Review of negative and low-grade cervical smears in women with invasive cervical cancer after the first 3 years of the national cervical screening programme in Slovenia.

OBJECTIVE: The purpose of the study was to perform a national review of negative, low-grade and inadequate smears reported during the latest screening period before cervical cancer diagnosis in 2006, after the first 3 years of the screening programme. METHODS: Among 162 new cervical cancer cases there were 47 (29%) without previous cytology, 47 (29%) with one high-grade smear prior to diagnosis and 68 (42.0%) with at least one previous negative, low-grade, atypical or inadequate smear 1-40 months before diagnosis. Of the latter 68 cases, 37 patients with 59 smears (together with 118 control slides) were included in the review as 31 had smears reported at laboratories no longer operating. Findings were related to the last cytology report before diagnosis as well as to histological type and stage of the cancer. RESULTS: In our study group, 19 (51%) of 37 patients had squamous cell carcinoma, 15 (41%) adenocarcinoma and 3 (8%) adenosquamous carcinoma, compared with 121 (75%), 26 (16%), 12 (7%), respectively, and 3 (2%) other types, for all carcinomas. Twenty-one of 37 women also had high-grade cytology prior to diagnosis of cancer. Women with previous cytology (with or without recent high-grade smears) were more likely to have stage I cancers than those without cytology (P < 0.0001). The expert group upgraded 17/33 smears in the patients with squamous carcinomas, which was more than in those with adeno- and adenosquamous carcinomas (5/24, P < 0.05). CONCLUSION: As expected, a higher proportion of smears preceding adenocarcinomas were true negative. Under-diagnosed smears were not related to cancer stage or last cytology report before diagnosis.

Relationships between bone mineral density and cell size in cervical smears, serum estradiol levels, and anthropometric characteristics.

OBJECTIVE: To evaluate relationships between bone mineral density and morphometric characteristics of squamous cells in cervical smears, serum estradiol levels, body weight, and body mass index. METHOD: Dual X-ray absorptiometry measurements were performed in 107 women who had recently undergone routine screening for cervical cancer. Serum estradiol levels were determined. Mean areas for squamous cells, squamous cell nuclei, and squamous cell cytoplasm were calculated, as well as the nucleus area to cytoplasm area ratio. RESULTS: The mean cell and cytoplasmic areas were significantly lower in women with lower T scores for femoral neck and lumbar spine (P<0.001). Mean T scores were significantly lower for the women with atrophic cells than for those with mature cells (P<0.001). A correlation between estradiol levels and T scores was found for the lumbar spine (P<0.05) but not for the femoral neck. Multiple linear regression analysis showed the cytoplasmic area to be the most significant predictor of T scores for the total hip, followed by BMI and age, and to be the only significant predictor of T scores for the total spine. CONCLUSION: Relationships were found between bone mineral density and both the total cell and cytoplasmic areas of squamous cells obtained from cervical smears.

Etidronate does not suppress periprosthetic bone loss following cemented hip arthroplasty.

Periprosthetic bone loss after arthroplasty may threaten prosthesis survival. The current study investigated the effect of etidronate therapy on periprosthetic, contralateral hip, and spine bone mineral density (BMD) in a one-year, prospective, randomized, double-blind study on 46 patients after cemented hip arthroplasty. BMD was measured with dual-energy X-ray absorptiometry (DXA). There were no significant differences between mean BMD measurements of the etidronate and placebo groups, with the exception of the mean percent change in the spine at six months and 12 months and in Gruen zone 3 at six months; in all three cases, the etidronate group had significantly greater mean values. These findings suggest that cyclic etidronate therapy has no significant effect in suppressing periprosthetic bone loss following cemented hip arthroplasty.