ABSTRACT
Background: Cervical cancer is the most common, preventable cancer and does not develop suddenly from normal epithelium but is presented by a spectrum of intraepithelial neoplasia. Pap smear is an ideal screening and low cost effective test to detect intraepithelial neoplasia especially in developing countries but has limitations and needs confirmation by histopathology. The study aimed to determine the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of pap smears as screening test in cervical lesions by comparing with histopathology. Methods: This is a prospective study conducted at a tertiary care centre in Department of pathology from October 2012 to September 2014. A complete clinical history and demographic status of the subjects was recorded. Conventional pap smears were reported adopting Bethesda system and biopsies were taken in cases of epithelial cell abnormality, routinely processed and stained with H&E. Results: Total number of pap smears analysed were 356. NILM (negative for intraepithelial lesions or malignancy) constituted major group 248/356 (69.64%) and epithelial cell abnormality were 98/356 (27.5%). In the present study overall sensitivity was 94.11% specificity 64.28% positive predictive value 82.75%,negative predictive value 85%,diagnostic accuracy 83.33%,concordance rate 78.2% and P value <0.001. Concordance rate for CIN I was 78.9%, for CINII and CINIII 60% and for squamous cell carcinoma 100%. Conclusion: Pap smear is simple, inexpensive and can be performed in the outpatient department. Hence, it should be recommended routinely as a method of improving reproductive health, early detection of premalignant and malignant cervical lesions.
ABSTRACT
The effects of polluted water at three sites in the Marinho River, Brazil, on Oreochromis niloticus (Nile tilápia) were investigated using histological, hematological and biochemical approaches. Fish exposed to the impacted water demonstrated that histological changes in gills were accompanied by nuclear and micronuclei abnormalities in cells. The activity of liver and plasma biomarkers (alkaline phosphatase (ALP), acid phosphatase (ACP), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and liver glutathione S-transferase (GST)) showed an expressive change due to the. The results were also correlated with the highest levels of Cu+2, Zn+2 and Mn+2 in the water. The data of this study evidenced the importance of using a set of biomarkers to quantify pollution in lentic ecosystems. Additionally, histological analyses of gills and erythrocytes have proven to be an important instrument for signaling the impact of pollutants in rivers.
Os efeitos da poluição da água de três locais do Rio Marinho, Brasil, em Oreochromis niloticus foram investigados usando técnicas histológicas, hematológicas e bioquímicas. Peixes expostos à água impactada demonstraram que alterações histológicas nas brânquias foram acompanhadas de anomalias nucleares e micronúcleo nas células. A determinação da atividade de biomarcadores em fígado e plasma de tilápia (fosfatase alcalina (ALP), fosfatase ácida (ACP), alanina aminotransferase (ALT), aspartato aminotransferase (AST) e glutationa S-transferase (GST)) mostrou uma substancial alteração em função da poluição. Os resultados são correlacionados com os níveis mais elevados de Cu+2, Zn+2 e Mn+2 na água. Os dados deste estudo demonstram a importância de utilizar um conjunto de biomarcadores para quantificar a poluição em ecossistemas lênticos. Adicionalmente, as análises histológicas das brânquias e de eritrocitos têm provado ser importante instrumento para sinalizar a impactação de poluentes ao longo de rios.
Subject(s)
Phosphoric Monoester Hydrolases , Tilapia/anatomy & histology , TransaminasesABSTRACT
OBJECTIVE: The aim of this study was to evaluate the correlation between the results of preoperative PAP smears and known poor prognostic factors in patients with endometrial carcinoma. METHODS: Between Jan. 2000 and Dec. 2003, preoperative evaluation of PAP smears were done in 111 patients with endometrial carcinoma who underwent surgical staging. Pathologic parameters of permanent specimens were evaluated and correlated with the results of PAP smears. chi-square-test was used for statistical analysis and p-values <0.05 was considered as statistically significant result. RESULTS: The mean age of patients was 49 years with range between 24 and 75 years old. The results of preoperative PAP smears were normal in 70 patients (57.7%), atypical glandular cells of undetermined significance (AGUS) in 22 patients (22.5%), adenocarcnoma in 19 patients (19.8%) on preoperative PAP smears. Statistically significant associations were found between preoperative PAP smears and poor histologic grade (p=0.000), depth of myometrial invasion (p=0.000), lymph-vascular space invasion (p=0.003), cervical involvement (p=0.004), adnexal involvement (p=0.024), positive peritoneal cytology (p=0.042). However, old age, poor histologic type, higher surgical staging, pelvic nodes metastasis and para-aortic lymph node metastases were not statistically significant. CONCLUSION: This study revealed glandular cell abnormalities on preoperative PAP smears in patients with endometrial carcinoma were significantly associated with poor histologic grade, deep myometrial invasion, lympho-vascular invasion, cervical involvement, adnexal involvement, positive peritoneal cytology. Therefore, the results of preoperative PAP smears could be considered as an important part of the preoperative evaluation in patients with endometrial carcinoma.