Significance of punch biopsy and endocervical curretage in diagnostics of cervical intraepithelial lesions

Background/Aim. Diagnostic procedures during the detection of cervical intraepithelial lesions (CIN) are a combination of cytology, colposcopy, punch biopsy and endocervical curretage. An optimal therapeutic approach according to the distribution, size and grade of cervical lesions is the result of this diagnostic protocol. This study was carried out to assess reliability of the punch biopsy and endocervical curretage in diagnostics of cervical intraepithelial lesions. Methods. Fifty patients undergoing cervical conization were studied retrospectively to evaluate the correlation between the grade of preoperative punch biopsy and endocervical curretage, and the grade of the dysplastic epithelial changes in the cone biopsy. CIN grade was established according to the WHO/ISGYP classification and comparation of the results was performed after that. Results. Out of the total number of patient, 89.36% of them with dysplastic epithelial changes on cone biopsy had also dysplastic changes in the preoperative punch biopsy. An exact correlation between CIN grades was identified in 56% of the cases, 20% in CIN2, and 36% in CIN3 cases. There were 24.14% patients with negative endocervical curretage, while only in one case the cone biopsy was negative, too. Among the remaining 22 patients with CIN changes in endocervical curretage specimens, only one had a negative cone biopsy. An exact correlation of CIN grade was identified in 37.93% of the cases, 13.79% of CIN2, and 24.14% of the CIN3 cases. Conclusion. There was a positive cor relation between the CIN grades in punch and cone biopsy, as well as between the grade on the endocervical curretage and cone biopsy specimen, but with the lower degree than previous.

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DIAGNOSTIC COLPOSCOPIC ACCURACY BY THE GYNOCULAR AND A STATIONARY COLPOSCOPE

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462315000252 ◽

2015 ◽

Vol 31 (3) ◽

pp. 181-187 ◽

Cited By ~ 4

Author(s):

Helena Kopp Kallner ◽

Maria Persson ◽

Marcus Thuresson ◽

Daniel Altman ◽

Isaac Shemer ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Sensitivity And Specificity ◽

Low Cost ◽

Kappa Statistic ◽

Punch Biopsy ◽

Cervical Cytology ◽

Cervical Lesions ◽

High Agreement ◽

Abnormal Cervical Cytology ◽

Cone Biopsy

Objectives: The aim of this study was to evaluate the diagnostic accuracy of sensitivity and specificity of cervical lesions by the low-cost, portable Gynocular colposcope and a stationary colposcope, in women referred for colposcopy with abnormal cervical cytology.Methods: A randomized cross-over clinical trial for evaluating the diagnostic accuracy in detecting cervical lesions by the Gynocular and a stationary colposcope. The Swede score systematic colposcopy system was used for evaluation of colposcopic abnormalities. Directed punch biopsy and excisional cone biopsy were used as the “gold-standard” by histologically confirmed high grade cervical lesions CIN2+ (CIN2, CIN3, CIN3+). In total, 123 women referred for colposcopy due to abnormal cervical cytology were recruited at the Department of Obstetrics and Gynecology, Danderyd Hospital, Stockholm, Sweden. The percentage agreement and the kappa statistic were calculated for Swede score by the Gynocular and a stationary colposcope. Swede scores were compared with the results from directed punch biopsy and excisional cone biopsy.Results: The Gynocular and the stationary colposcope had a high agreement of Swede scores with a Kappa statistic of 0.947, p < .0001. Punch biopsy diagnosed CIN2+ (CIN2, CIN3, and invasive cancer) in 44 (35.7 percent) women while cytology detected CIN2+ in 34 (27.6 percent) women. There were no significant differences of the sensitivity and specificity for different Swede scores by the Gynocular or a stationary colposcope in detecting CIN 2+.Conclusions: There were no significant differences in sensitivity or specificity in detecting cervical lesions by the Gynocular or stationary colposcope. The Gynocular is as accurate in diagnosing cervical lesions as a stationary colposcope.

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HPV-Chlamydial Coinfection, Prevalence, and Association with Cervical Intraepithelial Lesions: A Pilot Study at Mbarara Regional Referral Hospital

Journal of Cancer Epidemiology ◽

10.1155/2019/9092565 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Frank Ssedyabane ◽

Diaz Anaya Amnia ◽

Ronald Mayanja ◽

Aisagbonhi Omonigho ◽

Charles Ssuuna ◽

...

Keyword(s):

Risk Factors ◽

Cervical Cancer ◽

Chlamydia Trachomatis ◽

Pap Smear ◽

Low Grade ◽

Cervical Lesions ◽

Cross Sectional ◽

Hpv Dna ◽

Cervical Intraepithelial Lesions ◽

Intraepithelial Lesions

Background. Human Pappilloma Virus (HPV) is the necessary cause of cervical cancer. A number of risk factors are believed to influence the role of HPV in the development of cervical cancer. This is so because majority of HPV infections are cleared and only a few are able to result into cancer. Chlamydia trachomatis (CT) is considered a potential cofactor in the development of cervical intraepithelial neoplasia (CIN), although different studies have produced contradicting information (Silins et al., 2005, Bellaminutti et al., 2014, and Bhatla et al., 2013). The objective of this cross-sectional study was to determine the prevalence and association of HPV-Chlamydial coinfection with cervical intraepithelial lesions and other risk factors for cervical intraepithelial lesions at a hospital in south western Uganda (MRRH). Methods. The study included 93 participants, with an age range of 25 to 80 years, from whom cervical specimens were collected and enrolment forms were completed upon consent. Experienced midwives collected one cervical smear and two endocervical swabs from each participant. The swabs were used for HPV DNA and Chlamydia trachomatis antigen testing. Data was entered in Microsoft excel and analysed using STATA 12 software. With the help of spearman’s correlation at the 0.05 level of significance, bivariate and multivariate analysis were done by logistic regression, to determine associations of risk factors to cervical lesions. Results. The results showed the prevalence of HPV-Chlamydial coinfection to be 8.6% (8/93). Positive Pap smear results were found in 60.22% (56/93) participants, most of whom had low grade squamous intraepitherial lesion (LSIL) (54.84%). HPV-Chlamydial coinfection showed a significant correlation with a positive cytology result and only relatively significantly correlated with LSIL grade of cytological positivity. HPV was found to be the risk factors associated with cervical intraepithelial lesions at MRRH. Conclusion. HPV, Chlamydia, and HPV-Chlamydial coinfection are prevalent infections and there is a likelihood of association between HPV-Chlamydial coinfection and with cervical intraepithelial lesions. This study recommends general sexually transimitted infections (STIS) screening for every woman that turns up for cervical cancer screening and a larger study, probably a multicentre study.

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HUBUNGAN ANTARA LESI PRAKANKER SERVIKS DENGAN SOSIODEMOGRAFI PEREMPUAN DI KECAMATAN LEGOK KABUPATEN TANGERANG TAHUN 2018

Jurnal Muara Sains, Teknologi, Kedokteran dan Ilmu Kesehatan ◽

10.24912/jmstkik.v4i1.6321 ◽

2020 ◽

Vol 4 (1) ◽

pp. 193 ◽

Cited By ~ 1

Author(s):

Destiyana Cika Claritha ◽

Chandra Dewi ◽

Shintia Christina

Keyword(s):

Breast Cancer ◽

Cervical Cancer ◽

Analytical Study ◽

Precancerous Lesions ◽

Total Sample ◽

Cervical Lesions ◽

Cervical Intraepithelial Lesions ◽

Cervical Precancerous Lesions ◽

Precancerous Cervical Lesions ◽

Intraepithelial Lesions

Cervical and breast cancer are the highest prevalence cancer in Indonesia in 2013 which caused death to Indonesian women, cervical cancer by 0.8‰ and breast cancer by 0.5‰. Precancerous lesions of the cervix also known as cervical intraepithelial lesions (Cervical Intraepithelial Neoplastic) are the beginning of changes to cervical carcinoma. In general, precancerous lesions of the cervix originate from the squamous columnar junction in the uterine cervix, which undergoes the process of metaplasia. This study aims to determine whether there is a relationship between precancerous cervical lesions and sociodemography of women in Kecamatan Legok Kabupaten Tangerang in 2018. This study uses an analytical study with cross sectionaI approach. The population is all women in Kecamatan Legok Kabupaten Tangerang who had sexual relations. Total sample are 47 people. Keywords: cervical cancer, cervical precancerous lesions, parity ABSTRAKPenyakit kanker serviks dan payudara merupakan penyakit kanker dengan prevalensi tertinggi di Indonesia pada tahun 2013 yang menyebabkan kematian pada perempuan Indonesia, yaitu kanker serviks sebesar 0,8‰ dan kanker payudara sebesar 0,5‰. Lesi prakanker pada serviks dikenal juga dengan sebutan lesi intraepitelial serviks (Cervical Intraephitelial Neoplasia) merupakan awal dari perubahan menuju karsinoma serviks. Pada umumnya lesi prakanker serviks ini berawal dari daerah squamocolumnar junction pada serviks uteri yang mengalami proses metaplasia. Penelitian ini bertujuan untuk mengetahui adakah hubungan antara lesi prakanker serviks dengn sosiodemografi perempuan di Kecamatan Legok Kabupaten Tangerang tahun 2018. Penelitian ini merupakan studi analitik dengan pendekatan cross sectionaI. Populasi penelitian adalah semua perempuan di Kecamatan Legok Kabupaten Tangerang yang sudah berhubungan seksual. Total sampel 47 orang.

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HUBUNGAN ANTARA LESI PRAKANKER SERVIKS DENGAN SOSIODEMOGRAFI PEREMPUAN DI KECAMATAN LEGOK KABUPATEN TANGERANG TAHUN 2018

Jurnal Muara Sains, Teknologi, Kedokteran dan Ilmu Kesehatan ◽

10.24912/jmstkik.v4i1.3010 ◽

2020 ◽

Vol 4 (1) ◽

pp. 1

Author(s):

Destiyana Cika Claritha ◽

Chandra Dewi Kartika Setyaningsih ◽

Shintia Christina

Keyword(s):

Breast Cancer ◽

Cervical Cancer ◽

Analytical Study ◽

Precancerous Lesions ◽

Total Sample ◽

Cervical Lesions ◽

Squamocolumnar Junction ◽

Cervical Intraepithelial Lesions ◽

Precancerous Cervical Lesions ◽

Intraepithelial Lesions

Cervical and breast cancer are the highest prevalence cancer in Indonesia in 2013 which caused death to Indonesian women, cervical cancer by 0.8‰ and breast cancer by 0.5‰. Precancerous lesions of the cervix also known as cervical intraepithelial lesions (Cervical Intraepithelial Neoplastic) are the beginning of changes to cervical carcinoma. In general, precancerous lesions of the cervix originate from the squamous columnar junction in the uterine cervix, which undergoes the process of metaplasia. This study aims to determine whether there is a relationship between precancerous cervical lesions and sociodemography of women in Kecamatan Legok Kabupaten Tangerang in 2018. This study uses an analytical study with cross sectionaI approach. The population is all women in Kecamatan Legok Kabupaten Tangerang who had sexual relations. Total sample are 47 people. ABSTRAKPenyakit kanker serviks dan payudara merupakan penyakit kanker dengan prevalensi tertinggi di Indonesia pada tahun 2013 yang menyebabkan kematian pada perempuan Indonesia, yaitu kanker serviks sebesar 0,8‰ dan kanker payudara sebesar 0,5‰. Lesi prakanker pada serviks dikenal juga dengan sebutan lesi intraepitelial serviks (Cervical Intraephitelial Neoplasia) merupakan awal dari perubahan menuju karsinoma serviks. Pada umumnya lesi prakanker serviks ini berawal dari daerah squamocolumnar junction pada serviks uteri yang mengalami proses metaplasia. Penelitian ini bertujuan untuk mengetahui adakah hubungan antara lesi prakanker serviks dengn sosiodemografi perempuan di Kecamatan Legok Kabupaten Tangerang tahun 2018. Penelitian ini merupakan studi analitik dengan pendekatan cross sectionaI. Populasi penelitian adalah semua perempuan di Kecamatan Legok Kabupaten Tangerang yang sudah berhubungan seksual. Total sampel 47 orang.

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Space reconstruction of the aneurysms of the vertebrobasilary confluence based on conventional angiography: Our experience

Acta chirurgica iugoslavica ◽

10.2298/aci0802075n ◽

2008 ◽

Vol 55 (2) ◽

pp. 75-78

Author(s):

I.M. Nikolic ◽

M.Lj. Rakic ◽

E.E. Slavik ◽

G.M. Tasic ◽

B.M. Djurovic ◽

...

Keyword(s):

Blood Vessels ◽

Diagnostic Procedures ◽

Conventional Angiography ◽

Two Dimensional Image ◽

Diagnostic Protocol ◽

Clinical Center ◽

Golden Standard ◽

Preoperative Diagnostic ◽

Third Dimension ◽

Initial Results

Besides current development of the new diagnostic procedures conventional angiography still represents the golden standard in the diagnosing of intracranial aneurysms. Since it gives a two-dimensional image if the presentation of the third dimension is wanted it is necessary to apply appropriate algorithm structures and computers. In this study we show our experience in the application of space reconstruction of blood vessels and aneurysms of the vertebrobasilary confluence in 6 patients operated at the Institute for Neurosurgery, Clinical Center of Serbia. Intraoperative finding in all patients matched the finding that we got by space reconstruction of the blood vessels, which was possible to observe from different angles. Postoperative course in all patients was satisfying. Upon discharge the patients were without rough lateralization of the pyramidal system. Our initial results and their practical agreement with the interoperative finding give us right to recommend this method as the standard for the preoperative diagnostic protocol.

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The risk factors of residual lesions and recurrence of the high-grade cervical intraepithelial lesions (HSIL) patients with positive-margin after conization

Medicine ◽

10.1097/md.0000000000012792 ◽

2018 ◽

Vol 97 (41) ◽

pp. e12792 ◽

Cited By ~ 4

Author(s):

Jun-yu Chen ◽

Zhi-ling Wang ◽

Zhao-yang Wang ◽

Xing-sheng Yang

Keyword(s):

Risk Factors ◽

Positive Margin ◽

High Grade ◽

Cervical Intraepithelial Lesions ◽

Intraepithelial Lesions ◽

Residual Lesions

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Cervical cytologic abnormalities and negative colposcopy: histologic assessment

International Journal of Gynecological Cancer ◽

10.1046/j.1525-1438.1994.04050348.x ◽

1994 ◽

Vol 4 (5) ◽

pp. 348-351 ◽

Cited By ~ 4

Author(s):

R. Chenoy ◽

S. Manohar ◽

C. W.E. Redman ◽

D. M. Luesley

Keyword(s):

Cervical Cytology ◽

Histologic Diagnosis ◽

Abnormal Cervical Cytology ◽

Accurate Definition ◽

Cone Biopsy ◽

Histologic Evaluation ◽

Simple Regression Analysis ◽

Definition Of ◽

Cytologic Abnormalities ◽

Intraepithelial Lesions

Colposcopic assessment may be normal in the presence of severe or persistent minor cytologic abnormality. To assess the significance of negative satisfactory colposcopy in patients with abnormal cervical smears, a retrospective review was carried out on 1170 patients who had undergone out-patient loop diathermy excision for abnormal cervical cytology. Of these, 69 patients were treated for abnormal cervical cytology, despite normal colposcopic findings. Cytologic abnormalities ranged from persistent borderline changes to severe dyskariosis. Histologic assessment of the excision specimens revealed cervical intraepithalial neoplasia (CIN) in 43 (62.3%) cases, of which high-grade CIN accounted for 24 (34.8%) cases. There was good correlation between cytologic and histologic diagnosis. Simple regression analysis showedr= 0.46,P< 0.0001. The cytologic abnormality was highly predictive of the corresponding histologic diagnosis. This analysis has shown that significant intraepithelial lesions may exist despite negative colposcopic examination and highlights the need for histologic evaluation in such cases. In these circumstances, loop cone biopsy permits accurate definition of lesion severity, avoids potential undertreatment of significant lesions and causes less morbidity than conventional cone biopsy.

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