A study of evaluation of unhealthy cervix by various diagnostic modalities

Background: This study was carried out to evaluate cases of unhealthy cervix by using Pap (Papanicolaou) smear, colposcopy and cervical biopsy and to arrive at a definitive diagnosis. It correlated the findings of Pap smear, colposcopy and histopathology. It is important to strictly implement the screening program and spread awareness of the disease symptoms and its management to reduce the overall incidence of morbidity and mortality reported due to cervical cancer.Methods: A total 120 patients satisfying the inclusion/exclusion criteria were recruited for the study and informed consent was taken from all the participants. Pap smear was taken for all the cases. Then cases were subjected to colposcopy followed by biopsy. All the findings were correlated and analyzed. The findings of Pap smear and colposcopy were correlated with the gold standard of histopathology.Results: The sensitivity and specificity of Pap smear and colposcopy with respect to cervical biopsy were 53.1% and 98.7%, 87.87% and 72.72% respectively. Colposcopy had higher sensitivity and lower specificity than Pap smear for screening of cancer cervix.Conclusions: Cervical cancer is one of the preventable and highly curable conditions when diagnosed in the precancerous stage. The incidence of deaths resulting from cervical cancer can be brought down with adequate cervical cancer screening. Colposcopy and colposcopy directed biopsy should be done along with Pap smear in screening for early detection of cervical cancer since the accuracy of detection of cervical abnormalities is higher when these two methods are used complementarily.

Prospective comparative study between colposcopy and histopathology for diagnosis of CIN and carcinoma cervix

Background: Cervical cancer develops from precursor lesions and detection of these lesions is of utmost importance. The detection of precancerous lesions is made with help of screening tests most important include PAP smear and colposcopy. So we conducted this study to understand the role of colposcopy in down staging of Carcinoma cervix.Methods: We performed a prospective study between Jan 2018 to Dec 2018 on 180 subjects chosen from patients who sought consultation for various gynaecological complaints between age group of 18-60 years. A Pap smear followed by a colposcopy was performed and colposcopic directed biopsies were taken and subjected to histolopathological examination.Results: Colposcopy had a sensitivity of 83.3%, specificity of 78.5%, PPV of 68.9% for CIN 1. It had a sensitivity of 90.9%, specificity of 95.2%, PPV of 83.33% for CIN 2 and 3 when co related with gold standard histopathology which is much higher as compared to Pap smear.Conclusions: Colposcopy is an effective tool in down staging of Carcinoma cervix.

Comparative evaluation of colposcopy, cytology and histopathology for diagnosis of cervical lesions

Background: Cervical cancer is the fourth most frequent cancer globally in women with an estimated 570,000 new cases and 311,000 deaths in 2018 representing 6.6% of all female cancers. To correlate the cytology, colposcopy and histopathology of cervical lesions in patients attending gynaecology OPD in a tertiary care centre, Ghaziabad.Methods: 208 women were enrolled from Gynaecology OPD of Santosh Medical College and Hospital, Ghaziabad, irrespective of their chief complaints. Women aged 19-80 years were included in the study group. Those with pregnancy and already diagnosed or treated with CIN, Cervical cancer or Cervical HPV infection were excluded from the study. PAP-smear was taken for all the patients followed by colposcopy without waiting for PAP-smear report. Cervical biopsy was taken from patients with abnormal colposcopic findings (90 patients).Results: Majority of women were in age group 30-39 years. 37.5% had unhealthy, 21.6% had hypertrophied cervix and only 9.1% had normal cervix. It was found that PAP -smear has a sensitivity of 33.33%, specificity of 92.59%, accuracy of 68.89%, positive predictive value of 75% and negative predictive value of 67.57%. Test parameters calculated for colposcopy revealed that it has sensitivity of 73.33%, specificity of 92%, PPV of 64.7%, NPV of 94.52% and accuracy of 88.89%.Conclusions: The results from the current study conclude that it is better to use cytology and colposcopy together as part of routine screening for cervical cancer rather than pap smear alone in order to detect maximum number of lesions.

Clinical value of new rapid pathological diagnosis technique in the examination of cervical lesions in primary medical institution / 中国基层医药

Objective@#To explore the clinical value of new rapid pathological diagnosis technology in the examination of cervical lesions in primary medical institution.@*Methods@#In the Affiliated Hospital of Yangzhou University, 25 cases of cervical scraping and 22 cases of cervical biopsy were selected.Twenty-five cases of cervical scraping scraped two wipers during operation, the results were compared with conventional pathological techniques and new rapid pathological diagnosis techniques.Twenty-two cases of cervical biopsy used a new rapid pathological diagnosis technique to perform cytological diagnosis of biopsy tissue rolls in biopsy operation.According to the results of rapid pathological diagnosis, the biopsy operation plan was adjusted to analyze the clinical value of the new rapid pathological diagnosis technique in cervical lesions in primary medical institution.@*Results@#The new rapid pathological diagnosis technology required less space and no pollution, and the diagnosis took about 2-3 min, which did not affect the normal inspection operation.Twenty-five cases of cervical scraping were produced with new rapid pathological diagnosis technique, and the quality of cervical scraping produced with conventional pathological technique was consistent, which could satisfy the needs of pathological cytological diagnosis; twenty-two cases of cervical biopsy under the vaginal device were assisted by this technology and it could increase the positive rate of the first biopsy.@*Conclusion@#Cervical scraping and cervical biopsy are still the main methods for cervical lesions examination in primary hospitals.The new rapid pathological diagnosis technology can provide the real-time pathological diagnosis of cervical scraping, improve the positive detection rate of the first biopsy of cervical biopsy, and the cost is low, suitable for promotion in primary medical institution.

Clinical value of new rapid pathological diagnosis technique in the examination of cervical lesions in primary medical institution / 中国基层医药

Objective To explore the clinical value of new rapid pathological diagnosis technology in the examination of cervical lesions in primary medical institution.Methods In the Affiliated Hospital of Yangzhou University,25 cases of cervical scraping and 22 cases of cerrical biopsy were selected.Twenty-five cases of cervical scraping scraped two wipers during operation,the results were compared with conventional pathological techniques and new rapid pathological diagnosis techniques.Twenty-two cases of cervical biopsy used a new rapid pathological diagnosis technique to perform cytological diagnosis of biopsy tissue rolls in biopsy operation.According to the results of rapid pathological diagnosis,the biopsy operation plan was adjusted to analyze the clinical value of the new rapid pathological diagnosis technique in cervical lesions in primary medical institution.Results The new rapid pathological diagnosis technology required less space and no pollution,and the diagnosis took about 2-3 min,which did not affect the normal inspection operation.Twenty-five cases of cervical scraping were produced with new rapid pathological diagnosis technique,and the quality of cervical scraping produced with conventional pathological technique was consistent,which could satisfy the needs of pathological cytological diagnosis;twenty-two cases of cervical biopsy under the vaginal device were assisted by this technology and it could increase the positive rate of the first biopsy.Conclusion Cervical scraping and cervical biopsy are still the main methods for cervical lesions examination in primary hospitals.The new rapid pathological diagnosis technology can provide the real-time pathological diagnosis of cervical scraping,improve the positive detection rate of the first biopsy of cervical biopsy,and the cost is low,suitable for promotion in primary medical institution.

Comparison Of Cervical Biopsy Using Punch Biopsy Forceps Versus Loop Electrode

Context: The biopsy of cervix can be obtained by various methods with availability of newer modalities like loop elec-trode. Objectives: To compare the histo-pathological parameters and clinical outcome of cervical biopsy obtained using punch biopsy forceps versus loop electrode. Methods: Women attending OPD were screened for cervical pa-thology, and colposcopy was done for those who screened positive. Patients who required cervical biopsy after col-poscopy were allocated into 2 group; one undergoing LEEP biopsy and other half biopsied with Punch forceps. During procedure patients were evaluated for the intra–op pain and bleeding and their severity. The histo-pathological di-agnosis was carried out and the sample was studied for its size, adequacy, and presence of any thermal or crush ar-tefacts. Result: The two methods of biopsy were comparable in intra-op parameters, except for the increased re-quirement for additional haemostasis in LEEP biopsy. There was no case of bleeding from biopsy site at the follow-up visit. LEEP biopsy was associated with continued vaginal discharge more often than punch biopsy. An adequate sam-ple for histopathological diagnosis was obtained in 91.25% of all cases. The comparative findings were reflective of comparable efficacy of both methods in providing an acceptable tissue sample for diagnosis. Conclusion: After ana-lysing and comparing the aforementioned parameters, we opined that neither method can be deemed clearly supe-rior to the other as a cervical biopsy procedure.

A high prevalence of human papillomavirus 16 and 18 co-infections in cervical biopsies from southern Brazil

ABSTRACT HPV types 16 and 18 were studied in paraffin-fixed cervical biopsy collected in southern Brazil. HPV 16, HPV 18 and co-infection HPV 16/18 were identified in 10/57 (17.5%), 4/57 (7%) and in 43/57 (75.4%) samples, respectively. Southern Brazil has one of the highest prevalence rates of HPV 16/18 reported.

Clinical analysis of 128 cases of cervical lesion diagnosed by multi-point biopsy of colposcopy and endocervical curettage / 中华肿瘤杂志

Objective@#To investigate the clinical values of colposcopy and cervical biopsy and/or endocervical curettage (ECC) in the diagnosis of cervical lesion.@*Methods@#Clinical data of 128 cases of cervical lesion diagnosed by Xuzhou Cancer Hospital from January 23, 2014 to October 11, 2016 were collected and retrospectively analyzed, all patients underwent colposcopy and cervical biopsy and/or ECC.@*Results@#Among them, the age between 30 to 50 years old were 70 cases, whose transformation zone types of Ⅰ, Ⅱ and Ⅲ were 28 cases (40.0%), 23 cases (32.9%) and 19 cases (27.1%), respectively. The age older than 50 years were 45 cases, whose transformation zone types of Ⅱ and Ⅲ were 1 case (2.2%) and 44 cases (97.8%), respectively. Among the 128 cases of cervical lesions, diagnostic results of colposcopy showed that the chronic inflammation were 57 cases, cervical intraepithelial neoplasia (CIN)Ⅰwere 35 cases, CINⅡor CINⅡ~Ⅲ were 8 cases, CIN Ⅲ were 5 cases and cervical cancer were 23 cases. Alternatively, the pathological results showed that the chronic inflammation were 81 cases, CINⅠwere 17 cases, CINⅡor CINⅡ~Ⅲ were 7 cases, CIN Ⅲ were 5 cases and cervical cancer were 18 cases, respectively. Among the 81 cases of chronic inflammation diagnosed by pathology, 52 cases (64.2%) were consistent with the diagnostic results of colposcopy. Among the 17 cases of low grade squamous epithelial cell lesion (LSIL) diagnosed by pathology, 10 cases were in agree with the diagnostic results of colposcopy. Among the 12 cases of high-grade squamous epithelial cell lesion (HSIL) diagnosed by pathology, 9 cases were concordant with the diagnostic results of colposcopy. Among the 18 cases of cervical cancer diagnosed by pathology, 17 cases were consistent with the diagnostic results of colposcopy.@*Conclusions@#The type of transformation zone is positively correlated with the age, and it can help to choose biopsy and therapeutic manner. The diagnostic accuracies of HSIL and early stage of cervical cancer by multi-point biopsy of colposcopy and/or ECC are high. The cervical lesions which are difficultly found by direct visualization can be identified by colposcopy, and thus provides objective evidence to determine the therapeutic manner for patients with stage ⅡA of cervical cancer.

Risks of cervical intraepithelial neoplasia grade 3 or invasive cancers in ASCUS women with different management: a population-based cohort study / 부인종양

OBJECTIVE: To investigate the progression risk of atypical squamous cells of undetermined significance (ASCUS) with different clinical managements. METHODS: Women with their first diagnosis of ASCUS cytology were retrieved from the national cervical cancer screening database and linked to the national health insurance research database to identify the management of these women. The incidences of developing cervical intraepithelial neoplasia grade 3 and invasive cervical cancer (CIN3+) were calculated, and the hazard ratios (HRs) were estimated using a Cox proportional hazards model. This study was approved by the Research Ethics Committee of the National Taiwan University Hospital and is registered at ClinicalTrials.gov (Identifier: NCT02063152). RESULTS: There were total 69,741 women included. Various management strategies including colposcopy, cervical biopsies and/or endocervical curettage, and cryotherapy, failed to reduce the risk of subsequent CIN3+ compared with repeat cervical smears. Loop electrosurgical excision procedure/conization significantly decreased risk of subsequent CIN3+ lesions (HR=0.22; 95% confidence interval [CI]=0.07–0.68; p=0.010). Women in their 40s–50s had an approximately 30% risk reduction compared to other age groups. Women with a previous screening history >5 years from the present ASCUS diagnosis were at increased risk for CIN3+ (HR=1.24; 95% CI=1.03–1.49; p=0.020). CONCLUSION: In women of first-time ASCUS cytology, a program of repeat cytology can be an acceptable clinical option in low-resource settings. Caution should be taken especially in women with remote cervical screening history more than 5 years.

A high prevalence of human papillomavirus 16 and 18 co-infections in cervical biopsies from southern Brazil

ABSTRACT HPV types 16 and 18 were studied in paraffin-fixed cervical biopsy collected in southern Brazil. HPV 16, HPV 18 and co-infection HPV 16/18 were identified in 10/57 (17.5%), 4/57 (7%) and in 43/57 (75.4%) samples, respectively. Southern Brazil has one of the highest prevalence rates of HPV 16/18 reported.

Value of combined application of high risk human papillomavirus DNAdetection and thinprep cytologic test for cervical cancer screening / 中国生化药物杂志

Objective To evaluate the diagnostic value of thinprep cytologic test (TCT) combined with high-risk human papillomavirus (HR-HPV) DNA for cervical cancer (CC). Methods 141 cases of patients with abnormal cervical lesions were abnormal examined by TCT and were graded by the results of TCT and cervical biopsy, the HR-HPV-DNA was detected by surface plasmon resonance (SPR). Results The cervical biopsy positive rate 65.2% (92/141) was significantly higher than the positive rate of TCT 39.0% (55/141) (χ2=19.45, P < 0.05). The positive rate of HR-HPV-DNA was 66.0% (93/141) was significantly higher than the positive rate of TCT 39.0% (55/141), (χ2=20.53, P < 0.05). Conclusion TCT, HR-HPV-DNA and cervical biopsy are important clinical diagnostic methods for cervical lesions, combine detection of TCT and HR-HPV-DNA can improve the detection rate of cervical lesions.

Biopsia de cérvix: serie de casos / Cervical biopsy: cases series

Objetivo: Realizar una descripción de los resultados de los estudios de anatomía patológica de biopsias de cérvix de pacientes atendidas en la Clínica Universitaria San Juan de Dios (Cartagena, Colombia). Metodología: Estudio de serie de casos de biopsias de cérvix tomadas durante tres meses de 2011. Resultados: Se seleccionaron 59 casos. La edad promedio fue de 46,017 años, con una SD de 10,47, con un rango entre 18 y 69 años y un 50 % de los valores centrales estuvo comprendido entre 42 y 52 años. El diagnóstico de patología más frecuentemente reportado fue la cervicitis crónica, con 32,2 %, seguido de LIE de bajo grado, con 16,9 %, y pólipo endocervical, 16,9 %, el LIE de alto grado estuvo en el 8,5 % de los casos y se identificó CA en 3 casos (5,1 %). Conclusiones: Las pacientes mayores son más atentas a realizarse citologías vaginales. Las LIEs se distribuyen en todos los grupos etáreos y en el 6,8 % se diagnosticó cáncer.

Objetives: To make a description of the results of the pathological studies of cervical biopsies from patients treated at the University Hospital San Juan de Dios. Methodology: Study of cases series of cervical biopsies taken during three months of 2011. Results: 59 cases were selected. The average age of 46.017 years in a SD of 10.47 with a range between 18 and 69 years and 50% of the mean values were between 42 and 52 years. The most frequent pathology diagnosis reported was chronic cervicitis 32.2%, followed by low-grade SIL with 16.9% and 16.9% endocervical polyp, the high-grade SIL was at 8.5% of CA case was identified in 3 cases (5.1%). Conclusions: The elderly patients are more prone to perform Pap smears. The IELs are distributed in all age groups, and 6.8% were diagnosed with cancer.