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

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%.

scholarly journals Value of Nucleolar Organizer Regions count in cervical pathology

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

scholarly journals Clinical application of the 2011 IFCPC colposcope terminology

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bei Zhang ◽  
Shuhui Hong ◽  
Guihui Zhang ◽  
Fengnian Rong
Keyword(s):  
Diagnostic Accuracy ◽  
Precancerous Lesions ◽  
High Specificity ◽  
Diagnostic Value ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Diagnostic Significance ◽  
Cervical Precancerous Lesions ◽  
Intraepithelial Lesion ◽  
Common Sign

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.

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

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.

Cytologic Features of Low-Grade Squamous Intraepithelial Lesion in ThinPrep Papanicolaou Test Slides and Conventional Smears: Comparison of Cases That Performed Poorly With Those That Performed Well in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology

2005 ◽  
Vol 129 (1) ◽  
pp. 23-25 ◽  
Author(s):  
Andrew A. Renshaw ◽  
Barbara Dubray-Benstein ◽  
Jennifer Haja ◽  
Jonathan H. Hughes
Keyword(s):  
Interlaboratory Comparison ◽  
Pap Test ◽  
Median Number ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Papanicolaou Test ◽  
Abnormal Cells ◽  
Intraepithelial Lesion ◽  
Intraepithelial Lesions

Abstract Context.—Both conventional and ThinPrep Papanicolaou smears with high-grade squamous intraepithelial lesions that are frequently missed are known to have relatively few abnormal cells. Whether this is also true of cases of low-grade squamous intraepithelial lesion is not known. Objective.—To compare the cytologic features of cases of low-grade squamous intraepithelial lesion that perform poorly with the features of cases that perform well. Design.—The cytologic features of 10 ThinPrep Pap Test and conventional smear cases of low-grade squamous intraepithelial lesion that performed poorly in the College of American Pathologists Interlaboratory Comparison Program were compared with 46 ThinPrep Pap Test and conventional smear cases that performed extremely well. The numbers of abnormal cells were categorized into less than 50, 51 to 100, 101 to 250, 251 to 500, and more than 500. Results.—The median number of abnormal cells for cases that performed poorly was less than 50, whereas the median number of abnormal cells for cases that performed well was between 101 and 250. Overall, cases that performed poorly were significantly more likely to have less than 50, less than 100, and less than 250 abnormal cells than cases that performed well (P &lt; .001, P &lt; .001, and P = .009, respectively). A minority of cases performed well even with very few abnormal cells and groups. The same findings were present when conventional smears and ThinPrep specimens were analyzed separately. Conclusions.—ThinPrep Pap Test cases and conventional smears with a diagnosis of low-grade squamous intraepithelial lesion that perform poorly in this program have significantly fewer abnormal cells than those that perform well. The median number of abnormal cells in cases that performed well is lower than that of comparable high-grade cases in the program.

scholarly journals Molecular detection of HPV 16 and 18 in cervical samples of patients from Belo Horizonte, Minas Gerais, Brazil

2007 ◽  
Vol 49 (5) ◽  
pp. 297-301 ◽  
Author(s):  
Taíse Palmeiras Freitas ◽  
Bianca Bianco do Carmo ◽  
Francisco Danilo Ferreira Paula ◽  
Lucas Fonseca Rodrigues ◽  
Ana Paula Fernandes ◽  
...  
Keyword(s):  
Hpv Infection ◽  
Low Grade ◽  
High Grade ◽  
Public Health Services ◽  
Hpv 16 ◽  
Molecular Tests ◽  
Intraepithelial Lesion ◽  
Belo Horizonte ◽  
Intraepithelial Lesions ◽  
Hpv 18

PURPOSE: The aim of this study was to investigate the frequency of HPV infection and the types 16 and 18 in cervical samples from patients attended at two public health services of the city of Belo Horizonte, MG. METHODS: Cervical samples from 174 patients were collected for cytopathological and molecular tests. HPV infection was searched by PCR utilizing MY09 and MY11 primers or HPV 16 and HPV 18 specific primers. RESULTS: Amongst the 174 samples analyzed, 20.7% presented squamous intraepithelial and/or invasive lesions detected on cytopathological analysis and of those, 94.4% were infected by HPV. HPV 16 was found in 20% of the cases of low-grade squamous intraepithelial lesions and in 40% and 50% of high-grade squamous intraepithelial lesion and squamous invasive carcinoma, respectively. HPV 18 was detected in 6.7% of the low-grade lesion samples and in two HPV16 co-infected samples. In 50% of the cases of high-grade lesion, the HPV type was not determined. CONCLUSION: The HPV 16 was the virus type more frequently detected. However, more than 50% of the positive samples at the cytopathological analysis were negative for HPV 16 and 18, indicating that possibly other virus types are present in relative high frequencies in the studied population.

scholarly journals Do Infection Patterns of Human Papillomavirus Affect the Cytologic Detection of High-Grade Cervical Lesions on Papanicolaou Tests?

2017 ◽  
Vol 142 (3) ◽  
pp. 347-352 ◽  
Author(s):  
Siavash Azadmanesh Samimi ◽  
Roxanne R. Mody ◽  
Steven Goodman ◽  
Eric Luna ◽  
Donna Armylagos ◽  
...  
Keyword(s):  
Hpv Infection ◽  
Low Grade ◽  
Lower Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesions ◽  
Cervical Lesions ◽  
Atypical Squamous Cell ◽  
Intraepithelial Lesion ◽  
Intraepithelial Lesions ◽  
Hpv 18

Context.— Persistent infection with high-risk human papillomavirus (hrHPV) is the major cause of cervical cancer. The effect of HPV infection patterns on cytologic detection of cervical lesions is unknown. Objective.— To determine the effect of HPV infection patterns on the sensitivity of cytologic detection of high-grade cervical lesions. Design.— Papanicolaou tests from 257 women with biopsy-confirmed, high-grade squamous intraepithelial lesions were analyzed with respect to HPV infection patterns. Results.— Among 257 biopsy-confirmed, high-grade squamous intraepithelial lesion cases, the preceding cytology showed 20 cases (8%) were benign; 166 cases (65%) were low-grade cervical lesions, including atypical squamous cell of undetermined significance and low-grade squamous intraepithelial lesions; and 71 cases (28%) were high-grade cervical lesions, including atypical squamous cells cannot rule out high-grade squamous intraepithelial lesion (atypical squamous cell–high), atypical glandular cells, and high-grade squamous intraepithelial lesions. In 236 cases tested for HPV, those exhibiting low-grade cervical lesions on cytology were often associated with coinfections of mixed hrHPV genotypes (31 of 40; 78%) or non-16/18 hrHPV (75/103; 73%), compared with single-genotype infections of HPV-16 (33 of 62; 53%) or HPV-18 (2 of 6; 33%) (P = .001). In contrast, high-grade cervical lesion cytomorphology tended to associate with the single-genotype infection of HPV-16 (20 of 62; 32%) or HPV-18 (3 of 6; 50%), compared with non-16/18 hrHPV (25 of 103; 24%) or multigenotype infection (8 of 40; 20%) (P = .01). Conclusions.— Our findings suggest that multigenotypic or non-16/18 hrHPV infections often produce deceptive lower-grade cytomorphology, which could result in underdiagnosis and delay of treatment. The HPV infection patterns may offer unrecognized benefit beyond HPV genotyping and should be considered during clinical risk evaluation of women with lower-grade cytology.

Only a Small Fraction of High-Grade Cervical Lesions Are Discovered After an Interpretation of Atypical Squamous Cells of Undetermined Significance When Using Imager-Assisted, Liquid-Based Papanicolaou Tests and the Bethesda 2001 System

2012 ◽  
Vol 137 (7) ◽  
pp. 936-941 ◽  
Author(s):  
Kelly A. Khan ◽  
Debora A. Smith ◽  
Michael J. Thrall
Keyword(s):  
Low Grade ◽  
High Grade ◽  
Test Results ◽  
Squamous Intraepithelial Lesion ◽  
Squamous Intraepithelial Lesions ◽  
Papanicolaou Test ◽  
Squamous Cells ◽  
Intraepithelial Lesion ◽  
Intraepithelial Lesions ◽  
Undetermined Significance

Context.—Previous work has reported that most high-grade cervical neoplasia is seen in patients with preceding Papanicolaou test results of atypical squamous cells of undetermined significance. This information was based on conventional test results and the Bethesda 1991 reporting system and was determined before the current treatment guidelines. Objective.—Our objective was to perform a retrospective review of all histologically confirmed, high-grade cervical neoplasia to determine the diagnosis of the preceding liquid-based Papanicolaou test. Design.—A total of 189 histologically confirmed, high-grade cervical intraepithelial neoplasia (CIN) cases grade 2 and greater were identified for a 1-year period. Results.—Of the 189 cases, 10 (5.3%) had a previous diagnosis of atypical squamous cells of undetermined significance; 55 (29.1%) had low-grade squamous intraepithelial lesions; 31 (16.4%) had low-grade squamous intraepithelial lesions, unable to rule out a high-grade squamous intraepithelial lesion; 21 (11.1%) had atypical squamous cells, unable to rule out a high-grade squamous intraepithelial lesion; 68 (36%) had high-grade squamous intraepithelial lesions; 1 (0.5%) had atypical glandular cells; 1 (0.5%) had adenocarcinoma in situ; and 2 (1%) had invasive carcinoma. Combined “low grade” Papanicolaou test results (atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesion) preceded 51 of 103 cases of CIN 2 (49.5%) and 14 of 103 cases (13.6%) of CIN 3/cancer, whereas “high grade” Papanicolaou test results (atypical squamous cells, unable to rule out a high-grade squamous intraepithelial lesion; low-grade squamous intraepithelial lesions, unable to rule out a high-grade squamous intraepithelial lesion; high-grade squamous intraepithelial lesions; atypical glandular cells; adenocarcinoma in situ; and invasive carcinoma) preceded 52 of 103 CIN 2 cases (50.5%) and 72 of 103 CIN 3/cancer cases (69.9%). Conclusions.—Our data show that we can now more-reliably predict high-grade dysplasia on routine Papanicolaou tests. Only a small fraction of histologically confirmed CIN 2/3 cases are found following a Papanicolaou test diagnosis of atypical squamous cells of undetermined significance.

scholarly journals Detection of Cervical Cytological Abnormalities by Pap smears Method among Women Attending the Screening Clinic of Nsambya Hospital

2019 ◽  
pp. 1-4
Author(s):  
Mwesigwa Boaz ◽  
◽  
Andrew Livex Okwi Okwi ◽  
Othieno Emmanuel ◽  
◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Pap Smear ◽  
Public Health Problem ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Squamous Cells ◽  
Cytological Abnormalities ◽  
Intraepithelial Lesion ◽  
Intraepithelial Lesions

Background: Cervical cancer is an important public health problem. In Uganda, it ranks the most frequent cause of cancer among women aged between 15 to 44 years of age. Early detection and eradication of cervical cancer and its precursor lesions is the mainstay for control of this disease. The Pap smear method is the most cost-effective means of screening cervical pre-malignant, malignant processes and non-neoplastic lesions. Aim: To describe the cervical cytological abnormalities as detected byPap smear method and to determine the prevalence of such abnormalities Methodology: This was a prospective study, in which a total of 175 women were recruited from May to June, 2016. Cervical samples were collected from these women and stained according to the papanicolaou staining protocol. Results were reported using the 2014 Bethesda reporting system. Results: Out of 175 cases, 163 (93.1%) were reported as negative for intraepithelial lesion or malignancy [NILM]. Cervical intraepithelial lesions were reported in 12 (6.9%) cases which included atypical squamous cells of undetermined significance [ASCUS] in 4(2.3%) cases, atypical squamous cells cannot exclude high grade squamous intraepithelial lesions [ASCH] in 1(0.6%) case, low-grade squamous intraepithelial lesion [LSIL] in 5 (2.9%) cases, high-grade squamous intraepithelial lesion [HSIL] in 1(0.6%) case and atypical glandular cells [AGC] in 1(0.6%) case. Conclusion: Cervical cytology by Pap smear method should be used to screen women routinely because it is an effective method in detecting pre-malignant and malignant lesions of the cervix.

scholarly journals Therapeutic Assessment of Vulvar Squamous Intraepithelial Lesions with CO2 Laser Vaporization in Immunosuppressed Patients

2018 ◽  
Vol 40 (01) ◽  
pp. 026-031
Author(s):  
Julisa Ribalta ◽  
Mariana Mateussi ◽  
Neila Speck
Keyword(s):  
Co2 Laser ◽  
Genital Tract ◽  
Laser Vaporization ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Lower Genital Tract ◽  
Immunosuppressed Patients ◽  
Intraepithelial Lesion ◽  
Intraepithelial Lesions

Objective A vulvar squamous intraepithelial lesion is deemed to be a preceding lesion to vulvar cancer, especially in women aged under 40 years, holders of an acquired or idiopathic immunosuppression. Several treatments have been used to treat these lesions. One of the aesthetically acceptable therapeutic methods is the CO2 laser vaporization. Methods In a transversal study, 46 records of immunosuppressed women bearing a vulvar low grade and/or high grade squamous intraepithelial lesion were selected out of the retrospective analysis, computing age, date of record, date of vulvar lesion treatment with CO2 laser, the time elapsed between the first and the last visit (in months), the number of visits, the presence or absence of condylomatous lesions in other female lower genital tract sites and whether or not recurrences and persistence of intraepithelial lesions have been noticed during the follow-up. Results Patients bearing vulvar high-grade squamous intraepithelial lesion and immunosuppressed (serum positive for human immunodeficiency virus [HIV] or with solid organs transplantation) have shown a higher level of persistence of lesions and a higher chance of having other areas of the female lower genital tract involved. Conclusion While the CO2 laser vaporization is the most conservative method for the treatment of vulvar high-grade intraepithelial lesions, it is far from being the ideal method, due to the intrinsic infection features considered. The possibility of persistence, recurrences and spontaneous limited regression indicates that a closer surveillance in the long-term treated cases should be considered, in special for immunosuppressed patients.

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.

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