scholarly journals Liquid-based Cytology for the Detection of Cervical Intraepithelial Lesions in Jimma Town, Ethiopia

2020 ◽  
Author(s):  
Getnet Tesfaw ◽  
Yesuf Ahmed ◽  
Lealem Gedefaw ◽  
Lamessa Dube ◽  
Samson Godu ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cervical Dysplasia ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Kappa Test ◽  
Intraepithelial Lesion ◽  
Liquid Based Cytology ◽  
Epithelial Lesions ◽  
Intraepithelial Lesions

Abstract Background: Cervical cancer is the second leading type of female cancer in Ethiopia. Screening for cervical cancer is primarily conducted using visual inspection with 5% acetic acid (VIA). Liquid-based cytology (LBC) is not yet widely used in Ethiopia. Method: Women aged 21-65 years were tested using LBC and VIA to detect cervical dysplasia. Logistic regression analysis was conducted to identify associated factors. Cohen’s Kappa test was conducted to test agreement between LBC and VIA. Results: Forty-two percent (n=188) of 448 participants were 31 to 40 years of age and only two participants were above 60. Of the 448 participants, 419 (93.5%) were tested with LBC, 294 (65.6%) VIA and 272 (60.7%) with both LBC and VIA. Among women screened using LBC, 305 (72.8%) were negative for intraepithelial lesion or malignancy (NILM), 97 (23.2%) had low-grade squamous intraepithelial lesion (LSIL) and 17 (4.1%) had high-grade squamous intraepithelial lesion (HSIL). Presence of cervical lesions was generally lower in younger and older women. Majority, 39 (40%) of women with LSIL and 10 (59%) with HSIL were 41-50 years of age. Women aged 51-60 were more likely to have abnormal intraepithelial lesions compared to women aged 21-30 (AOR= 20.9, 95% CI=[7.2-60.9], p=0.00). Out of 47 (10.8%) HIV-positive women, 14 (32.56%) had intraepithelial lesions of which 10 (23.3%) and 4 (9.3%) had LSIL and HSIL, respectively. Among women screened with VIA, 18 (6.1%) were positive; among the 272 (60.7%) women screened using both LBC and VIA, 6 (2.2%) were positive on both LBC and VIA tests. The level of agreement between the two tests was weak at a statistically significant level (kappa value=0.155, p=0.006). Conclusion: LBC demonstrated high rates of cervical squamous intra-epithelial lesions in our study. VIA was a less reliable predictor of cervical squamous intra-epithelial lesions than LBC. Evaluating diagnostic accuracy of both LBC and VIA against a histological endpoint should be completed before adopting either or both screening modalities.

scholarly journals Liquid Based Cytology for the Detection of Cervical Intraepithelial Lesions among Women in Jimma Town, Ethiopia

2020 ◽  
Author(s):  
Getnet Tesfaw ◽  
Yesuf Ahmed ◽  
Lealem Gedefaw ◽  
Lamessa Dube ◽  
Samson Godu ◽  
...  
Keyword(s):  
Cervical Dysplasia ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Kappa Value ◽  
Intraepithelial Lesion ◽  
Liquid Based Cytology ◽  
Epithelial Lesions ◽  
High Cervical ◽  
Intraepithelial Lesions

Abstract Background: Cervical cancer is the second leading type of female cancer in Ethiopia. Screening is primarily conducted using visual inspection with 5% acetic acid (VIA). Liquid-based cytology (LBC) has not yet been used in Ethiopia.Method: Women aged 21-65 years were tested using LBC and VIA for the detection of cervical dysplasia. Logistic regression analysis was conducted to identify associated factors. Cohen’s K test was conducted to test agreement between LBC and VIA. Results: Forty-two percent (n=188) of 448 participants were 31 to 40 years of age and only two participants were above 60. Of the 448 participants, 419 (93.5%) were tested with LBC, 294 (65.6%) VIA and 272 (60.7%) with both LBC and VIA. Among women screened using LBC, 305(72.8%) were negative for intraepithelial lesion or malignancy (NILM), 97 (23.2%) had low grade squamous intraepithelial lesion (LSIL) and 17 (4.1%) high grade squamous intraepithelial lesion (HSIL). Presence of cervical lesions was generally lower in younger and older aged women. Majority, 39(40%) with LSIL and 10 (59%) of women with HSIL were 41-50 years old. Women aged 51-60 years were more likely to have abnormal intraepithelial lesions compared to women aged 21-30 (AOR= 20.9,95%CI=[7.2-60.9], p=0.00). Out of 47 (10.8%) HIV-patients,14(32.56%) had intraepithelial lesion of which 10(23.3%) and 4(9.3%) had LSIL and HSIL, respectively. Among women screened with VIA, 18 (6.1%) were positive. Among the 272 (60.7%) women screened using both LBC and VIA, 6 (2.2%) were positive on both LBC and VIA. The level of agreement between the two tests was weak and statistically significant (kappa value=0.155, p=0.006). Conclusion: LBC detected high cervical squamous intra-epithelial lesions in our setting. VIA was a less reliable predictor of cervical squamous intra-epithelial lesions than LBC. Evaluating diagnostic accuracy of both LBC and VIA against histological endpoint should be completed before adopting either screening modalities.

scholarly journals Liquid Based Cytology for the Detection of Cervical Intraepithelial Lesion among Women in Jimma town, Ethiopia

2019 ◽  
Author(s):  
Getnet Tesfaw ◽  
Yesuf Ahmed ◽  
Lealem Gedefaw ◽  
Lamessa Dube ◽  
Samson Godu ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cervical Dysplasia ◽  
Screening Tests ◽  
Cancer Case ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Kappa Value ◽  
Intraepithelial Lesion ◽  
Liquid Based Cytology

Abstract BackgroundCervical cancer is the second leading type of female cancer in Ethiopia and screening is based on visual inspection with 5% acetic acid (VIA). Liquid-based cytology (LBC) has not yet been used. MethodWomen aged 21-65 years were enrolled. Liquid based cytology and VIA were done for the detection of cervical dysplasia. Logistic regression analysis were conducted to identify factors associated. Finally Cohen’s K was done to test agreement between the methods of diagnostics.ResultsFrom the total 448 participants, (296, 66%) were 35-65 years old. Four hundred nineteen (93.5 %) were screened using LBC of which, 97 (23.2%) had low grade squamous intraepithelial lesion (LSIL) and 17 (4.1%) had high grade squamous intraepithelial lesion (HSIL). Among women with LSIL, 84(86.6%) women as well as all those HSIL were 35-65 years old and women aged 35-65 years old had 4.7 times higher odds of having intraepithelial lesions (P=0.00). A total of 294/448 (65.6%) women underwent VIA examination, of these 18 (6.1%) were found positive. Two hundred seventy two (60.7%) women screened using both LBC and VIA. Of this 6 (2.2%) were positive with both LBC and VIA screening tests. The level of agreement between the two methods was weak and statistically significant (kappa value=0.155, p=0.006). ConclusionPrevalence of cervical lesions is higher among older women. There is high variability in LBC and VIA results. Though more expensive and requiring equipment, using LBC where possible would increase cervical cancer case detection.

scholarly journals COMPARISON OF LIQUID-BASED CYTOLOGY AND CONVENTIONAL CYTOLOGY FOR EVALUATION OF CERVICAL PAP SMEARS

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Dr. Bipin Gandhi
Keyword(s):  
Cervical Cancer ◽  
Epithelial Cell ◽  
Pap Smear ◽  
Developed Countries ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Conventional Cytology ◽  
Resource Setting ◽  
Intraepithelial Lesion ◽  
Liquid Based Cytology

INTRODUCTION: This high mortality rate from cervical cancer globally can be reduced by an approach that includes prevention, early diagnosis, effective screening and treatment programmes. There are currently vaccines that protect against common cancer-causing types of human papilloma virus and can significantly reduce the risk of cervical cancer. in low socioeconomic or developing countries where screening programmes are not available, diagnosing cervical cancer at an early stage and providing access to effective treatment can significantly improve the likelihood of survival. Liquid-based cytology (LBC) was introduced at around mid-1990s as an alternative technique to process the cervical samples. After that most of the developed countries has switched from conventional Pap smear to LBC. LBC has been proposed to be beneficial than Pap smear because of less number of unsatisfactory smears MATERIAL AND METHODS: This study comprises of 287 cervical samples from women visiting the Department of Obstetrics and Gynaecology over a period of 1 year.  Samples were taken and divided into two parts by split-sample technique.  Material was taken from the fornix, portio, and endocervix from all women. Slides for conventional cytology and LBC were stained according to the Pap method. LBC was considered representative if the slide contained >5000 epithelial cells. Endocervical cells were considered present if the slide contained ≥2 groups of glandular/metaplastic cells with ≥5 cells each or if the slide contained ≥10 dissociated glandular/metaplastic cells RESULTS: 287 patients were included in the study. Epithelial cell abnormality was observed in 10 cases in conventional smear while in LBC it was 11. In conventional smear pap report of Unsatisfactory, normal, atrophic, altered flora and candida was in 21,193, 21, 46 and 10 cases respectively. In LBC pap report Unsatisfactory, normal, atrophic, altered flora and candida was in 15,214, 22, 44 and 13 cases respectively. Epithelial cell abnormality was seen in 10 (3.5%) cases by both the methods. Of these 10 cases low grade squamous intraepithelial lesion was observed in 2 cases, High grade squamous intraepithelial lesion in one case, Squamous cell carcinoma in one case and atypical squamous cells of undetermined significance in 6 cases. CONCLUSION: There was a similar detection rate of epithelial abnormalities and infections in both the methods. US rate of CPS was 7.3% and 5.2% for LBC. Thus LBC can be a superior test as compared to conventional pap smear but has to reconsidered in the low-resource setting.

scholarly journals Association between asymptomatic sexually transmitted infections and high-risk human papillomavirus in cervical lesions

2019 ◽  
Vol 47 (11) ◽  
pp. 5548-5559 ◽  
Author(s):  
Lei Wang ◽  
Lizhe Zhu ◽  
Han Li ◽  
Nan Ma ◽  
Huifang Huang ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
High Risk ◽  
Sexually Transmitted Infections ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Sexually Transmitted ◽  
Increased Risk ◽  
Intraepithelial Lesion

Objective This study aimed to determine the association of asymptomatic sexually transmitted infections (STIs), including Ureaplasma urealyticum (UU), Mycoplasma hominis (MH), Mycoplasma genitalium, Chlamydia trachomatis, and herpes simplex virus type 2, with high-risk human papillomavirus (hrHPV) in cervical intraepithelial lesions and neoplasms. Methods A total of 320 hrHPV-positive and 160 hrHPV-negative women were divided into high-grade squamous intraepithelial lesion (HSIL) + invasive cervical cancer and low-grade squamous intraepithelial lesion + normal subgroups, respectively, on the basis of pathological cervical lesions. Cervical brush specimens were amplified and hybridized using polymerase chain reaction kits. Results MH was associated with hrHPV infection, but not with specific hrHPV genotypes or with single or multiple genotypes. Coinfection of hrHPV and UU serotype 14 (Uup14) showed an increased risk of HSILs and cervical carcinoma (odds ratio [OR]: 12.541, 95% confidence interval [CI]: 3.625–43.390). U. urealyticum biovar (Uuu) and Uup1 infections showed a similar increased risk (OR: 11.646, 95% CI: 1.493–90.850; OR: 7.474, 95% CI: 1.140–49.015, respectively) without hrHPV. Conclusions Asymptomatic STIs are widespread. This study shows an association between UU subtypes and cervical cancer, providing new insight into cervical lesion etiology. Screening for MH, Uup14, Uup1, and Uuu is important under different hrHPV statuses.

scholarly journals Characteristics of the Cervicovaginal Microenvironment in Childbearing-Age Women with Different Degrees of Cervical Lesions and HR-HPV Positivity

2021 ◽  
Vol 70 (4) ◽  
pp. 489-500
Author(s):  
QINGZHI ZHAI ◽  
WEIYI ZHANG ◽  
ZHE ZHANG ◽  
YURONG FU ◽  
YANG LI ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Chinese Women ◽  
Hpv Infection ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Childbearing Age ◽  
Positive Interaction ◽  
Healthy Group ◽  
Intraepithelial Lesion

Persistent infection with high-risk human papillomavirus (HR-HPV)is the most important determinate in the development of cervical cancer, and cervical microecology can modulate cervical viral infec¬tion. However, few studies have been conducted on the microeco¬logical analysis of cervical diseases using strict physiological factors. This study investigated the characteristics and dynamics of cervical microecology in childbearing-age Chinese women with different degrees of HR-HPV-positive cervical lesions. A total of 168 subjects were selected according to the selection criteria, including healthy HPV-negative individuals (n = 29), HR-HPV-infected individuals (n = 29), low-grade squamous intraepithelial lesion individuals (LSIL, n = 32), high-grade squamous intraepithelial lesion indi¬viduals (HSIL, n = 40), and cervical cancer individuals (n = 38). We sampled cervical secretions from each subject and performed com¬parative analysis using the 16S rRNA sequencing method. Com¬parison analysis showed that Lactobacillus and Ignatzschineria were the dominant genera in the healthy group, while Gardnerella and Prevotella were more enriched in the disease groups. Based on the taxa composition, we roughly divided the development of cervical cancer into two phases: phase I was from healthy status to HR-HPV infection and LSIL; phase II was from LSIL to HSIL and cervical cancer. Different interactions among different genera were observed in different groups. Prevotella inhibited the abundance of Lactoba¬cillus in the healthy group, while Prevotella inhabited the abundance of Gardnerella in the other groups. In the HR-HPV infection group, Ignatzschineria and Enterococcus showed a positive interaction but dissociated with the increase in cervical lesions, which might even¬tually lead to a continuous decrease in the abundances of Lactoba¬cillus and Ignatzschineria.

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.

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 High-risk HPV genotypes and cervical lesions association in postmenopausal women

2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
Ana Rita Fernandes Miranda da Costa ◽  
Cláudia Sousa ◽  
Erica Isidoro ◽  
Regina Silva ◽  
Cristiana Mourato
Keyword(s):  
Cervical Cancer ◽  
High Risk ◽  
Postmenopausal Women ◽  
Age Groups ◽  
Low Grade ◽  
High Grade ◽  
Cervical Lesions ◽  
Intraepithelial Lesion ◽  
The Bethesda System ◽  
High Risk Hpv

Abstract Background Persistent infection by high-risk Human Papillomavirus (hrHPV) are the major cause of cervical cancer. Studies report disparities in the incidence of infection and the various genotypes of this virus in different age groups, suggesting a higher frequency of hrHPV in young women and low-risk subtypes being predominant in older women. This study aimed to investigate the incidence and distribution of hrHPV genotypes in postmenopausal women as well as the correlation with the cytological findings. Methods 16 859 women, aged 50–64 years, performed cervical cancer screening test in Friuri Venezia Giulia region, Italy. The infection was evaluated by the Polymerase Chain Reaction methodology and the positive samples were evaluated by Liquid Based Cytology according to the Bethesda System from 2014. A statistical analysis was performed to study the molecular and cytological data of this population. Results hrHPV infection were found in 5.8% of the women and 78.3% of these were caused by hrHPV other than HPV16 and HPV18 (). Also, 65.7% of the positive samples were negative for intraepithelial lesion or malignancy while low grade squamous intraepithelial lesion was the most frequent (22.4%). There was an increase in the number of high-grade intraepithelial lesions in the presence of HPV16 compared to that recorded when this genotype was absent (20.8% vs. 8.5%). No cervical cancers were detected. Conclusions Infection with hrHPV is uncommon in postmenopausal women and it is mostly caused by subtypes less associated with the development of cervical cancer. Yet, HPV16 infection triggers the development of high-grade lesions.

scholarly journals High prevalence of Human Papillomavirus (HPV) type 66 in low-grade cervical lesions of Mexican women

2020 ◽  
Author(s):  
Karina Juárez-González ◽  
Vladimir Paredes-Cervantes ◽  
Silvia Gordillo-Rodríguez ◽  
Saúl González-Guzmán ◽  
Xochilt Moncayo-Valencia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Transmitted Disease ◽  
Low Grade ◽  
Mexican Women ◽  
Cervical Lesions ◽  
Hpv 16 ◽  
High Prevalence ◽  
Hpv Types ◽  
Intraepithelial Lesions

AbstractBackgroundHPV-16 infections constitute the highest risk for developing uterine cervix cancer. However, the role of other high-risk types is still controversial.ObjectiveTo analyze HR-HPV prevalence and its possible associations between HPV and risk factors related to cervical lesions among Mexican women.MethodsCross sectional study using 362 cervical samples collected between 2016 and 2017. Fourteen HR-HPV types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68) were detected by highly sensitive PCR amplification followed by reverse hybridization. Bivariate and multivariate analyses were performed to investigate the association between HPV types and risk factors among lesions.ResultsMost samples were HR-HPV positive (83.43%). HPV-16 was the most prevalent infection among negative for intraepithelial lesions or malignancy (78.6%), high-grade squamous intraepithelial lesions (50%), and cervical cancer (58.2%). HPV-66 showed an unexpected high prevalence in atypical squamous cells of undetermined significance (50%), low-grade squamous intraepithelial (45.7%), and only found in 3.6% of cervical cancers. HPV-16 was significantly prevalent among women between 30-39 years, whereas types 66 and 52 were significantly associated when previously sexually transmitted disease had occurred (p< 0.05).ConclusionsHPV-66 either in single or co-infection with other HR-HPV types (excluding 16 and 18) might be indicative of non-progressive cancer lesions. HPV-66 prevalence was unusually high in low-grade cervical lesions, predominantly in co-infection with HPV-51, and very low among cervical cancer. This should be addressed to interpret results obtained by methods that group type 66 with other HR-types.

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