Digital Cytology as the Tool for Organization of Cytology Online Quality Assurance Programs

2018 ◽  
Vol 7 (1) ◽  
pp. 31-39
Author(s):  
Ekaterine Kldiashvili ◽  
Nikoloz Shakulashvili
Keyword(s):  
Quality Assurance ◽  
Digital Images ◽  
Information Management System ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Double Blind ◽  
Squamous Cells ◽  
Maximum Resolution ◽  
Glass Slides ◽  
Intraepithelial Lesion

The article aims at evaluating the use of telecytology and laboratory information management system (LIMS) as tools for the implementation of online cytology quality assurance programs under the conditions of Georgia. Five hundred gynecological cytology cases (benign – 350; atypical squamous cells of undetermined significance (ASCUS) – 80; low-grade squamous intraepithelial lesion (LSIL) – 35; high-grade squamous intraepithelial lesion (HSIL) - 35) were randomly selected. The randomization has been done by using the Research Randomizer. Digital images were obtained in all cases at a maximum resolution of 2048x1536 pixels. Then, all 500 cases (medical data and images) were uploaded to the LIMS and were labelled “QA”. Diagnosis of glass slides and digital images were made independently in a double-blind manner by three certified cytologists, commencing with the diagnosis of “QA” cases followed by a diagnosis of glass slides four months later. It was found that the diagnoses of “QA” cases correspond with initial diagnoses.

Human Papillomavirus Testing and Reporting Rates: Practices of Participants in the College of American Pathologists Interlaboratory Comparison Program in Gynecologic Cytology in 2006

2008 ◽  
Vol 132 (8) ◽  
pp. 1290-1294 ◽  
Author(s):  
Ann T. Moriarty ◽  
Mary R. Schwartz ◽  
Galen Eversole ◽  
Marilee Means ◽  
Amy Clayton ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Interlaboratory Comparison ◽  
Low Grade ◽  
Hpv Testing ◽  
Squamous Intraepithelial Lesion ◽  
Papanicolaou Test ◽  
Frequency Distributions ◽  
Squamous Cells ◽  
Hpv Test ◽  
Intraepithelial Lesion

Abstract Context.—Oncogenic, high-risk human papillomavirus (HR-HPV) testing is used to evaluate women who are older than 20 years with atypical squamous cells of undetermined significance (ASC-US) and in conjunction with a screening Papanicolaou test in women older than 30 years. Objectives.—To evaluate the 2006 laboratory practice data from laboratories incorporating human papillomavirus (HPV) testing with the Papanicolaou test. Design.—To use the College of American Pathologists (CAP) Supplemental Questionnaire Survey for 2006 to determine laboratory practices of participants in the CAP Interlaboratory Comparison Program in Cervicovaginal Cytology. Results.—A total of 679 laboratories responded to the questionnaire. Most (73%) refer HPV testing to reference laboratories. Nine percent perform HPV testing in cytology. Forty-five percent offer low-risk HPV (LR-HPV) testing. The most common reflex is ASC-US, although HR-HPV is also offered with low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), or any other Papanicolaou test result. Digene Hybrid Capture II is the most common method. Human papilloma virus median test volumes are 55 monthly. Frequency distributions of HPV test volumes are significantly different from those found in 2003. Laboratories performing in-house testing reported significantly higher monthly HPV volumes (P < .001). Median rates for HR-HPV positivity are 36.6% for ASC-US, 50.0% for atypical squamous cells, cannot exclude HSIL (ASC-H), and 4% for women 30 years of age and older in conjunction with a screening Papanicolaou test. Conclusions.—Reference HPV testing remains the most common pattern. The most common reflex indication is for ASC-US, but HPV testing is modified locally to include a variety of scenarios. LR-HPV testing is commonly offered despite its lack of clinical significance. These data form a baseline for ongoing monitoring of HPV testing practice trends.

scholarly journals p16 immunostaining can avoid overdiagnosis in postmenopausal cervical cytology

2021 ◽  
Vol 9 (1) ◽  
pp. 1-8
Author(s):  
Yutaka Tsutsumi ◽  
◽  
Kazuya Shiogama ◽  
Ken Sakurai ◽  
Toru Arase ◽  
...  
Keyword(s):  
Cervical Cytology ◽  
Sampling Errors ◽  
Squamous Intraepithelial Lesion ◽  
Squamous Cells ◽  
Glass Slides ◽  
Intraepithelial Lesion ◽  
P16 Ink4a ◽  
Age Range ◽  
Chronic Cervicitis ◽  
P16 Expression

Senile (atrophic) colpitis is microscopically characterized by the predominance of parabasal squamous cells and the paucity of superficial cells. The activated parabasal cells or dyskeratotic superficial cells may be confused with squamous intraepithelial lesion (SIL) in the routine cytology practice. A total of 29 cervical cytology specimens diagnosed as atypical squamous cells (ASC) or SIL were retrospectively sampled from 24 postmenopausal women (age range: 56–84 years, mean: 65.5, median: 65). Cytological diagnoses in the routine services included ASC-US 20, ASC-H 2, LSIL 4 and HSIL 3. All the specimens showed an atrophic background (senile colpitis). There were two microscopic patterns of senile colpitis with atypia: 1) parabasal cells were clustered (n = 23) and 2) dyskeratotic superficial cells were seen in a highly inflamed background (n = 6). Immunostaining for p16-INK4a (p16 in short) was performed, after the cells were transferred to trimethoxy[3-(phenylamino)propyl]silane-coated glass slides. Only three of the 29 cytology specimens (two of the 24 cases) judged as HSIL cytologically revealed p16 positivity in clustered atypical parabasal cells. Biopsy was performed in 11 cases, and chronic cervicitis without p16 expression was seen in nine. Two lesions showed p16-positive dysplasia (one mild dysplasia and another moderate dysplasia). In one lesion in an 84 year-old female, both cytology and histology specimens showed p16 positivity (HSIL). Discrepancy of p16 expression between the cytology and histology specimens was encountered in two lesions, representing sampling errors. It is of note that the overcytodiagnosis is avoidable with the aid of p16 immunostaining. Keywords: Atypical squamous cells (ASC), cell transfer technique, p16-INK4a, senile colpitis, squamous intraepithelial lesion (SIL).

The Evaluation of p16ink4a Immunoexpression/Immunostaining and Human Papillomavirus DNA Test in Cervical Liquid-Based Cytological Samples

2011 ◽  
Vol 21 (1) ◽  
pp. 79-85 ◽  
Author(s):  
Maria Nasioutziki ◽  
Angelos Daniilidis ◽  
Kostos Dinas ◽  
Maria Kyrgiou ◽  
George Valasoulis ◽  
...  
Keyword(s):  
High Risk ◽  
Hpv Infection ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Dna Test ◽  
Hpv Dna ◽  
Squamous Cells ◽  
Intraepithelial Lesion ◽  
High Risk Hpv ◽  
Hpv Dna Test

Aim:To evaluate the role of p16INK4a immunoexpression and human papillomavirus (HPV) DNA test for the detection of dyskaryotic cells in high-risk women.Materials and Methods:This work was a retrospective diagnostic study conducted in the University Hospital of Thessaloniki from January to December 2008. The subjects were women with current or previous HPV infection and current or previous cervical intraepithelial lesion (with or without treatment) or clinical warts. All liquid-based cytological samples were tested for P16INKa and HPV DNA test. The accuracy parameters used for the outcome included sensitivity, specificity, and positive predictive value.Results:A total of 226 women were included; the mean age was 29 years. Expression of p16INK4a was detected in the cytological samples of 13% of the negative cases, 44% of the cases of atypical squamous cells of undetermined significance, 46% of the cases of low-grade squamous intraepithelial lesion, and 78% of the cases of high-grade squamous intraepithelial lesion. A total of 91 women tested positive for high-risk HPV infection, and 54 of those had p16INK4a-positive staining reaction cells. The concordance between the 2 tests, HPV DNA and p16, was 59% regarding infection-positive cases. Diffuse strong parabasal p16INK4a immunostaining (nuclear score >2) was observed in 17 cases of the abnormal cytological findings (atypical squamous cells of undetermined significance, 2 cases; low-grade squamous intraepithelial lesion, 8 cases; high-grade squamous intraepithelial lesion, 7 cases). Colposcopy-directed biopsies were used as the criterion standard for the detection of cervical intraepithelial neoplasia in 91 women. The sensitivity of p16INK4a was 95% and the specificity was 92%, whereas the sensitivity of high-risk HPV was 100% and the specificity was 78%. The positive predictive value of p16INK4a was 71%, whereas that of HPV DNA was 44%.Conclusion:The findings suggest that p16INK4a immunostaining can improve the accuracy of cytological examination and HPV DNA test and may be particularly useful in the triage of low-grade lesions.

scholarly journals Evaluation of the In Situ Hybridization Signal Patterns of Liquid-Based Cytological Human Papillomavirus Specimens for Diagnosing Squamous Intraepithelial Lesion

2011 ◽  
Vol 2011 ◽  
pp. 1-9
Author(s):  
Katsunari Ishida ◽  
Makoto Nagasaki ◽  
Masayuki Kobayashi ◽  
Tatsushi Nakagawa ◽  
Toru Nabika ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Routine Testing ◽  
Squamous Cells ◽  
Intraepithelial Lesion ◽  
Liquid Based Cytology ◽  
Undetermined Significance

To examine the diagnostic utility for squamous intraepithelial lesion (SIL) by cytological in situ hybridization (c-ISH) for the human papillomavirus using liquid-based cytology specimens, we investigated c-ISH signal patterns in the cases of low-grade SIL (LSIL), atypical squamous cells of undetermined significance (ASC-US), and high-grade SIL (HSIL). Episomal (E) and/or integrated (I) signals were observed. Two signal patterns (E≧I or I>E) were obtained by counting the number of E+ or I+ cells. E≧I was specific to LSIL and ASC-US (10/12); I>E, to HSIL (9/11) (P<0.01, χ2 test), suggesting significant utility of c-ISH in diagnosing SIL. In the cell fraction, E≧I in large cells was dominant in LSIL. Two cases of I>E in large cells of LSIL showed HPV persistence and/or progression during follow-up. Thus, c-ISH is useful in routine testing for diagnosing cervical dysplastic lesions, especially for detecting LSIL suspected for progression.

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