cytology ◽  
Pap Smears ◽  
Low Grade ◽  
Age Group ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Smear ◽  
Intraepithelial Lesion ◽  
Liquid Based Cytology ◽  
Pap Method

BACKGROUND The major cause of mortality among women is cancer of the uterine cervix. It is the second most common cancer worldwide. Pap smear is done as a method of cervical screening to detect precancerous and cancerous lesions of the cervix. Early detection of these lesions prevent the number of deaths from cervical cancer. Liquid based cervical cytology was developed to improve the diagnostic accuracy of pap smears. The main purpose of this study was to compare the profile of distribution of cervical smear cytology lesions obtained by thin prep preparation (liquid based cytology) and conventional pap method among women in the age group of 25 – 60 yrs. METHODS This is a cross sectional study done among 110 women from the outpatient department of Obstetrics and Gynaecology. Conventional and liquid based cytology smears were taken simultaneously from the same women and reported according to the 2001 Bethesda system. RESULTS Majority of the women included in this study fall in the age group of 41 - 50 years [65 (59.1 %)]. Women with a history of persistant vaginal infection were 13 (11.8 %). Out of the 110 pap smears taken by both conventional and liquid based methods, unsatisfactory smears were not detected in liquid based cytology and 6 (5.5 %) unsatisfactory smears were found in conventional pap method. In liquid based cytology, inflammatory smears were detected more (80 %), atrophic smears (2.7 %), smears with features of atypical squamous cells of undetermined significance (ASCUS) were 4.5 %, low-grade squamous intraepithelial lesion (LSIL) were 3.6 %, and smears with high-grade squamous intraepithelial lesion (HSIL) were 0.9 %. Epithelial cell abnormalities were found to be high in liquid based cytology. CONCLUSIONS Abnormal epithelial lesions were detected more in liquid based cytology (thin prep method). The number of unsatisfactory smears were found to be decreased when compared to conventional pap method. KEY WORDS Bethesda Cervical Cytology, Cervical intraepithelial lesion, Conventional Pap Smear, Liquid Based Cytology Smear

Low Utility in Colposcopy-directed Biopsies for Non-high Grade Cytological Abnormalities on PAP Smear

2020 ◽  
Vol 16 (1) ◽  
pp. 18-22
Author(s):  
Eronmwon E. Gbinigie ◽  
Joshua Fogel ◽  
Maggie Tetrokalashvili
Keyword(s):  
Pap Smear ◽  
Multinomial Logistic Regression ◽  
Cervical Dysplasia ◽  
Outcome Variable ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Intraepithelial Lesion ◽  
Cytologic Abnormalities ◽  
Cytology Screening

Background: Clinicians commonly perform colposcopy directed biopsies on patients with low grade squamous intraepithelial lesion (LSIL) on PAP cytology even when not consistent with clinical guidelines. Objective: We study the association of PAP cytology screening results with cervical intra-epithelia neoplasia (CIN) 2-3 high-grade dysplasia, as confirmed by colposcopy-directed biopsy. Methods: A retrospective study of 263 women with an abnormality on the PAP smear. Multinomial logistic regression was performed with predictors of PAP cytology screening results with the outcome variable of colposcopy-directed biopsy. Results: High grade squamous intraepithelial lesion (HSIL) had significantly increased relative risk for CIN 2-3 (RR: 9.85, 95% CI: 1.84, 52.79, p=0.008). LSIL was not significantly associated with CIN 2-3. In the comparisons of negative with CIN-1, both HSIL and LSIL were not significantly associated with a negative biopsy. Conclusion: HSIL is associated with cervical dysplasia of CIN 2-3 while LSIL is not associated with cervical dysplasia of CIN 2-3. We do not recommend routine biopsies in patients with LSIL cytologic abnormalities unless additional compelling factors exist.

scholarly journals Low-Grade Squamous Intraepithelial Lesion or High-Grade Squamous Intraepithelial Lesion? Concordance Between the Interpretation of Low-Grade Squamous Intraepithelial Lesion and High-Grade Squamous Intraepithelial Lesion in Papanicolaou Tests: Results From the College of American Pathologists PAP Education Program

2018 ◽  
Vol 143 (1) ◽  
pp. 81-85 ◽  
Author(s):  
Barbara A. Crothers ◽  
Mohiedean Ghofrani ◽  
Chengquan Zhao ◽  
Leslie G. Dodd ◽  
Kelly Goodrich ◽  
...  
Keyword(s):  
Education Program ◽  
Repeated Measures ◽  
False Negative ◽  
Misclassification Rate ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Significant Difference ◽  
Intraepithelial Lesion ◽  
Diagnostic Concordance

Context.— Obtaining diagnostic concordance for squamous intraepithelial lesions in cytology can be challenging. Objective.— To determine diagnostic concordance for biopsy-proven low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL) Papanicolaou test slides in the College of American Pathologists PAP Education program. Design.— We analyzed 121 059 responses from 4251 LSIL and HSIL slides for the interval 2004 to 2013 using a nonlinear mixed-model fit for reference diagnosis, preparation type, and participant type. We evaluated interactions between the reference diagnosis and the other 2 factors in addition to a repeated-measures component to adjust for slide-specific performance. Results.— There was a statistically significant difference between misclassification of LSIL (2.4%; 1384 of 57 664) and HSIL (4.4%; 2762 of 63 395). There was no performance difference between pathologists and cytotechnologists for LSIL, but cytotechnologists had a significantly higher HSIL misclassification rate than pathologists (5.5%; 1437 of 27 534 versus 4.0%; 1032 of 25 630; P = .01), and both were more likely to misrepresent HSIL as LSIL (P < .001) than the reverse. ThinPrep LSIL slides were more likely to be misclassified as HSIL (2.4%; 920 of 38 582) than SurePath LSIL slides (1.5%; 198 of 13 196), but conventional slides were the most likely to be misclassified in both categories (4.5%; 266 of 5886 for LSIL, and 6.5%; 573 of 8825 for HSIL). Conclusions.— More participants undercalled HSIL as LSIL (false-negative) than overcalled LSIL as HSIL (false-positive) in the PAP Education program, with conventional slides more likely to be misclassified than ThinPrep or SurePath slides. Pathologists and cytotechnologists classify LSIL equally well, but cytotechnologists are significantly more likely to undercall HSIL as LSIL than are pathologists.

scholarly journals Adenoid Basal Carcinoma of Cervix: A Rare Case Report

2020 ◽  
Vol 3 (2) ◽  
pp. 392-394
Author(s):  
Alina Karna ◽  
Nisha Sharma
Keyword(s):  
Pap Smear ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Adenoid Cystic ◽  
Carcinoma Of Cervix ◽  
Rare Case Report ◽  
Intraepithelial Lesion

Adenoid basal carcinoma of the uterine cervix is a rare low-grade tumor and its cell origin is still obscure. Adenoid basal carcinoma can be confused with adenoid basal hyperplasia, adenoid cystic carcinoma, and basaloid squamous cell carcinoma of the cervix. We present here a case of a 59 year-old-female who initially presented with a high-grade squamous intraepithelial lesion on Pap smear. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Histopathology revealed focal invasive adenoid basal carcinoma with extensive areas of a high-grade squamous intraepithelial lesion involving the endocervical gland. The immunohistochemical stain was positive for p16.

scholarly journals A multicentre, prospective, randomised controlled trial to evaluate hexaminolevulinate photodynamic therapy (Cevira®) as a novel treatment in patients with high grade squamous intraepithelial lesion: APRICITY Phase 3 study protocol

2021 ◽  
Author(s):  
Fei Chen ◽  
Zoltán Novák ◽  
Christian Dannecker ◽  
Long Sui ◽  
Youzhong Zhang ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Low Grade ◽  
High Grade ◽  
Efficacy And Safety ◽  
Squamous Intraepithelial Lesion ◽  
Phase 3 ◽  
Link Type ◽  
Surgical Methods ◽  
Intraepithelial Lesion ◽  
Randomised Controlled

AbstractIntroductionHigh-risk human papilloma virus (HPV)-associated cervical cancer is the fourth most common cancer in women worldwide. Current treatments of high grade squamous intraepithelial lesion (HSIL) of the cervix are based on invasive surgical interventions, compromising cervical competence and functionality.ObjectiveAPRICITY is a multicentre, prospective, double-blind, randomised controlled Phase 3 study further evaluating the efficacy and safety of Cevira®, an integrated drug- and light-delivery device for hexaminolevulinate photodynamic therapy, which shows promise as a novel, non-invasive therapy for women with HSIL.Methods and analysisPatients with biopsy-confirmed HSIL histology are invited to participate in the study currently being conducted at 47 sites in China and 25 sites in Ukraine, Russia and European Union. The aim is to include at least 384 patients which will be randomised to either Cevira® or placebo group (2:1). All patients will be assessed 3 months after first treatment and a second treatment will be administered in patients who are HPV positive or have at least low grade squamous intraepithelial lesion (LSIL). Primary endpoint is the proportion of the responders at 6 months after first treatment. Secondary efficacy endpoints and safety endpoints will be assessed at 6 months, and data for secondary performance endpoints for Cevira® device will be collected at 3 months and 6 months, in case second treatment was administered. All patients in the Cevira® group will be enrolled in an open, long-term extension study following patients for further 6 months to collect additional efficacy and safety data (study extension endpoints).ConclusionDue to its non-invasiveness and convenient application, Cevira® may be a favourable alternative to surgical methods in treatment of patients with HSIL.Ethics and disseminationThe study was approved by the ethics committee of the Peking Union Medical College Hospital and Hannover Medical University, Germany. Findings will be disseminated through peer review publications and conference presentations.Trial registration numberclinicaltrials.govNCT04484415

scholarly journals Evaluation of cervicovaginal smear results at postmenopausal period

2016 ◽  
Vol 2 (1) ◽  
Author(s):  
Sefa Kelekci ◽  
Emre Destegül ◽  
Servet Gençdal ◽  
Emre Ekmekçi ◽  
Hüseyin Aydoğmuş ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Pap Smear ◽  
Premalignant Lesions ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Screening Programs ◽  
Postmenopausal Period ◽  
Pap Smear Screening ◽  
Intraepithelial Lesion

<p>This study evaluates the statistical analysis of cervicovaginal smear results at postmenopausal period accompanied by literature. Cervicovaginal smear results of 894 postmenopausal women were evaluated retrospectively according to the 2001 Bethesda system (BS) in Adana Numune Training and Research Hospital of Obstetrics and Gynecology Clinic from 2007–2010. The study found, normal results on 287 patients (32.1%), benign findings on 556 patients (62.2%), abnormal epithelial cell changes on 48 patients (5.36%) and malignant changes on 3 patients (0.33%). The abnormal epithelial changes were observed to be atypical cells of undetermined significance (ASC-US) for 22 patients (2.46%), <a href="http://medical-dictionary.thefreedictionary.com/high-grade+squamous+intraepithelial+lesion">low-grade squamous intraepithelial lesion</a> (LSIL) for 11 patients (1.23%), <a href="http://medical-dictionary.thefreedictionary.com/high-grade+squamous+intraepithelial+lesion">high-grade squamous intraepithelial lesion</a> (HSIL) for 7 patients (0.78%), findings that cannot exclude a high-grade squamous intraepithelial lesion (ASC-H) for 6 patients (0.55%) and atypical glandular cells-not otherwise specified (AGC-NOS) for 2 patients (0.22%). Malignant results were 2 squamous cell carcinomas (SCC) (0.22%) and 1 adenocarcinoma (ACC) (0.11%). Cervical cancer screening programs should be expanded and Pap smear screening should be applied to all postmenopausal women. The longer time span involved from premalignant lesions to cancer improves our chance for the diagnosis and treatment. As the incidence of invasive cancer increases in menopausal period, gynecological smear examination and regular check-up are crucial. A high rate of abnormalities of epithelial cells was detected in this study.</p><p> </p>

Papanicolaou Tests With Mixed High-Grade and Low-Grade Squamous Intraepithelial Lesion Features: Distinct Performance in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytopathology

2006 ◽  
Vol 130 (4) ◽  
pp. 456-459
Author(s):  
Andrew A. Renshaw ◽  
Dina R. Mody ◽  
Patricia Styer ◽  
Mary Schwartz ◽  
Barbara Ducatman ◽  
...  
Keyword(s):  
Interlaboratory Comparison ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Performance Trends ◽  
Mixed Features ◽  
Intraepithelial Lesion ◽  
Slide Type ◽  
Pure Versus ◽  
Better Than

Abstract Context.—Previous studies have shown that in gynecologic cytology, cases of low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL) perform differently on interpretive review. The performance of cases with mixed LSIL and HSIL features is unknown. Objective.—To compare the performance of gynecologic cytology cases of “pure” LSIL and HSIL with cases showing mixed LSIL and HSIL features. Design.—We compiled performance data from the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytopathology from the years 2003 and 2004, and compared the performance of slides showing relatively pure LSIL and HSIL (≤10% misclassification as HSIL and LSIL, respectively) with slides showing mixed LSIL or HSIL features (cases misclassified as LSIL or HSIL &gt;10% of the time). Results.—Interpretations from a total of 4508 cases (2452 HSIL and 2056 LSIL) were analyzed. Overall, the sensitivity of participants on slides with a reference diagnosis of HSIL was 97.3%, and of LSIL was 95.9%. Performance trends for pure versus mixed cases varied by slide type and reference diagnosis. For conventional slides, participant sensitivity on pure HSIL cases was greatest (98.0%) and on pure LSIL cases was least (95.2%), while participant performance on cases with mixed features was intermediate (97.0% for mixed HSIL and 96.7% for mixed LSIL). In contrast, participant performance on ThinPrep slides showed the greatest sensitivity for mixed LSIL slides (97.9%), while performance on mixed HSIL slides showed the lowest sensitivity (95.7%); slides with pure features had intermediate sensitivity levels (96.3% for both HSIL and LSIL). Further evaluation demonstrated that conventional pure HSIL slides performed significantly better than mixed HSIL slides (P = .006), whereas mixed LSIL slides performed better than pure LSIL slides (P = .01). For ThinPrep slides, pure HSIL cases performed similarly to mixed HSIL cases (P = .43), while mixed LSIL cases performed better than pure LSIL cases (P = .04). Conclusion.—Slides with mixed LSIL and HSIL features have measurably distinct performance characteristics in comparison to slides with pure LSIL or HSIL features. Participant performance on conventional mixed cases is distinctly different from performance on ThinPrep mixed cases.

scholarly journals Should LSIL with ASC-H (LSIL-H) in cervical smears be an independent category? A study on SurePath™ specimens with review of literature

CytoJournal ◽  
2007 ◽  
Vol 4 ◽  
pp. 7 ◽  
Author(s):  
Vinod B Shidham ◽  
Nidhi Kumar ◽  
Raj Narayan ◽  
Gregory L Brotzman
Keyword(s):  
Current Evidence ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Predictive Values ◽  
Hpv Dna ◽  
Cervical Smears ◽  
Management Algorithm ◽  
The Status ◽  
Intraepithelial Lesion

Background Cervical smears exhibiting unequivocal features of ‘low grade squamous intraepithelial lesion’ (LSIL) are occasionally also admixed with some cells suspicious for, but not diagnostic of, ‘high grade squamous intraepithelial lesion’ (HSIL). Only a few studies, mostly reported as abstracts, have evaluated this concurrence. In this study, we evaluate the current evidence that favors a distinct category for “LSIL, cannot exclude HSIL” (LSIL-H), and suggest a management algorithm based on combinations of current ASCCP guidelines for related interpretations. Methods We studied SurePath™ preparations of cervical specimens from various institutions during one year period. Cytohisto correlation was performed in cases with cervical biopsies submitted to our institution. The status of HPV DNA testing was also noted in some LSIL-H cases with biopsy results. Results Out of 77,979 cases 1,970 interpreted as LSIL (1,523), LSIL-H (146), ‘atypical squamous cells, cannot exclude HSIL’ (ASC-H) (109), and HSIL (192) were selected. Concurrent biopsy results were available in 40% (Total 792 cases: 557 LSIL, 88 LSIL-H, 38 ASCH, and 109 HSIL). Biopsy results were grouped into A. negative for dysplasia (ND), B. low grade (HPV, CIN1, CIN1 with HPV), and C. high grade (CIN 2 and above). The positive predictive values for various biopsy results in relation to initial cytopathologic interpretation were: a. LSIL: (557 cases): ND 32% (179), low grade- 58% (323), high grade- 10% (55); b. LSIL-H: (88 cases): ND 24% (21), low grade- 43% (38), high grade- 33% (29); c. ASCH: (38 cases): ND 32% (12), low grade- 37% (14), high grade- 31% (12); d. HSIL (109 cases): ND 5% (6), low grade 26% (28), high grade 69% (75). The patterns of cervical biopsy results in cases reported as LSIL-H were compared with that observed in cases with LSIL, ASC-H, and HSIL. 94% (32 of 34) of LSIL-H were positive for high risk (HR) HPV, 1 was negative for HR HPV but positive for low risk (LR), and 1 LSIL-H was negative for HR and LR both. Conclusion LSIL-H overlapped with LSIL and ASC-H, but was distinct from HSIL. A management algorithm comparable to ASC-H and HSIL appears to be appropriate in LSIL-H cases.

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