Utility of Pap Smear Screening for Prevention of Cervical Cancer-A 3yrs Study from Rural Tripura-A Northeastern State of India

Background: Cancer cervix is a leading cause of mortality and morbidity among women worldwide. According to National Cancer Registry Program of India, cancers of cervix and breast are leading malignancies in Indian women. The morbidity and mortality could be significantly reduced with an active cervical smear screening programme. Objective: The study was done to evaluate the knowledge and attitudes of women about cervical smear testing, to establish a cervical smear screening program and to evaluate the cervical cytological abnormalities. It was done to determine the applicability, limitations and utility of this screening in a district hospital. Materials and Methods: A total of 287 married women were included in our study. Knowledge about Pap smear testing was determined through printed questionnaires. Pap smear screening was performed on every woman in our study group. Detailed clinical data and cytology reports were noted in a proforma. Results: About 92% women of our study group had never heard or undergone Pap smear screening before. Maximum number of patients was in 4th decade. Of the 287 smears, 276(96.16%) were adequate. Normal smear were 78(27.18%), inflammatory 168(58.54%), whereas epithelial cell abnormalities were seen in 26(9.05%) cases. The 26 abnormal cases comprised of 17(5.92%) cases with ASCUS, 5(1.74%) cases of LSIL, 1(0.35%) cases of HSIL, 3(1.04%) cases of squamous cell carcinoma. Conclusions: Epithelial cell abnormality in our study group was less than Western countries. There is poor knowledge about Pap smear screening. Pap smear study can be easily done through a chain built between the primary health care unit and district hospital and laboratory

Câncer de colo de útero: adesão das mulheres quanto ao exame citopatológico / Cervical cancer: accession of women as the Pap smear

O câncer de colo do útero é uma afecção iniciada com transformações intra-epiteliais progressivas. A prática de medidas preventivas para detecção e tratamento precoce deste tipo de câncer constitui uma medida essencial. Objetivo:Avaliar a não adesão das mulheres ao exame citopatológico em uma Unidade Básica de Saúde da Família.Método:O estudo foi exploratório, descritivo, longitudinal retrospectivo, de série temporal, com abordagem qualitativa e caracterizado como pesquisa-ação. Os dados foram analisados seguindo a técnica de Análise do Discurso do Sujeito Coletivo Resultados:Foram incluídos 293 mulheres de amostra ampliada. Foi visualizado que parte das mulheres possuíam conhecimentos sobre a prevenção e a importância do exame, no entanto, desconheciam a verdadeira utilidade deste. A falha no registro dos prontuários configurou-se como maior dificuldade na busca ativa dessas mulheres para a realização do preventivo.Conclusão:Os resultados contribuíram para o reconhecimento dos profissionais sobre o conhecimento dessas mulheres em relação ao exame citopatológico e dessa forma auxiliar a inverter o quadro de não adesão destas ao preventivo...

Cervical cancer is a disease initiated with progressive intraepithelial changes. The practice of preventive measures for early detection and treatment of this cancer is an essential measure. Objective: To evaluate the non-adherence of women to the cytological examination in a Basic Health Unit Family. Method: The study was exploratory, descriptive, retrospective longitudinal time series with a qualitative approach and characterized as action research. Data were analyzed according to the analysis technique of the Collective Subject Discourse Results: We included 293 women expanded sample. It was seen that some of the women had knowledge about prevention and the importance of the examination, however, unaware of the true utility of this. Failure to record the medical records was configured as greater difficulty in active search of these women to perform preventive. Conclusion: The results contributed to the recognition of professional knowledge about these women m relation to the Pap test and thus help reverse the non-compliance framework to these preventive...

El cáncer cervical es una enfermedad iniciada con cambios progresivos intraepiteliales. La práctica de medidas preventivas para la detección y el tratamiento de este cáncer a tiempo es una medida esencial. Objetivo: Evaluar la no adhesión de las mujeres para el examen citológico en una Unidad Básica de Salud Familiar. Método: El estudio fue exploratorio, descriptivo, retrospectivo de series de tiempo longitudinal con un enfoque cualitativo y caracterizado como la investigación-acción. Los datas se analizaron de acuerdo con la técnica de análisis de las resultados discurso del sujeto colectivo: Se incluyeron 293 mujeres muestra expandida. Fue visto . que algunas de las mujeres tenían conocimiento sobre la prevención y la importancia del examen, sin embargo, sin darse cuenta de la verdadera utilidad de este. Falta de registro de las registros médicos se configuró como una mayor dificultad en la búsqueda activa de estas mujeres para realizar preventiva. Conclusión: Los resultados contribuyeron ai reconocimiento de las conocimientos profesionales de estas mujeres en relación con la prueba de Papanicolaou y de este modo ayudar a revertir el marco de incumplimiento de estos preventiva...

Utility of Papanicolaou test in diagnosis of cervical lesions: a study in a tertiary care centre of western Uttar Pradesh.

Background: Cervical cancer is the most common cancer among females in India. It is also one of the major causes of deaths among them. Papanicolaou (Pap) cytological test helps in detecting the early epithelial abnormalities in cervical cells. The morbidity and mortality due to cervical cancer has come down in countries with well-established screening programmes at national level. This study was conducted to emphasize the value of cervical screening as a tool for early detection of non-neoplastic and neoplastic lesions of cervix. Slide positivity rate was computed and clinico-pathological correlation was done. Methods: This cross-sectional study was conducted from January 2012 to December 2014 (3 years), on 2202 women aged between 20-70 years coming for a Pap smear examination in a tertiary care hospital in Bareilly, India. After staining with conventional Papanicolaou technique, all cases were classified as per Bethesda nomenclature (2001). Results: Out of 2202 cases, 85.16% slides were found to be negative for intraepithelial abnormalities and 14.84% slides were labelled as positive for epithelial lesions. 97.67% of high grade lesions were found in women more than 40 years. Smears with epithelial cell abnormality were found more common in older age groups whereas smears negative for epithelial cell abnormality were found more common in young age groups. Conclusion: Pap test is a cost effective cancer screening and is a simple method to detect various lesions of cervix, non-neoplastic as well as neoplastic. High risk screening programmes should be directed to all women >40 years. Pap test is especially useful to diagnose precancerous lesions of cervix, thereby early detection of these lesions & subsequent proper treatment can be helpful in prevention of cervical cancer.

The Pattern of Cervical Cytology in Women Attending Various Clinics at a Tertiary Hospital in Anambra Southeast, Nigeria.

Background: Cervical cancer is one of the most common female reproductive tract malignancies with high morbidity and mortality most especially in the developing countries. Our purpose of this study is to determine the pattern of cervical smear and also to determine the effect of socio-demographic factors on the pattern of cervical cytology among women attending gynaecological clinic in Nnewi, Southeast Nigeria. Materials and Methods: This cross-sectional prospective study was conducted at Nnamdi Azikwe University Teaching Hospital, (NAUTH), Nnewi, Anambra state, in South East Nigeria from December 2007–July 2008. Result: Ninety six (68.6%) of the women had normal cervical smear while forty one (29.3%) had abnormal cervical smear. The proportion of unsatisfactory smear was 2.1%. The number and rates of abnormal cervical smear was further sub-classified as LSIL (25 cases, 17.9%), HSIL (12 cases, 8.6%), ASC-US (3 cases, 2.1%) and glandularintraepithelial lesion (1 case, 0.7%). No case of squamous cell carcinoma was detected. Conclusion: The study shows that various patterns of abnormal cytology were found among our women and the prevalence of this abnormal smear is high. these findings underscore the need for massive and sustained reproductive health education and establishment of cervical cancer screening centres.

Evaluation of cervical smear in high risk women.

Background: Objectives of current study were (i) To find out the pattern of cervical smear in females having risk factors. (ii) To observe the relationship between abnormal cervical smear with high risk factors. Methods: A cross-sectional descriptive study was carried out in the department of obstetrics and gynecology, Guwahati medical college & hospital from July 2009 to August 2010 with the help of Pathology department. 200 women attending gynecological OPD with associated risk factors were selected at random. Detailed history, demographic information, contraceptive history and coital history were taken. Smear was taken from endocervix with the help of Ayer’s spatula or cytobrush. Results: Out of 200 cases, in 110 (55%) the smear was reported negative for malignancy. 73(36.5%) had an inflammatory smear, 11 (5.5%) had CIN, 1(0.5%) had malignancy and 5(2.5%) the smear was inadequate for cytological examination. In the study mean age of Cervical Intraepithelial Neoplasia (CIN) was 42.64 ± 6.34 years. Low socio-economic status, high parity & the use of oral contraceptive pills were major risk factors. Conclusion: Cervical smear should be routinely used as a reliable diagnostic aid for early detection carcinoma cervix especially in high risk cases. The need of the hour is to create awareness and easy accessibility to proper screening.

Infección por virus papiloma humano en pacientes con células escamosas atípicas de un programa de pesquisa de cáncer cervical / Human papilloma virus infection in patients with atypical squamous cells of a screening program for cervical cancer

Evaluar la frecuencia de la infección por virus del papiloma humano en pacientes con células escamosas atípicas de un programa de pesquisa de cáncer de cuello uterino. Laboratorio Asistencial “Lic. Celina Sánchez Rincón y Laboratorio de Biología y Medicina Experimental LABIOMEX. Universidad de Los Andes. Mérida, Estado Mérida. Estudio prospectivo y descriptivo que incluyó las pacientes vistas entre marzo de 2006 y diciembre de 2009. Se tomaron muestras para evaluación citológica y detección del virus papiloma humano, mediante la metodología molecular PCR-RFLP a pacientes de pesquisa de cáncer cervical. Se estudiaron 2 805 pacientes seleccionándose las que presentaron informe citológico de células escamosas con atipias de significado indeterminado y con atipias que no excluyen lesión intraepitelial escamosa de alto grado. Del total de mujeres evaluadas por citología, 121 (4,31 por ciento) tenían informe de anormalidades en células epiteliales. Las células escamosas atípicas se encontraron en 58 (2,06 por ciento) citologías, 52 (1,85 por ciento) eran células escamosas con atipias de significado indeterminado y 6 (0,21 por ciento) eran células escamosas con atipias que no excluyen lesión intraepitelial de alto grado. La prevalencia general de la infección por virus del papiloma humano fue de 32/58 (53,4 por ciento). Los virus del papiloma humano de alto riesgo oncogénico se encontraron en 10/58 (17,2 por ciento) de los casos, la mayoría en el grupo etario de 21-30 años. No se pudo determinar el tipo viral en un 16/58(27,5 por ciento) de las muestras. Se observó una elevada prevalencia de virus del papiloma humano en pacientes con informe citológico de células escamosas atípicas.

To evaluate the frequency of human papillomavirus infection in patients with atypical squamous cells of a cervical cancer detection program. Between March 2006 to December 2009, specimens for cervical smears and human papillomavirus molecular detection by PCR-RFLP were taken from the patients attended at the cervical cancer clinic prevention. Facultad de Farmacia y Bioanálisis. Laboratorio Asistencial “Lic. Celina Sánchez Rincón y Facultad de Ciencias, Laboratorio de Biología y Medicina Experimental LABIOMEX. Universidad de Los Andes. Mérida, Estado Mérida, Venezuela. A total of 2 805 patients were evaluated, those with atypical squamous cells of undetermined significance and atypical squamous cells that cannot exclude a high intraepithelial lesion were chosen. Abnormalities in epithelial cells were found in 4,31 percent. Atypical squamous cells were found in 58 (2,06 percent) of the cases, 1,85 percent were atypical squamous cells of undetermined significance and 0,21 percent were atypical squamous cells that cannot exclude a high intraepithelial lesion. The overall prevalence of human papillomavirus infection was 32/58 (53,4 percent). High risk human papillomavirus was found in 10/58 (17,2 percent)of the patients, most of them between 21 and 30 years old. Human papillomavirus could not be determinedin 16/58 (27,5 percent) of the cases. It was observed a high frequency of human papillomavirus in patients with atypical squamous cells in their cervical smears.

Research on Thin-layer Cytology Assistant Screening System / 中国医学物理学杂志

Objective: Cervical smear screening for abnormal cells plays an important role in reducing the mortality of cervical cancer. However, all smears must be approved by the naked eyes using microscopes, and there has been a higher false-positive rate and false-negative rate. Methods: To solve this problem, the thin-layer cytology assistant screening system was developed. On the hardware side, the traditional computer-aided analysis system was improved; and on the software side, gray level transformation, edge detection, image mosaic, and some other image processing methods were introduced; and by the use of neural network, the system could realize the function of acquisition, mosaic, process, measure and recognition of the liquid-based cytology image. Results: This system was brought into the test of 150 thin-layer cytology technology(TCT) cervical cell samples, and the agreement between the results of computer-aided analysis and the manual analysis by pathology experts exceeded 90%. Conclusion: Both the traditional Pap smear and TCT preparation smear can be diagnosed by this system. As a result, the false-positive rate and false-negative rate of the cervical smear screening will be significantly reduced, meanwhile, work efficiency of pathologist can be greatly improved.

Correlation Analysis Between Cervicovaginal Cytologic and Histopathologic Diagnoses in Cervical Squamous Cell Neoplasm

BACKGROUND: The aim of this study was to confirm the usefulness of cervicovaginal smears in the screening of squamous cell neoplasms of the uterine cervix by comparative analysis between the cytologic diagnosis of cervicovaginal smears and the histologic diagnosis of tissue specimens. METHODS: We selected 743 patients who had both cervicovaginal smears and histologic evaluations of the uterine cervix by colposcopic biopsy, conization, or hysterectomy at the Kangbuk Samsung Medical Center between January 2005 and December 2007. RESULTS: The accuracy rate of cervicovaginal smears and histologic diagnoses was 93.0% (691/743) and showed a high correspondence (kappa value, 0.770, p-value, 0.000). The false-negative and false-positive rates were 0.5% (6/484) and 17.8% (46/259), respectively. The sampling and interpretation errors were identified in four and two cases of six false-negative cases and 29 and 17 cases of 46 false-positive cases, respectively. In screening high grade squamous cell neoplasms, there were no false-negative cases and only one false-positive case which resulted from sampling error. The false-negative rate of cervicovaginal smears and the false-positive rate in high-grade squamous cell neoplsams were very low. CONCLUSIONS: The cervicovaginal smear is a powerful tool for screening of cervical squamous cell neoplasms.

Factores asociados con lesiones neoplásicas del tracto genital inferior femenino en adolescentes del departamento de Caldas / Fatores associados com lesões neoplásticas do conduto genital inferior feminino em adolescentes do departamento de Caldas / Factors associated with neoplasm of the lower female genital tract in teens in the department of Caldas

En este artículo se presentan los resultados de un estudio epidemiológico analítico-descriptivo, cuyos objetivos fueron: conocer y determinar cómo se asocian factores biológicos y psicosociales con la presencia de lesiones neoplásicas del tracto genital inferior femenino en una población adolescente del departamento de Caldas, lo cual se relacionó, por un lado, con el análisis de la distribución y frecuencia de la población estudiada en cuanto a sexualidad, reproducción, factores culturales y factores psicosociales, y por otro, con la interacción de factores de riesgo en la aparición de dichas lesiones. Se tomó una muestra de 269 mujeres, seleccionadas después de su participación en jornadas educativas respecto a cáncer de cuello uterino y de mama. A este grupo se le aplicó una encuesta estructurada, diseñada para tal fin, la cual se diligenció directamente por los investigadores, previo consentimiento informado. A cada informante se le realizó citología y colposcopia, con un manejo estrictamente confidencial de la información. Los datos se analizaron retomando su distribución y frecuencia por categorías de variable, con lo cual se buscó determinar la asociación de los factores con la presencia o no de lesiones neoplásicas al contrastarlos con los resultados de citología y colposcopia.

This article presents the results of an epidemiologic analytical-descriptive study whose objectives were to examine and determine how biological and psychosocial factors are associated to the presence of neoplastic lesions of the lower female genital tract in a teenage population in the department of Caldas. The study analyzed the distribution and frequency of the studied population in terms of sexuality, reproduction, cultural and psychosocial factors, and secondly, the interaction of risk factors in the occurrence of such injury. A sample of 269 women, selected after their involvement in educational sessions related to cervical cancer and breast cancer, was interviewed by means of a structured survey, which was filled-out directly by the researchers, with prior consent from the women. A cervical smear and a colposcopy were performed on each patient, confidentially handling the information. The data was analyzed taking into consideration the distribution and frequency of the variable categories, looking to determine the association of factors with the presence or absence of neoplastic lesions, when contrasted with the cervical smear and colposcopy results.

Em este artigo apresentam se os resultados duma pesquisa epidemiológica analítico-descritivo, cujos objetivos foram: conhecer e determinar como associam se fatores biológicos y psicossociais com a presença de lesões neoplásicas do conduto genital inferior feminino numa povoação adolescente do Departamento de Caldas, o qual se relacionou, por um lado, com a análise da distribuição e freqüência da povoação estudada em quanto a sexualidade, reprodução, fatores culturais e fatores psicossociais, e por outro lado, com a interação de fatores de risco na aparição de ditas lesões. Tomou se uma amostra de 269 mulheres, selecionadas depois de sua participação em jornadas educativas respeito ao câncer de colo uterino e mama. A este grupo aplicou se uma enquete estruturada, desenhada tal fim, a qual diligenciou se direitamente por os pesquisadores, prévio consentimento informado. A cada informante realizou se citologia e colposcopia, com um manejo estritamente confidencial da informação. Os dados realizaram se retomando sua distribuição e freqüência por categorias de variável, com o qual se procurou determinar a associação dos fatores com a presença ou não de lesões neoplásicas ao contrastarlos com os resultados de citologias e colposcopias.

Una mirada al programa de prevención del cáncer de cuello uterino en Caldas (Colombia), 2005-2006 / Uma mirada ao programa de prevenção do câncer de colo uterino en Caldas (Colombia), 2005-2006 / A glimpse at the cervical cancer prevention program in Caldas (Colombia), 2005-2006

El cáncer de cuello uterino es un problema de salud específico de la mujer con repercusiones sociales y económicas, en ella, la familia y la comunidad; en este sentido, los programas de detección precoz deben estructurarse y sistematizarse adecuadamente con el fin de garantizar educación, prevención, diagnóstico precoz y tratamiento oportuno. Con el fin de evaluar la estructura, procesos y resultados del Programa de Prevención de Cáncer Cuello Uterino en Caldas durante los años 2005 y 2006, se realizó un estudio en alianza Universidad de Caldas, Dirección Territorial de Salud de Caldas, con un diseño descriptivo, evaluativo y retrospectivo. Se seleccionaron 4 municipios estratégicamente situados en el departamento de Caldas; los responsables del programa de cada hospital, diligenciaron una base de datos que fué la guía para el diagnóstico, diseñado por las investigadoras. Las mujeres asistentes al programa en su mayoría tenían entre 26 y 45 años. Las horas de dedicación del personal de salud encargado fueron muy altas con relación al número de citologías tomadas; se presentaron problemas de registro de colposcopias; faltaron reportes de citologías; aspectos estos que afectan la calidad de la atención a las usuarias y al programa. Los reportes obtenidos sobre cáncer invasivo se realizaron sólo a través de citología; en el informe recibido no se reportaron resultados de biopsias a pesar de ser esta la prueba de oro que confirma el diagnóstico; además, el seguimiento a las usuarias tratadas era incipiente y discontinuo. Se evidenciaron fallas y ambigüedad para especificar las funciones del personal de enfermería; las citologías fueron tomadas en su mayoría por auxiliar de enfermería y la norma técnica para tamizaje recomienda que sea realizado por médico o enfermera capacitados. Del mismo modo, se detectaron debilidades en la educación para la salud a la comunidad para la prevención del cáncer de cuello uterino.

A structured and systematized early detection program for cervical cancer should ensure education, prevention, early diagnosis, and adequate treatment. Cervical cancer is a social and economic problem that impacts the woman, as well as her family and community. This study was conducted during 2005 and 2006 by means of an alliance with the Universidad de Caldas, Department and Territorial Health Office of Caldas. The study had a descriptive, evaluative and retrospective design. Four strategically located municipalities of Caldas were selected for education and follow-up. The staff of each hospital filled out a database that guided the process, which was designed by the researchers. Women between the ages of 26 and 45 were the most common cases. The hours the staff dedicated to the program were high, in comparison to the number of cervical smears performed. There were problems regarding the colposcopy records, lost cervical smear records, all of which affect the program's patients. The reports on invasive cancer were obtained only by means of cervical smears; no biopsies were reported, despite this being the best test for confirming the diagnosis. The patients' follow-ups were not continuous. A lack of specificity in nursing functions was also seen, since cervical smears are usually performed by nursing assistants, when the norm states that a trained physician or chief nurse should perform the procedure. A weakness in education to the community was seen.

O câncer de colo uterino é um problema de saúde especifico da mulher com repercussões sociais e econômicas, na família e a comunidade, neste sentido, os programas de detenção preços devem estruturasse e sistematizasse adequadamente com o fim de garantir educação, prevenção, diagnostico preços e tratamento oportuno. Com o fim de avaliar a estrutura, processos e resultados do Programa de Prevenção de Câncer de Colo Uterino em Caldas durante os anos 2005 e 2006, se realizou uma pesquisa em aliança Universidade Caldas, Direção Territorial de Saúde de Caldas, com um desenho descritivo, evaluativo, e retrospectivo. Se selecionaram 4 municípios estrategicamente situados no Estado de Caldas; os responsáveis do programa de cada hospital, diligenciaram uma base de dados que foi a guia para o diagnostico, desenhado pelas investigadoras. As mulheres assistentes ao programa em sua maioria tinham entre 26 e 45 anos. As horas de dedicação do pessoal de saúde encarregado foram muito altas com relação ao numero de citologias tomadas; se apresentaram problemas de risco de colposcopias; faltaram reportes de citologias, aspectos estes que afetam a qualidade da atenção às usuárias e ao programa. Os reportes obtidos sobre câncer invasivo se realizaram só a través de citologia, no informe recebido não se reportaram resultados de biopsias a pesar de ser esta a prova de ouro que confirma o diagnostico; alias o seguimento às usuárias tratadas era incipiente e descontinuo. Evidenciaram-se falha e antiguidades para especificar as funções do pessoal de enfermaria; as citologias foram tomadas em sua maioria por auxiliares de enfermaria e a norma técnica para tamisasse recomenda que seja realizado por um medico ou enfermeira capacitados. Do mesmo modo, detectaram debilidades na educação para a saúde à comunidade para a prevenção do câncer de colo uterino.

Misinterpretation of Pregnancy Related Changes: Effect on the Postpartum Regression Rate of Abnormal Cervical Smears in Pregnancy / 대한세포병리학회지

An aim of this study was to evaluate an effect of misinterpretation of pregnancy related cellular changes on the postpartum regression rate of abnormal cervical smears in pregnancy. A series of 265 cases with abnormal cervical smears in pregnancy were selected from a database of cervical smear results. The selected cases were classified as regression, persistence, and progression based on the results of postpartum cervical smears and histology. Of the selected cases, 162 cases were classified as regression and the postpartum regression rate was 61.1% (162/265). We reviewed abnormal cervical smears in pregnancy these cases. The primary cytologic diagnoses of these cases were ASCUS (118 cases), AGUS (2 cases), ASCUS/AGUS (1 case), LSIL (25 cases), LSIL R/O HSIL (2 cases), and HSIL (14 cases). With information of the pregnacy, we identified decidual cells in 24 cases, but cells identified by the Arias-Stella reaction and trophoblasts were not found. Sixteen cases out of 162 cases were reclassified as a pregnancy related change rather than an abnormal. Desidual cells were considered as ASCUS in 15 cases and as LSIL in one case. The revised postpartum regression rate was 55.5%(147/265) and was lower than the original. Consequently, misinterpretation of the pregnancy related cellular changes has an effect on a rise of the postpartum regression rate of the abnormal cervical smear in pregnancy. Pathologists may diagnose pregnancy related cellular changes as abnormal findings if they do not have information regarding the pregnancy. Therefore, clinical information of pregnancy and knowledge about the pregnancy related cellular changes are essential to prevent misinterpretation.

Uterine Tumor Resembling Ovarian Sex-Cord Tumor: A Case Report of the Cytologic Finding / 대한세포병리학회지

Uterine stromal tumors with features of ovarian sex-cord differentiation are relatively rare. The neoplasms composed of sex cord-like components in more than 50% of the tumor are classified as group II. We report the cytologic findings of a case of uterine tumor resembling ovarian sex-cord tumor. The cervical smears of a 62-year-old woman with submucosal tumor showed loose aggregates of spindle cells as well as glandular or tubular structures of round cells with a distinct cell membrane and a prominent small nucleolus. Because uterine stromal tumor can have sex cord differentiation, its possibility should be considered in the interpretation of cervical smears.

Sensitivity of AutoPap Primary Screening System with Location-Guided Screening in Uterine Cervical Cytology / 대한세포병리학회지

OBJECTIVE: The sensitivity of the AutoPap Primary Screening System with Location-Guided Screening (AutoPap LGS) for identifying atypical cells in cervicovaginal smears was evaluated. METHODS: Two hundred forty one slides with atypical cervical cytology randomly sampled were rescreened both manually and by the AutoPap LGS. The AutoPap LGS localized the atypical cells as 15 fields of view(FOVs), which were reexamined by manual review. The sensitivity was also evaluated in accordance with the cellularity of the smears. RESULTS: The AutoPap LGS successfully processed 232 out of 241 slides. The sensitivity of the AutoPap LGS identifying the atypical cells in successfully processed slides was 97.4%(226/232). The false negative rate was 2.6%(6/232). There was no false negative case in high grade squamous intraepithelial lesion (HSIL) or squamous cell carcinoma(SCC) smears in the AutoPap LGS. The FOVs localized the diagnostic-atypical cells in 97.8%(221/226). The number of diagnostic-atypical FOVs was increased in higher-degree of atypical cytology. The AutoPap LGS localized the atypical cells in 100% of adequately cellular smears and in 92.5% even in low cellular smears. CONCLUSION: The AutoPap LGS showed relatively good sensitivity to detect atypical cells. It can be a valuable system to localize atypical cells, especially in HSIL or cancer slides, even in smears with low cellularity.

Cytologic Features of Papillary Immature Metaplasia of Uterine Cervix / 대한세포병리학회지

Papillary immature metaplasia (PIM) of the uterine cervix (immature condyloma) is a subset of low grade squamous intraepithelial lesion (LSIL) which is frequently associated with human papilloma virus (HPV) types 6 and 11. The histologic features of PIM include filiform papillae lined by evenly spaced immature metaplastic-type cells with frequent nucleoli, mild anisokaryosis, and a low mitotic index. To characterize the cytologic changes associated with PIM, we analyzed 14 cases of PIM from our file. We reviewed biopsy slides and the cervicovaginal smears taken proximate to the time of biopsy. Histologically, nine cases had either flat condyloma (7 cases) or high grade squamous intraepithelial lesion (HSIL) (2 cases). Cytologic changes included cells in various stages of maturation with karyomegaly (14 cases), cells with irregularities in the nuclear membrane (13 cases), intermediate cells with karyomegaly(13 cases), cells with binucleation (13 cases), and aborted koilocytes (11 cases). Cervicovaginal smears from all cases were interpreted as atypical squamous cells of undetermined significance (ASCUS), NOS or ASCUS, rule out squamous intraepithelial lesion (SIL) or LSIL in two cases with flat condyloma or HSIL in a case with severe dysplasia. PIM is a distinct histologic entity that can present with a spectrum of cytologic findings, but cytologic findings may resemble variable reactive conditions and immature HSIL. Therefore, it is difficult to diagnose PIM by cytology alone. However, the meticulous efforts for making the cytologic diagnoses which can induce active management of patients are recommended because PIM is a variant of LSIL and frequently has a flat condyloma or HSIL.