scholarly journals A retrospective analysis of cervical smears for detection of precancerous lesions

2015 ◽  
Vol 5 (10) ◽  
pp. 847-849
Author(s):  
A Jha ◽  
AK Chaurasia

Background:  Diseases of the cervix are common in women. Detection of neoplastic lesions is of prime importance in the evaluation of cervical smears although their frequency is less than the non-neoplastic conditions. Reactive and inflammatory conditions, however, may mimic or obscure the dysplastic changes. The aim of this study was to evaluate the frequencies of various inflammatory, reactive and neoplastic   lesions in the cervical smears.Materials and Methods: This was a retrospective study of 150 cases of cervical smears collected from medical record section of the hospital and Department of Pathology at National Medical College from April 2013 to April 2015.Results: Of 150 patients who underwent cervical cytology, only 15 cases (10%) had epithelial cell abnormalities. This was followed by reactive cellular changes associated with inflammation (16.7%), infections (5.3%) and atrophy (1.3%). Low grade squamous intraepithelial lesion (6%) was the most common epithelial cell abnormality followed by high grade squamous intraepithelial lesion (2%), atypical glandular cells (1.3%) and squamous cell carcinoma (0.7%).Conclusion: Reactive changes including atrophy were the commonest finding. Squamous intraepithelial lesion was commonest finding among epithelial abnormalities. Glandular intraepithelial lesions and squamous cell carcinoma were also identified. Among infections Trichomoniasis  and candidiasis  were seen.

1970 ◽  
Vol 1 (1) ◽  
pp. 30-33 ◽  
Author(s):  
SK Ranabhat ◽  
R Shrestha ◽  
M Tiwari

Background: Like in other developing countries, cancer of cervix is one of the most common malignancies in women in Nepal. Most women never undergo a cervical Pap smear screening. The objective of this study is to determine the prevalence of abnormal cervical epithelial lesions. Materials and Methods: This was a retrospective study of 880 conventional cervical Pap smears reported from the Department of Pathology, Chitwan Medical College in Chitwan, Nepal. The time period was from June 2009 to November 2010. Results: In this study, High-grade Squamous Intraepithelial Lesion was the most common with 6 cases (40%), followed by Low-grade Squamous Intraepithelial Lesion with 3 cases (20%), then Atypical Squamous Epithelial Cells of Undetermined Significance, and atypical Glandular Cells and Squamous cell carcinoma with 2 cases each (13.3%). Eighty per cent of all the abnormal epithelial lesions were found in women above the age of 40 years. Conclusion: At least one Pap screening test of the cervix of all women between the ages of 40-50 years is recommended. Keywords: Pap smear; Cervical Intraepithelial Lesion; Squamous cell carcinoma. DOI: 10.3126/jpn.v1i1.4447Journal of Pathology of Nepal (2011) Vol.1, 30-33


2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Qing Cong ◽  
Yu Song ◽  
Qing Wang ◽  
Hongwei Zhang ◽  
Shujun Gao ◽  
...  

Punch biopsy is important in the diagnosis of cervical cancer. However, it may fail to detect early cervical cancers. A retrospective study was performed in the largest academic women’s hospital in China to demonstrate cervical cancer that colposcopy-directed biopsy failed to detect. Methods. Patients who were diagnosed with high-grade squamous intraepithelial lesion (HSIL), adenocarcinoma in situ (AIS), and persistent low-grade squamous intraepithelial lesion (LSIL) via colposcopy-directed biopsy and had further undergone loop electrosurgical excision procedure (LEEP) conization were included. These procedures were performed at Obstetrics and Gynecology Hospital of Fudan University from July 1, 2013, to December 31, 2016. In total, 5.98% (760/12714) of patients who underwent conization were diagnosed with invasive cervical cancer. Persistent LSIL (0.24%), HSIL (6.37%), and AIS (24.31%) were detected cancer by conization. Histological subtypes included squamous cell carcinoma (92.0%), adenocarcinoma (5.1%), adenosquamous carcinoma (1.8%), adenoid basal type carcinoma (0.9%), and small cell neuroendocrine carcinoma (0.1%). Cytology reports consisted of HSIL (45.4%), atypical squamous cells of undetermined significance (ASC-US) (16.1%), and LSIL (11.6%), and atypical squamous cells cannot exclude HSIL (ASC-H) (9.3%), squamous cell carcinoma (0.9%), AGC (atypical glandular cells, 0.9%), AIS (0.4%), and NILM (negative for intraepithelial lesion or malignancy, 15.4%). The sensitivity of high-risk human papillomavirus (hrHPV) screening (96.4%) was significantly higher than that of cytology (84.6%) (P<0.01), with sensitivity of cotesting at 99.8% and a ratio of double-negative results at 0.2%. The sensitivity of cytology and hrHPV screening of different cervical cancer histologic subtypes was also demonstrated. In this large retrospective study, we systematically reported the cytology, hrHPV, pathology, and stages of cervical cancer that colposcopy-directed biopsy failed to detect.


Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 864-872
Author(s):  
Wenting Li ◽  
Bo Yang ◽  
Yiqun Li ◽  
Cuicui Wang ◽  
Xinzhi Fang

Abstract Background We investigated the expression and clinical significance of miR-141 and miR-340 in cervical squamous cell carcinoma (CSCC). Methods Expression of miR-141 and miR-340 in CSCC, high-grade squamous intraepithelial lesion (HSIL), and normal cervical squamous epithelium were detected by qRT-PCR. PTEN was assessed by immunohistochemistry. Their relationship with clinicopathological features was analyzed. Results The changes of miR-141 and miR-340 were different in CSCC, HSIL, and normal squamous epithelium (P = 0.030). miR-141 expression was statistically significant in gross type, differentiation, uterine corpus invasion, nerve invasion, vagina invasion, and FIGO stage in CSCC (P < 0.05). miR-340 expression was related to tumor size, differentiation, nerve invasion, lymph node metastasis, and FIGO stage in CSCC (P < 0.05). miR-141 and miR-340 expressions were statistically significant in different ages (P < 0.05) in HSIL. The AUC of miR-141 in CSCC diagnosis and that of miR-340 in HSIL diagnosis were 0.893 and 0.764, respectively. The sensitivity and the specificity of miR-141 for diagnosis of CSCC were 95.0% and 60.8%, respectively, while those of miR-340 for diagnosis of HSIL were 90.0 and 48.6%, respectively. miR-141 and miR-340 expressions are associated with PTEN expression (P = 0.002 and P < 0.001). Conclusion miR-141 and miR-340 may be associated with their target gene PTEN and involved in the carcinogenesis of cervical squamous epithelium.


2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Yue-Jie Li ◽  
Xin Qing ◽  
Qing-Xu Tao ◽  
Li Xiang ◽  
Li Gong ◽  
...  

Background. Vasculogenic mimicry (VM), as an endothelium-independent cancer microcirculation, has been observed in many malignancies including cervical cancer. Erythropoietin (EPO) and erythropoietin receptor (EPO-R) could produce an angiogenic effect to promote cervical squamous cell carcinoma (CSCC) progression. However, the association between VM formation and EPO/EPO-R expression in CSCC is poorly explored. Methods. Seventy-six paraffin-embedded CSCC samples, 25 high-grade squamous intraepithelial lesion (HSIL) samples, 20 low-grade squamous intraepithelial lesion (LSIL) samples, and 20 normal cervix samples were collected. Immunohistochemistry SP method was performed to detect EPO/EPO-R expression and CD31/periodic acid-Schiff (PAS) double staining was performed to detect VM formation. The associations of EPO/EPO-R and VM with clinicopathological parameters of CSCC were analyzed. The associations between VM formation and EPO/EPO-R expression were also analyzed. Results. The positive expression rates of EPO and EPO-R were gradually increasing along the progression of normal cervix-LSIL-HSIL-CSCC sequence (P<0.05). EPO and EPO-R expression were not significantly associated with clinicopathological parameters of CSCC patients (P>0.05). VM was significantly associated with FIGO stage, lymphovascular space involvement, and lymph node metastasis (P<0.05). VM was positively associated with EPO expression (r=0.284, P<0.05) but was not associated with EPO-R expression (P>0.05). Conclusion. These data suggest that increased EPO/EPO-R expression may play an important role in cervical carcinogenesis. EPO overexpression may promote VM formation in CSCC.


2004 ◽  
Vol 128 (1) ◽  
pp. 17-22 ◽  
Author(s):  
Andrew A. Renshaw ◽  
Nancy A. Young ◽  
George G. Birdsong ◽  
Patricia E. Styer ◽  
Diane D. Davey ◽  
...  

Abstract Context.—Results of clinical trials suggest that interpretation of liquid-based cytology preparations is more accurate and is associated with less screening error than interpretation of conventional preparations. Objective.—In this study, the performance of participants in interpreting ThinPrep (TP) preparations was compared with participants' performance on conventional Papanicolaou tests in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology (PAP). Design.—The results of the PAP from the year 2002 were reviewed, and the discordancies to series and exact-match error rates for the 2 cytologic methods were compared. Results.—For this study, a total of 89 815 interpretations from conventional smears and 20 886 interpretations from TP samples were analyzed. Overall, interpretations of TP preparations had both significantly fewer false-positive (1.6%) and false-negative (1.3%) rates than those of conventional smears (P = .001 and P = .02, respectively) for validated or validated-equivalent slides, as assessed by concordance with the correct diagnostic series. In this assessment of concordance to series, interpretations of educational TP and conventional preparations were similar, except for high-grade squamous intraepithelial lesion, in which the performance was significantly worse for educational TP preparations (false-negative rate of 8.1% vs 4.1% for conventional smears, P &lt; .001). When interpretations were matched to the exact diagnosis, validated-equivalent TP preparations were generally more accurate for diagnoses in the 100 series and 200 series than were conventional smears. Notably, for the reference diagnosis of squamous cell carcinoma, the exact-match error rate on validated equivalent TP slides was significantly greater than that of conventional slides (44.5% vs 23.1%, P &lt; .001). Interpretations of educational TP preparations also had a significantly higher error rate in matching to the exact reference diagnosis for squamous cell carcinoma (33.7% vs 22.8%, P = .007). Conclusions.—Overall, TP preparations in this program were associated with significantly lower error rates than conventional smears for both validated and educational cases. However, unlike the negative for intraepithelial lesion and malignancy, not otherwise specified, low-grade squamous intraepithelial lesion, and adenocarcinoma cytodiagnostic challenges, participants' responses indicated some difficulty in recognizing high-grade squamous intraepithelial lesion and squamous cell carcinoma.


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