Chlamydia trachomatis and cervical intraepithelial neoplasia in married women in a Middle Eastern community.

The objective of this study was to determine the association between vaginal Chlamydia infection and cervical intraepithelial neoplasia (CIN). Data were collected in a case-control study for 60 patients with CIN in biopsy and 85 control subjects with normal colposcopy and biopsy. Serum antibodies to C trachomatis were associated with an increased risk for CIN [odds ratio (OR) = 7.3; 95% confidence interval (CI) 1.5-35.2)]. There was also a significant association between presence of inclusion bodies for C. trachomatis and CIN (OR = 5.5; 95% CI 2.4-12.4). These results indicate a strong association between CIN and chlamydial cervicitis.

Chlamydia trachomatis and cervical intraepithelial neoplasia in married women in a Middle Eastern community

The objective of this study was to determine the association between vaginal Chlamydia infection and cervical intraepithelial neoplasia [CIN]. Data were collected in a case-control study for 60 patients with CIN in biopsy and 85 control subjects with normal colposcopy and biopsy. Serum antibodies to C. trachomatis were associated with an increased risk for CIN [odds ratio [OR] = 7.3; 95% confidence interval [CI] 1.5-35.2]]. There was also a significant association between presence of inclusion bodies for C. trachomatis and CIN [OR = 5.5; 95% CI 2.4-12.4]. These results indicate a strong association between CIN and chlamydial cervicitis

Accuracy of intraoperative frozen section in the diagnosis of ovarian tumors.

BACKGROUND: Ovarian neoplasms are an important cause of morbidity and mortality in women. The surgical management of ovarian neoplasms depends on their correct categorisation as benign, borderline and malignant. AIM: The aim of this study was to determine the clinical benefits of intraoperative frozen section analysis into the surgical management policy of women referred with an adnexal mass suspicious of ovarian cancer. METHODS: A retrospective study of 106 ovarian frozen section results was examined to determine the accuracy of frozen section diagnosis. The accuracy, sensitivity, specificity, and positive and negative predictive value of frozen section were studied. RESULTS: The overall accuracy to determine the status of malignancy was 93.3%. Sensitivity of the test was highest in the benign groups at 97.4% and lowest in the borderline groups at 25%. The accuracy of frozen section was 80% in serous tumours and 60% in mucinous. There were two (2.5%) false positive, three (10.7%) false negative and two overestimated diagnosis in frozen section examination. Eight malignancies (30.7%) were of metastatic origin, all of which (100%), were correctly identified on frozen section. CONCLUSION: Frozen section appears to be an accurate technique for the histopathological diagnosis of ovarian tumours. Some limitations were observed among borderline and mucinous tumours. This emphasises the great value of frozen section in the diagnosis of ovarian tumours.

A cytohistologic study of atypical glandular cells detected in cervical smears during cervical screening tests in Iran.

Atypical glandular cells (AGC) often cause diagnostic uncertainty in cervicovaginal smears. To determine the incidence of significant pathologies associated with AGC on Papanicolaou test, AGC smears were correlated with subsequent biopsy diagnoses. A retrospective review of archives of our cytology files for cervicovaginal smears diagnosed as AGC from April 1998 to March 2001 was performed. In 9390 cervicovaginal smears, AGC were reported in 76 (0.81%) cases, with histologic follow-up in 42 patients (55.3%). Twenty-two patients (52.4%) had preneoplastic or neoplastic, squamous, or glandular lesions on histologic examination. Among them were cervical intraepithelial neoplasia, basal cell abnormality of undetermined significance, cervical adenocarcinoma, endometrial hyperplasia or adenocarcinoma, vaginal adenocarcinoma, endocervical glandular dysplasia, metastatic breast carcinoma, and simple nonvillous trophoblastic tissue. Therefore, presence of AGC in cervical smears may exhibit a spectrum of findings, ranging from benign/reactive changes to squamous or glandular premalignancy or malignancy. A majority of these lesions are squamous dysplasia, and a significant number of patients had glandular malignancy. The results of the current study underline the importance of follow-up for patients with the diagnosis of AGC. To our knowledge, this is the first report in Iran showing the significance of AGC diagnosis.

Can we substitute brush cytology for biopsy in the evaluation of cervical lesions under the guidance of colposcopy?

In cervical cancer screening, colposcopically directed biopsy is the gold standard method for identifying intraepithelial and occult invasive lesions of the uterine cervix. As biopsy needs special expertise and the procedure is not convenient for the patients, we sought to evaluate colposcopically directed brush cytology as a substitute for biopsy of cervical lesions. We studied a series of 150 women who were referred for colposcopic evaluation. Colposcopically directed brush cytology and biopsy were performed for all patients with abnormal colposcopic findings. A total of 40 samples were excluded due to unsatisfactory report of brush cytology. Of the remaining 110 samples, 34 abnormal pathologies were reported in biopsy evaluations, while only 9 abnormal cytologies were reported in brush cytology specimens. Brush cytology sensitivity and specificity were 26% and 97%, respectively. We conclude that colposcopically directed brush cytology is not a safe substitute for biopsy in the evaluation of cervical lesions.