scholarly journals Concurrent cytologic and colposcopic evaluation of symptomatic cervical erosion

2021 ◽  
Vol 11 (1) ◽  
pp. 125
Author(s):  
Shreya Goel ◽  
Prabha Lal
Keyword(s):  
Screening Tool ◽  
Cervical Dysplasia ◽  
Latency Period ◽  
High Grade ◽  
High Grade Lesion ◽  
Long Latency ◽  
Preinvasive Lesions ◽  
Sensitivity Specificity ◽  
Histopathological Results ◽  
Causes Of Deaths

Background: Cervical cancer is amongst the leading causes of deaths due to cancer in developing countries. Moreover, preinvasive lesions of the cervix have a long latency period for conversion into malignancy and are also detectable by screening techniques. Hence, colposcopy in addition to cytology should be carried out wherever facility is available to ensure early detection and timely management.Methods: Simultaneous cytology and colposcopy was done for 80 women with symptomatic cervical erosion followed by a colposcopic directed biopsy in women with MRCI >3. Finally, correlation between cytology, colposcopy and histopathological results was done.Results: 65/80 women were biopsied. 12/80 women had MRCI >6 amongst which 10/80 were confirmed to have a high grade lesion on histopathology. 13/80 had lesser abnormalities (ASCUS and LSIL) amongst which 3/80 had CIN1 on histopathology. Only 2/80 had HSIL on cytology as compared to 8/80 on histopathology that had CIN 2/3. Lastly, only 1/80 had SCC on cytology compared to 2/80 on histopathology. The sensitivity, specificity, PPV and NPV of cytology and colposcopy for diagnosing cervical dysplasia was 46.1%, 83.5%, 35.2%, 88.8% and 84.6%, 86.5%, 55%, 96.6% respectively making colposcopy a better screening tool than cytology for evaluating cervical malignancy.Conclusions: Colposcopic examination should ideally be carried out in all women with symptomatic cervical erosion in addition to cytology. Moreover, suspicious areas should be biopsied even if cytology is normal to exclude malignancy. 

scholarly journals HPV IMMUNOHISTOCHEMICAL TESTING AND CERVICAL DYSPLASIA

2016 ◽  
Vol 89 (2) ◽  
pp. 236-240
Author(s):  
Daniel Mureşan ◽  
Ioana Cristina Rotar ◽  
Silvana Apostol ◽  
Georgiana Coroiu ◽  
Florin Stamatian
Keyword(s):  
High Risk ◽  
Human Papilloma Virus ◽  
Immunohistochemical Staining ◽  
Screening Tool ◽  
Cervical Dysplasia ◽  
High Grade ◽  
Hpv Testing ◽  
Squamous Intraepithelial Lesion ◽  
Papilloma Virus ◽  
Intraepithelial Lesion

Background and aim. HPV (Human Papilloma Virus) infection represents a necessary condition for cervical carcinogenesis. The purpose of this study was to evaluate the efficiency of HPV testing using an immunohistochemical staining kit with implications upon both diagnosis and treatment of cervical intraepithelial neoplasia (CIN).Methods. Seventy-nine patients and eighty-six controls were enrolled in the study. Each patient had completed a physical examination, gynecological examination with cervical sampling using a liquid-based cytology system and also colposcopy. The cervical samples were analyzed according to Bethesda terminology and HPV-HR immunohistochemical staining was performed. In all the patients with high-grade lesion a surgical excision procedure was performed followed by pathological examination of the specimen. The collected data were analyzed using statistical software.Results. The colposcopic examination has detected acetowhite modifications of the cervical epithelium in 47% of patients with ASC-US (Atypical squamous cells of undetermined significance) in 71% of patients with LSIL (Low grade squamous intraepithelial lesion) and in 100% of patients with HSIL ( High grade squamous intraepithelial lesion). The biopsy confirmed the diagnosis of LSIL in 27% of biopsy specimens in patients with ASC-US and in 79.99% of patients with LSIL respectively. In all patients with HSIL the diagnosis was CIN II or higher. The percentage of HPV-HR (Human Papilloma Virus – High Risk) positivity porportionaly increased with the severity of cytological diagnosis: 30% in ASC-US, 42.86% in LSIL and 75% in HSIL patients. The sensitivity of detection of HPV-HR was 50% with CI 95% [17.45;82.55] for ASC-US, 77.77% with CI 95% [51.91;92.62] for LSIL and 81.81% with CI 95% [58.99;94.00] for HSIL.Conclusion. HPV testing can be an important screening tool for cervical dysplasia. The HPV testing targeting high risk types is indicated for ASC-US and LSIL triage. The present work sustains the idea of introducing HPV testing as a primary  screening tool for cervical cancer.

Correlation of Swede score colposcopy scoring system and histopathological results in patients with high-risk HPV infection other than HPV16 and 18

2019 ◽  
Vol 30 (1) ◽  
pp. 35-40
Author(s):  
Murat Alan ◽  
Ilker Gunyeli ◽  
Murat Gultekin ◽  
Muzaffer Sancı ◽  
Kunter Yuce
Keyword(s):  
High Risk ◽  
Predictive Value ◽  
Scoring System ◽  
Hpv Infection ◽  
Low Grade ◽  
High Grade ◽  
Epithelial Lesions ◽  
Sensitivity Specificity ◽  
Histopathological Results ◽  
High Risk Hpv

ObjectiveTriage with HPV genotyping has some caveats and debates for HPV positive cases other than 16 and 18. The Swede score colposcopic scoring system has not previously been evaluated in this group of patients.ObjectiveTo use the Swede score colposcopic scoring system to compare scores and final histopathological results in women who have undergone colposcopy owing to infection with high risk-HPVs other than HPV16 and 18 and to establish new cut-off values to predict pre-malignant lesions in this group of patients.MethodsThis study was conducted in 613 women undergoing colposcopic evaluation because of abnormal cervical cytology together with high-risk HPV infection. All patients referred were evaluated by an expert colposcopist, given a Swede score (using the Swede score colposcopic scoring system) by using five variables (acetowhiteness, margins plus surface, vessel pattern, lesion size, and iodine staining), and had at least one biopsy procedure (either colposcopically directed or by a loop electrical excision procedure). Sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio values, and receiver operating characteristic curves for each clinico-pathological variable to detect low-grade and high-grade squamous intra-epithelial lesions, and any squamous cell abnormality (low-grade + high-grade squamous intra-epithelial lesions) were evaluated individually.ResultsFinal histopathological results of the patients were normal in 53.2% of cases, low-grade lesions in 32.5% of cases, and high-grade lesions in 14.4% of cases. Swede score was ≥8 (median 7.97) for high-grade lesions and ≥5 (median 5.06) for low-grade lesions. The area under the curve values (95% CI) of Swede scores for low-grade and high-grade squamous intra-epithelial lesions, and low-grade + high grade lesions were 0.92, 0.98, and 0.96, respectively. A Swede score cut-off value ≥6 had a sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratios of 92%, 98%, 93%, 98%, and 50 (22.6 to 110.8), respectively, for high-grade lesions at the final pathology (P<0.001). One high-risk HPV type (except 16 and 18) was no better than another for calculating the median Swede score during colposcopy (P=0.43).ConclusionsThe Swede score colposcopic scoring system appears to be a useful tool for evaluating atypical cervical cytology in women with high-risk HPV infection other than HPV types 16 and 18.

scholarly journals The Performance of Artificial Intelligence in Cervical Colposcopy: A Retrospective Data Analysis

2022 ◽  
Vol 2022 ◽  
pp. 1-6
Author(s):  
Yuqian Zhao ◽  
Yucong Li ◽  
Lu Xing ◽  
Haike Lei ◽  
Duke Chen ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Medical Records ◽  
Precancerous Lesions ◽  
Diagnostic Study ◽  
Retrospective Data ◽  
High Grade ◽  
Hpv Testing ◽  
Retrospective Data Analysis ◽  
Sensitivity Specificity ◽  
Histopathological Results

Objective. We aimed to evaluate the performance of artificial intelligence (AI) system in detecting high-grade precancerous lesions. Methods. A retrospective and diagnostic study was conducted in Chongqing Cancer Hospital. Anonymized medical records with cytology, HPV testing, colposcopy findings with images, and the histopathological results were selected. The sensitivity, specificity, and areas under the curve (AUC) in detecting CIN2+ and CIN3+ were evaluated for the AI system, the AI-assisted colposcopy, and the human colposcopists, respectively. Results. Anonymized medical records from 346 women were obtained. The images captured under colposcopy of 194 women were found positive by the AI system; 245 women were found positive either by human colposcopists or the AI system. In detecting CIN2+, the AI-assisted colposcopy significantly increased the sensitivity (96.6% vs. 88.8%, p = 0.016 ). The specificity was significantly lower for AI-assisted colposcopy (38.1%), compared with human colposcopists (59.5%, p < 0.001 ) or the AI system (57.6%, p < 0.001 ). The AUCs for the human colposcopists, AI system, and AI-assisted colposcopy were 0.741, 0.765, and 0.674, respectively. In detecting CIN3+, the sensitivities of the AI system and AI-assisted colposcopy were not significantly higher than human colposcopists (97.5% vs. 92.6%, p = 0.13 ). The specificity was significantly lower for AI-assisted colposcopy (37.4%) compared with human colposcopists (59.2%, p < 0.001 ) or compared with the AI system (56.6%, p < 0.001 ). The AUCs for the human colposcopists, AI system, and AI-assisted colposcopy were 0.759, 0.674, and 0.771, respectively. Conclusions. The AI system provided equally matched sensitivity to human colposcopists in detecting CIN2+ and CIN3+. The AI-assisted colposcopy significantly improved the sensitivity in detecting CIN2+.

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.

Comparison Between 18F-Dopa and 18F-Fet PET/CT in Patients with Suspicious Recurrent High Grade Glioma: A Literature Review and Our Experience

2019 ◽  
Vol 12 (3) ◽  
pp. 220-228 ◽  
Author(s):  
Laura Evangelista ◽  
Lea Cuppari ◽  
Luisa Bellu ◽  
Daniele Bertin ◽  
Mario Caccese ◽  
...  
Keyword(s):  
Case Series ◽  
High Grade Glioma ◽  
High Grade ◽  
True Negative ◽  
Fet Pet ◽  
Positron Emission ◽  
Pet Ct ◽  
Magnetic Resonance Imaging Mri ◽  
Definition Of ◽  
Sensitivity Specificity

Purpose: The aims of the present study were to: 1- critically assess the utility of L-3,4- dihydroxy-6-18Ffluoro-phenyl-alanine (18F-DOPA) and O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) Positron Emission Tomography (PET)/Computed Tomography (CT) in patients with high grade glioma (HGG) and 2- describe the results of 18F-DOPA and 18F-FET PET/CT in a case series of patients with recurrent HGG. Methods: We searched for studies using the following databases: PubMed, Web of Science and Scopus. The search terms were: glioma OR brain neoplasm and DOPA OR DOPA PET OR DOPA PET/CT and FET OR FET PET OR FET PET/CT. From a mono-institutional database, we retrospectively analyzed the 18F-DOPA and 18F-FET PET/CT of 29 patients (age: 56 ± 12 years) with suspicious for recurrent HGG. All patients underwent 18F-DOPA or 18F-FET PET/CT for a multidisciplinary decision. The final definition of recurrence was made by magnetic resonance imaging (MRI) and/or multidisciplinary decision, mainly based on the clinical data. Results: Fifty-one articles were found, of which 49 were discarded, therefore 2 studies were finally selected. In both the studies, 18F-DOPA and 18F-FET as exchangeable in clinical practice particularly for HGG patients. From our institutional experience, in 29 patients, we found that sensitivity, specificity and accuracy of 18F-DOPA PET/CT in HGG were 100% (95% confidence interval- 95%CI - 81-100%), 63% (95%CI: 39-82%) and 62% (95%CI: 39-81%), respectively. 18F-FET PET/CT was true positive in 4 and true negative in 4 patients. Sensitivity, specificity and accuracy for 18F-FET PET/CT in HGG were 100%. Conclusion: 18F-DOPA and 18F-FET PET/CT have a similar diagnostic accuracy in patients with recurrent HGG. However, 18F-DOPA PET/CT could be affected by inflammation conditions (false positive) that can alter the final results. Large comparative trials are warranted in order to better understand the utility of 18F-DOPA or 18F-FET PET/CT in patients with HGG.

scholarly journals Metastatic Extraskeletal Mesenchymal Chondrosarcoma of the Pancreas: Report of an Unusual Case with Review of Literature

2021 ◽  
Author(s):  
Saloni Naresh Shah ◽  
Ashok Parameswaran ◽  
Prasanna Kumar Reddy
Keyword(s):  
Unusual Case ◽  
English Literature ◽  
Latency Period ◽  
Sudden Onset ◽  
Mesenchymal Chondrosarcoma ◽  
Pancreatic Tumors ◽  
Good Survival ◽  
Review Of Literature ◽  
Long Latency ◽  
Extraskeletal Mesenchymal Chondrosarcoma

AbstractExtraskeletal mesenchymal chondrosarcoma (ESMC) metastasizing to the pancreas in isolation is a rare occurrence. We report a 49-year-old gentleman who had undergone excision of an ESMC of the thigh in 2009 and presented with sudden onset abdominal pain and icterus in 2019. Radiological imaging revealed calcified mass of the pancreas with multiple nodules with extension into the adipose tissue. Distal pancreatectomy was performed and the pathology revealed a bimorphic tumor composed of undifferentiated round blue cells with abrupt transition to hyaline cartilage, typical of mesenchymal chondrosarcoma. To the best of our knowledge, there are only seven prior cases of metastatic ESMC of the pancreas in the English literature. Surgical intervention appears to be the preferred modality of treatment for metastatic pancreatic tumors. These patients may have long latency period before metastasizing and seem to have a good survival period post excision.

scholarly journals Validation of a rapid antigen test as a screening tool for SARS-CoV-2 infection in asymptomatic populations. Sensitivity, specificity and predictive values

2021 ◽  
pp. 100954
Author(s):  
Alejandro Fernandez-Montero ◽  
Josepmaria Argemi ◽  
José Antonio Rodríguez ◽  
Arturo H. Ariño ◽  
Laura Moreno-Galarraga
Keyword(s):  
Screening Tool ◽  
Antigen Test ◽  
Predictive Values ◽  
Sensitivity Specificity

scholarly journals Paracoccidioidomycosis Diagnosed in Europe—A Systematic Literature Review

2021 ◽  
Vol 7 (2) ◽  
pp. 157
Author(s):  
Gernot Wagner ◽  
Deddo Moertl ◽  
Anna Glechner ◽  
Verena Mayr ◽  
Irma Klerings ◽  
...  
Keyword(s):  
Latency Period ◽  
European Countries ◽  
Systemic Mycosis ◽  
Endemic Region ◽  
Travel History ◽  
Long Latency ◽  
Geographical Regions ◽  
The World ◽  
First Occurrence ◽  
Full Text Screening

Paracoccidioidomycosis is a systemic mycosis that is endemic in geographical regions of Central and South America. Cases that occur in nonendemic regions of the world are imported through migration and travel. Due to the limited number of cases in Europe, most physicians are not familiar with paracoccidioidomycosis and its close clinical and histopathological resemblance to other infectious and noninfectious disease. To increase awareness of this insidious mycosis, we conducted a systematic review to summarize the evidence on cases diagnosed and reported in Europe. We searched PubMed and Embase to identify cases of paracoccidioidomycosis diagnosed in European countries. In addition, we used Scopus for citation tracking and manually screened bibliographies of relevant articles. We conducted dual abstract and full-text screening of references yielded by our searches. To identify publications published prior to 1985, we used the previously published review by Ajello et al. Overall, we identified 83 cases of paracoccidioidomycosis diagnosed in 11 European countries, published in 68 articles. Age of patients ranged from 24 to 77 years; the majority were male. Time from leaving the endemic region and first occurrence of symptoms considerably varied. Our review illustrates the challenges of considering systemic mycosis in the differential diagnosis of people returning or immigrating to Europe from endemic areas. Travel history is important for diagnostic-workup, though it might be difficult to obtain due to possible long latency period of the disease.

High-risk HPV-positive and -negative high-grade cervical dysplasia: Analysis of 5-year outcomes

2021 ◽  
Author(s):  
Giorgio Bogani ◽  
Francesco Sopracordevole ◽  
Violante Di Donato ◽  
Andrea Ciavattini ◽  
Alessandro Ghelardi ◽  
...  
Keyword(s):  
High Risk ◽  
Cervical Dysplasia ◽  
High Grade ◽  
High Risk Hpv

scholarly journals New screening tool for neonatal nutritional risk in China: a validation study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e042467
Author(s):  
Mei Zhou ◽  
Yuwei Li ◽  
Huaying Yin ◽  
Xianhong Zhang ◽  
Yan Hu
Keyword(s):  
Validation Study ◽  
Head Circumference ◽  
Predictive Value ◽  
Screening Tool ◽  
Nutritional Risk ◽  
Risk Level ◽  
Spearman Correlation ◽  
Nutrition Risk ◽  
Sensitivity Specificity ◽  
Nutritional Risk Screening

ObjectiveA neonatal nutritional risk screening tool (NNRST) was developed by using Delphi and analytic hierarchy processes in China. We verified the accuracy of this tool and analysed whether it effectively screened neonates with nutritional risk.DesignProspective validation study.Setting and participantsIn total, 338 neonates who were admitted to the neonatal unit of Children’s Hospital of Chongqing Medical University from May–July 2016 completed the study. Nutritional risk screening and length and head circumference measurements were performed weekly. Weight was measured every morning, and other relevant clinical data were recorded during hospitalisation.Main outcome measuresWe evaluated the sensitivity, specificity, validity, reliability, and positive and negative predictive value of the screening tool. Various characteristics of neonates in different risk groups were analysed to determine the rationality of the nutritional risk classification.ResultsThe sensitivity, specificity, and positive and negative predictive values were 85.11%, 91.07%, 60.61% and 97.43%, respectively. The criterion validity was texted by the Spearman correlation analysis (r=0.530) and independent samples non-parametric tests (p=0.000). The content validity (Spearman correlation coefficient) was 0.321–0.735. The inter-rater reliability (kappa value) was 0.890. Among the neonatal clinical indicators, gestational age, birth weight, length, admission head circumference, admission albumin, admission total proteins, discharge weight, discharge length and head circumference decreased with increasing nutrition risk level; the length of stay and the rate of parenteral nutrition support increased with increasing nutrition risk level. In the comparison of complications during hospitalisation, the incidence of necrotising enterocolitis and congenital gastrointestinal malformation increased with increasing nutrition risk level.ConclusionThe validation results for the NNRST are reliable. The tool can be used to preliminarily determine the degree of neonatal nutritional risk, but its predictive value needs to be determined in future large-sample studies.Trial registration numberChiCTR2000033743.

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