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Kurita Y, Meguro S, Kosugi I, Enomoto Y, Kawasaki H, Kano T, Saitoh T, Shinmura K, Iwashita T. Enhancing cervical cancer cytology screening via artificial intelligence innovation. Sci Rep 2024; 14:19535. [PMID: 39174613 PMCID: PMC11341547 DOI: 10.1038/s41598-024-70670-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 08/20/2024] [Indexed: 08/24/2024] Open
Abstract
A double-check process helps prevent errors and ensures quality control. However, it may lead to decreased personal accountability, reduced effort, and declining quality checks. Introducing an artificial intelligence (AI)-based system in such scenarios could effectively address the risk of oversights. This study introduces an innovative AI-integrated workflow for cervical cytology screening that substantially improves efficiency and reduces the burden on cytologists. The AI model prioritizes cases for review based on anomaly scores and streamlines the first screening process to approximately 10 s per case. The model enhances the identification of high-risk cases via detailed microscopic observation, high anomaly scores cases, and a targeted review of low-score cases. The workflow highlights its capability for rapid, accurate, and less labor-intensive evaluations, demonstrating the potential to transform cervical cancer screening. This study highlights the importance of AI in modern medical diagnostics, particularly in areas with a high demand for accuracy and efficiency.
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Affiliation(s)
- Yuki Kurita
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
| | - Shiori Meguro
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
| | - Isao Kosugi
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Yasunori Enomoto
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Hideya Kawasaki
- Institute for NanoSuit Research, Preeminent Medical Photonics Education and Research Center, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tomoaki Kano
- Department of Obstetrics and Gynecology, JA Shizuoka Kohseiren Enshu Hospital, Hamamatsu, Shizuoka, Japan
| | - Takeji Saitoh
- Next Generation Creative Education Center for Medicine, Engineering, and Informatics, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Kazuya Shinmura
- Department of Tumor Pathology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Toshihide Iwashita
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
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Koyanagi T, Fujiwara H, Yamamoto K, Suzuki M, Kakizoe T. Cervical cancer screening efficacy using SurePath, ThinPrep and conventional cytology: A large data set analysis from the Japan Cancer Society. Cytopathology 2024. [PMID: 39118299 DOI: 10.1111/cyt.13431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 07/02/2024] [Accepted: 07/24/2024] [Indexed: 08/10/2024]
Abstract
OBJECTIVE Over the past decade, liquid-based cytology has replaced conventional cytology for cervical cancer screening in many countries, including Japan. We aimed to evaluate the efficacy of liquid-based cytology using a large database and compare two major liquid-based cytology platforms, SurePath and ThinPrep, to conventional cytology. METHODS Cervical cancer screening data were collected from the Japan Cancer Society between 2015 and 2019. The efficacy of liquid-based and conventional cytology in detecting cervical intraepithelial neoplasia (CIN) was evaluated. Detection rates and positive predictive values were compared using a Poisson regression model. RESULTS We collected data of 3,918,149 participants, including 2,248,202 conventional cytology, 874,807 SurePath and 795,140 ThinPrep smears. The detection rate of CIN2 or more was 1.14 times higher using SurePath than that using conventional cytology (95% confidence interval [CI], 1.09-1.20; p < 0.001). Contrastingly, the detection rate of CIN2 or more was 0.91 times lower using ThinPrep (95% CI, 0.86-0.96; p < 0.001). The detection rates of CIN3 or more did not differ significantly between SurePath and conventional cytology (detection rate ratio, 1.04; 95% CI, 0.97-1.12; p = 0.224). The positive predictive value ratios of CIN2 or more were 0.80 using SurePath (95% CI, 0.76-0.84; p < 0.001) and 0.83 using ThinPrep (95% CI, 0.79-0.87; p < 0.001) compared with conventional cytology. CONCLUSIONS Liquid-based cytology, particularly SurePath, was useful for detecting CIN2 or higher in population-based cervical cancer screening. Further widespread use of liquid-based cytology methods would lead to efficient detection of cervical precancerous lesions.
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Affiliation(s)
- Takahiro Koyanagi
- Department of Obstetrics and Gynecology, School of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Hiroyuki Fujiwara
- Department of Obstetrics and Gynecology, School of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Kouji Yamamoto
- Department of Biostatistics, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Mitsuaki Suzuki
- Department of Obstetrics and Gynecology, Shin-yurigaoka General Hospital, Kawasaki, Kanagawa, Japan
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Tambvekar SE, Balsarkar G. "Modernizing Cervical Cytology Screening with Liquid-Based Methods at Community-Level Hospitals: A Much-Needed Breakthrough for India". J Obstet Gynaecol India 2024; 74:371-377. [PMID: 39280206 PMCID: PMC11399528 DOI: 10.1007/s13224-024-02051-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2024] [Accepted: 08/08/2024] [Indexed: 09/18/2024] Open
Abstract
Introduction Cervical cancer still ranks highest causing cancer-related morbidity and mortality in women in India. It is prudent to emphasise and implement cervical cancer screening strategies in the population efficiently and with regular intervals. Conventionally, PAP smear cytology is obtained by wooden spatula-Ayre's spatula. To improve sensitivity and specificity of the procedure and detection rate, better techniques of cells retrieval are available mainly liquid-based cytology (LBC), with help of cyto-brush. Literature has consistently proven efficiency of the technique and also reduced the proportion of inadequate sampling. We conduct this study to compare both the techniques and efficiency in a community hospital from data over 6 years, to asses its role and benefits among Indian women. Aims and Objectives To compare conventional PAP smear and liquid-based cytology techniques analysing detection rates of positive lesions (CIN and also includes ASCUS and malignant), incidence of inadequate sampling, efficiency and cost-effectiveness. Methods This is retrospective study at tertiary care obstetric hospital affiliated to government-run medical college in a metropolitan city of Mumbai. Data are retrieved from the Pathology Department, Medical Records Department, laboratory books and OPD registers. Pap's smear sampling was done mainly from OPD with all indications including routine tests as a part of gynaecological evaluation and screening, as well as for suspicious lesions on inspection. Group A consists women who had conventional PAP smear test for 3 years (Dec 2015-Nov 2018) and Group B had women who benefited by LBC method for 3 years (Dec 2018-Nov 2021). COVID-19 pandemic majorly affected the routine gynaecological OPD practice during 2021 as hospital was COVID facility hospital. Results Demographic parameters and presentations were comparable and similar. LBC methods have higher detection rate for positive reports, including ASCUS. But results were comparable in both groups and not statistically different. Importantly, incidences of inadequate sampling are reduced significantly with the LBC method. Unsatisfactory smears war high in Group A (7.752%) compared to Group B (3.712%) p-value 0.005, stating the increased rate of requirement of sending repeat smears, which involves higher engagement of time, resources and active participation from healthcare personnel. Conclusion Good detection rates and significantly low rates of unsatisfactory smears make LBC rational and cost-effective. These are the times to switch to liquid-based cytology techniques, especially at the community level hospitals; in order to detect more women with cervical premalignant as well as malignant neoplastic lesions and to save lives. This can be made possible by emphasising the policy makers to incorporate these services through quality resources.
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Affiliation(s)
- Sunil E Tambvekar
- Deptartment of Obstetrics and Gynaecology, Nowrosjee Wadia Maternity Hospital, Seth GS Medical College, Mumbai, India
| | - Geetha Balsarkar
- Deptartment of Obstetrics and Gynaecology, Nowrosjee Wadia Maternity Hospital, Seth GS Medical College, Mumbai, India
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Onuma T, Shinagawa A, Kurokawa T, Orisaka M, Yoshida Y. Fractal Dimension, Circularity, and Solidity of Cell Clusters in Liquid-Based Endometrial Cytology Are Potentially Useful for Endometrial Cancer Detection and Prognosis Prediction. Cancers (Basel) 2024; 16:2469. [PMID: 39001531 PMCID: PMC11240598 DOI: 10.3390/cancers16132469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Revised: 06/28/2024] [Accepted: 07/03/2024] [Indexed: 07/16/2024] Open
Abstract
Endometrial cancer (EC) in women is increasing globally, necessitating improved diagnostic methods and prognosis prediction. While endometrial histology is the conventional approach, liquid-based endometrial cytology may benefit from novel analytical techniques for cell clusters. A clinical study was conducted at the University of Fukui Hospital from 2012 to 2018, involving 210 patients with endometrial cytology. The liquid-based cytology images were analyzed using cell cluster analysis with Image J software. Logistic regression, ROC analysis, and survival analysis were employed to assess the diagnostic accuracy and prognosis between cell cluster analysis and EC/atypical endometrial hyperplasia (AEH). Circularity and fractal dimension demonstrated significant associations with EC and AEH, regardless of age and cytology results. The ROC analysis revealed improved diagnostic accuracy when combining fractal dimension with cytology, particularly in menopausal age groups. Lower circularity and solidity were independently associated with poor overall survival, while higher fractal dimension values correlated with poorer overall survival in Grades 2 and 3 endometrial cancers. The combination of circularity and fractal dimension with cytology improved diagnostic accuracy for both EC and AEH. Moreover, circularity, solidity, and fractal dimension may serve as prognostic indicators for endometrial cancer, contributing to the development of more refined screening and diagnostic strategies.
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Affiliation(s)
- Toshimichi Onuma
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan; (A.S.); (M.O.); (Y.Y.)
| | - Akiko Shinagawa
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan; (A.S.); (M.O.); (Y.Y.)
| | - Tetsuji Kurokawa
- Department of Obstetrics and Gynecology, Fukui-ken Saiseikai Hospital, Fukui 918-8503, Japan;
| | - Makoto Orisaka
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan; (A.S.); (M.O.); (Y.Y.)
| | - Yoshio Yoshida
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan; (A.S.); (M.O.); (Y.Y.)
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Dovnik A, Repše Fokter A. The Role of p16/Ki67 Dual Staining in Cervical Cancer Screening. Curr Issues Mol Biol 2023; 45:8476-8491. [PMID: 37886977 PMCID: PMC10605736 DOI: 10.3390/cimb45100534] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/14/2023] [Accepted: 10/17/2023] [Indexed: 10/28/2023] Open
Abstract
Cervical cancer screening has enabled a decrease in the incidence and mortality of cervical cancer. Various screening modalities have been studied to date. In many countries, screening is still based on cervical cytology, where cervical cells obtained either on glass or in a liquid medium are examined under a microscope. However, the fact that the vast majority of cervical cancers are a result of persistent infection with high-risk human papillomaviruses (hr-HPV) has led to the implementation of primary HPV screening in many countries. Taking into consideration the fact that the majority of HPV infections are transient and do not cause cervical precancer, effective triage methods are needed to prevent an increase in colposcopy referrals. Among these, the most extensively investigated are HPV genotyping, HPV methylation, and p16/Ki67 dual staining. In this manuscript, we briefly summarize the current knowledge regarding different screening strategies for the prevention of cervical cancer, with a focus on p16/Ki67 dual staining. In addition, we provide an explanation regarding the rationale for the use of various screening modalities based on the molecular biology of cervical cancer and cervical precancerous lesions.
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Affiliation(s)
- Andraž Dovnik
- University Clinic for Gynaecology and Obstetrics, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia
| | - Alenka Repše Fokter
- Department of Pathology and Cytology, General Hospital Celje, Oblakova 5, 3000 Celje, Slovenia;
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Maheshwari Y, Handa U, Aggarwal P, Goel B. Comparative Analysis of Conventional Cytology and Liquid-Based Cytology in the Detection of Carcinoma Cervix and its Precursor Lesions. J Cytol 2023; 40:114-118. [PMID: 37745808 PMCID: PMC10516152 DOI: 10.4103/joc.joc_29_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 05/24/2023] [Accepted: 06/19/2023] [Indexed: 09/26/2023] Open
Abstract
Context The conventional smears (CS) and Liquid based cytology (LBC) are important tools to detect carcinoma cervix and its precursor lesions. Aims The present study was done to compare the cytomorphological features of cervical lesions using both techniques and compare with the histopathological diagnosis. Settings and Design This was a prospective observational study over a period of 1.5 years at a tertiary care hospital. Methods and Material A total of 969 women in the age group of 21-65 years presenting with either routine screening or complaints of vaginal bleeding, discharge, or pelvic pain were enrolled for the study. Both the CS and LBC smears were analyzed and compared with the corresponding histopathology diagnosis. The data was analyzed using Statistical Package for the Social Sciences (SPSS) software and P values <0.05 were considered significant. Results There were 8.57% unsatisfactory smears in CS as compared to 0.5% in LBC smears. Liquid-based cytology was superior to conventional preparations in terms of smear adequacy, lesser hemorrhagic and inflammatory background, and presence of more endocervical cells. Liquid-based cytology showed a better yield in detecting all the types of epithelial cell lesions with a concordance rate of 73.9% between the two techniques. On histopathology correlation of these lesions, LBC had a higher sensitivity (96.67%) and diagnostic accuracy (99.08%) as compared to CS (73.33% and 92.66%, respectively). Conclusions Liquid-based cytology is superior to conventional cytology for the detection of epithelial cell lesions. Reduction in the unsatisfactory smears, a cleaner background, and better representation of the sample are more significantly appreciated on LBC in contrast to CS.
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Affiliation(s)
- Yashika Maheshwari
- Department of Pathology, Govt. Medical College and Hospital, Chandigarh, India
| | - Uma Handa
- Department of Pathology, Govt. Medical College and Hospital, Chandigarh, India
| | - Phiza Aggarwal
- Department of Pathology, Govt. Medical College and Hospital, Chandigarh, India
| | - Bharti Goel
- Department of Obstetrics and Gynecology, Govt. Medical College and Hospital, Chandigarh, India
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Plotzker RE, Vaidya A, Pokharel U, Stier EA. Sexually Transmitted Human Papillomavirus: Update in Epidemiology, Prevention, and Management. Infect Dis Clin North Am 2023; 37:289-310. [PMID: 37105644 DOI: 10.1016/j.idc.2023.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
This review presents the epidemiology, pathophysiology, prevention, and management of sexually transmitted human papillomavirus (HPV) and its associated diseases. HPV is the most common sexually transmitted infection worldwide. Prevalence varies regionally. Low-risk strains cause anogenital warts, which can be managed with patient- or provider-applied therapies. High-risk strains cause lower anogenital cancers. Primary and secondary prevention strategies include vaccination and screening for precancerous lesions, respectively. Management of abnormal screening results vary by test result, anatomic site, and individual cancer risk. Approaches include close rescreening, high-resolution visualization with biopsy, and-when biopsy-proven precancer is identified-removal or destruction of the lesion.
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Affiliation(s)
- Rosalyn E Plotzker
- California Prevention Training Center, University of California San Francisco, Bixby Center for Global Reproductive Health 490 Illinois Street, 10th Floor, San Francisco, CA 94143, USA; Department of Epidemiology and Biostatistics, University of California San Francisco, Mission Hall: Global Health and Clinical Sciences, Box 0560 550 16th Street, San Francisco, CA 94143, USA.
| | - Akanksha Vaidya
- California Prevention Training Center, University of California San Francisco, Bixby Center for Global Reproductive Health 490 Illinois Street, 10th Floor, San Francisco, CA 94143, USA
| | - Utsav Pokharel
- California Emerging Infections Program, HPV Impact, 360 22nd Street #750, Oakland, CA 94612, USA
| | - Elizabeth A Stier
- Boston University School of Medicine, Boston Medical Center, 771 Albany Street, Dowling 4, Boston, MA 02118, USA
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Barrios L, Vizcaíno Y, Benedetti I. Liquid-Based Cytology in the Detection of Premalignant Lesions in Patients with "Atypia in Squamous Cells" in Conventional Cytology. J Cytol 2022; 39:148-154. [PMID: 36605874 PMCID: PMC9809424 DOI: 10.4103/joc.joc_22_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/06/2022] [Accepted: 10/07/2022] [Indexed: 11/15/2022] Open
Abstract
Background The management of patients with "Atypical Squamous Cells" (ASC) in conventional papanicolaou smears (CPS) is based on the risk of high-grade squamous intraepithelial lesion (HSIL). The efficacy of liquid-based cytology (LBC) to detect this premalignant lesion is variable, with little evidence of its performance in Colombian patients. Aims The aim of this study is to determine the performance of LBC in the detection of premalignant lesions, in patients with ASC in CPS. Materials and Methods Were obtained patients who attended colposcopy clinic due the result of ASC in CPS. An LBC was taken, which was interpreted by two pathologists without access to other results. The performance of LBC to detect HSIL, was determined, considering as a gold standard: histopathological study/negative-satisfactory colposcopy. Results Were included 114 patients, with a mean age of 38.4 years (SD ± 13.3). LBC had abnormal results in 40.36% (n = 46), with a slightly higher proportion of low-grade squamous intraepithelial lesion (LSIL) than HSIL. The total of abnormal diagnoses by colposcopy and/or biopsy was 51.75% (n = 59), with a predominance of LSIL (36.84%). The sensitivity of the liquid-based cytology to detect premalignant lesions was 76.5%, specificity: 66.0%, positive predictive value: 28.3% and negative predictive value: 94.1%; The Cohen's kappa index of LBC for detecting HSIL was 0.2492 for the total population and 0.2907 for ≥30 years. Discussion Although LBC decreases abnormal cytology and increases the detection of HSIL, which improves diagnostic accuracy; sensitivity and predictive values for detecting HSIL are not significantly different between CPS and LBC.
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Affiliation(s)
- Lia Barrios
- Histopathology Research Group, School of Medicine, Universidad de Cartagena, Colombia
| | - Yoled Vizcaíno
- Histopathology Research Group, School of Medicine, Universidad de Cartagena, Colombia
| | - Ines Benedetti
- Histopathology Research Group, School of Medicine, Universidad de Cartagena, Colombia
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Starodubtseva NL, Chagovets VV, Nekrasova ME, Nazarova NM, Tokareva AO, Bourmenskaya OV, Attoeva DI, Kukaev EN, Trofimov DY, Frankevich VE, Sukhikh GT. Shotgun Lipidomics for Differential Diagnosis of HPV-Associated Cervix Transformation. Metabolites 2022; 12:metabo12060503. [PMID: 35736434 PMCID: PMC9229224 DOI: 10.3390/metabo12060503] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/25/2022] [Accepted: 05/25/2022] [Indexed: 12/12/2022] Open
Abstract
A dramatic increase in cervical diseases associated with human papillomaviruses (HPV) in women of reproductive age has been observed over the past decades. An accurate differential diagnosis of the severity of cervical intraepithelial neoplasia and the choice of the optimal treatment requires the search for effective biomarkers with high diagnostic and prognostic value. The objective of this study was to introduce a method for rapid shotgun lipidomics to differentiate stages of HPV-associated cervix epithelium transformation. Tissue samples from 110 HPV-positive women with cervicitis (n = 30), low-grade squamous intraepithelial lesions (LSIL) (n = 30), high-grade squamous intraepithelial lesions (HSIL) (n = 30), and cervical cancers (n = 20) were obtained. The cervical epithelial tissue lipidome at different stages of cervix neoplastic transformation was studied by a shotgun label-free approach. It is based on electrospray ionization mass spectrometry (ESI-MS) data of a tissue extract. Lipidomic data were processed by the orthogonal projections to latent structures discriminant analysis (OPLS-DA) to build statistical models, differentiating stages of cervix transformation. Significant differences in the lipid profile between the lesion and surrounding tissues were revealed in chronic cervicitis, LSIL, HSIL, and cervical cancer. The lipids specific for HPV-induced cervical transformation mainly belong to glycerophospholipids: phosphatidylcholines, and phosphatidylethanolamines. The developed diagnostic OPLS-DA models were based on 23 marker lipids. More than 90% of these marker lipids positively correlated with the degree of cervix transformation. The algorithm was developed for the management of patients with HPV-associated diseases of the cervix, based on the panel of 23 lipids as a result. ESI-MS analysis of a lipid extract by direct injection through a loop, takes about 25 min (including preparation of the lipid extract), which is significantly less than the time required for the HPV test (several hours for hybrid capture and about an hour for PCR). This makes lipid mass spectrometric analysis a promising method for express diagnostics of HPV-associated neoplastic diseases of the cervix.
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Affiliation(s)
- Natalia L. Starodubtseva
- National Medical Research Center for Obstetrics Gynecology and Perinatology Named after Academician V.I., Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (N.L.S.); (M.E.N.); (N.M.N.); (A.O.T.); (O.V.B.); (D.I.A.); (E.N.K.); (D.Y.T.); (V.E.F.); (G.T.S.)
- Moscow Institute of Physics and Technology, 141700 Moscow, Russia
| | - Vitaliy V. Chagovets
- National Medical Research Center for Obstetrics Gynecology and Perinatology Named after Academician V.I., Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (N.L.S.); (M.E.N.); (N.M.N.); (A.O.T.); (O.V.B.); (D.I.A.); (E.N.K.); (D.Y.T.); (V.E.F.); (G.T.S.)
- Correspondence:
| | - Maria E. Nekrasova
- National Medical Research Center for Obstetrics Gynecology and Perinatology Named after Academician V.I., Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (N.L.S.); (M.E.N.); (N.M.N.); (A.O.T.); (O.V.B.); (D.I.A.); (E.N.K.); (D.Y.T.); (V.E.F.); (G.T.S.)
| | - Niso M. Nazarova
- National Medical Research Center for Obstetrics Gynecology and Perinatology Named after Academician V.I., Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (N.L.S.); (M.E.N.); (N.M.N.); (A.O.T.); (O.V.B.); (D.I.A.); (E.N.K.); (D.Y.T.); (V.E.F.); (G.T.S.)
| | - Alisa O. Tokareva
- National Medical Research Center for Obstetrics Gynecology and Perinatology Named after Academician V.I., Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (N.L.S.); (M.E.N.); (N.M.N.); (A.O.T.); (O.V.B.); (D.I.A.); (E.N.K.); (D.Y.T.); (V.E.F.); (G.T.S.)
- V.L. Talrose Institute for Energy Problems of Chemical Physics, Russia Academy of Sciences, 119991 Moscow, Russia
| | - Olga V. Bourmenskaya
- National Medical Research Center for Obstetrics Gynecology and Perinatology Named after Academician V.I., Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (N.L.S.); (M.E.N.); (N.M.N.); (A.O.T.); (O.V.B.); (D.I.A.); (E.N.K.); (D.Y.T.); (V.E.F.); (G.T.S.)
| | - Djamilja I. Attoeva
- National Medical Research Center for Obstetrics Gynecology and Perinatology Named after Academician V.I., Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (N.L.S.); (M.E.N.); (N.M.N.); (A.O.T.); (O.V.B.); (D.I.A.); (E.N.K.); (D.Y.T.); (V.E.F.); (G.T.S.)
| | - Eugenii N. Kukaev
- National Medical Research Center for Obstetrics Gynecology and Perinatology Named after Academician V.I., Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (N.L.S.); (M.E.N.); (N.M.N.); (A.O.T.); (O.V.B.); (D.I.A.); (E.N.K.); (D.Y.T.); (V.E.F.); (G.T.S.)
- Moscow Institute of Physics and Technology, 141700 Moscow, Russia
- V.L. Talrose Institute for Energy Problems of Chemical Physics, Russia Academy of Sciences, 119991 Moscow, Russia
| | - Dmitriy Y. Trofimov
- National Medical Research Center for Obstetrics Gynecology and Perinatology Named after Academician V.I., Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (N.L.S.); (M.E.N.); (N.M.N.); (A.O.T.); (O.V.B.); (D.I.A.); (E.N.K.); (D.Y.T.); (V.E.F.); (G.T.S.)
| | - Vladimir E. Frankevich
- National Medical Research Center for Obstetrics Gynecology and Perinatology Named after Academician V.I., Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (N.L.S.); (M.E.N.); (N.M.N.); (A.O.T.); (O.V.B.); (D.I.A.); (E.N.K.); (D.Y.T.); (V.E.F.); (G.T.S.)
| | - Gennady T. Sukhikh
- National Medical Research Center for Obstetrics Gynecology and Perinatology Named after Academician V.I., Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (N.L.S.); (M.E.N.); (N.M.N.); (A.O.T.); (O.V.B.); (D.I.A.); (E.N.K.); (D.Y.T.); (V.E.F.); (G.T.S.)
- Department of Obstetrics, Gynecology, Perinatology and Reproductology, First Moscow State Medical University Named after I.M. Sechenov, 119991 Moscow, Russia
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Honarvar Z, Zarisfi Z, Salari Sedigh S, Masoumi Shahrbabak M. Comparison of conventional and liquid-based Pap smear methods in the diagnosis of precancerous cervical lesions. J OBSTET GYNAECOL 2022; 42:2320-2324. [PMID: 35579303 DOI: 10.1080/01443615.2022.2049721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Cervical cancer is one of the five most common cancers among women. The present study aimed to compare conventional and liquid-based Pap smear methods in 2018 in Kerman, Iran. This was a cross-sectional study. Pap smear samples (conventional Pap smear (CN) and liquid-based cytology (LBC)) were collected from five health centres in Kerman. Samples were classified into two groups of liquid and CNs, and each group was classified into normal, abnormal (including, atypical squamous cells of undetermined significance (ASCUS+), atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H+), low-grade squamous intraepithelial lesion (LSIL+), high-grade squamous intraepithelial lesion (HSIL+) and cancer+) and unsatisfactory. Descriptive data analysis and chi-square/Fisher's exact test were performed in SPSS 20 (SPSS Inc., Chicago, IL). Totally, 31,513 women were screened by two CN and LBC. The mean age of subjects was 39.73 ± 9.58 years. The unsatisfactory smears (1.4% versus 0.02%; p=.001) and ASCUS+ (45.1% versus 39.4%; p=.007) were more reported by conventional tests, while LSIL+ (33.1% versus 38.9%; p=.005) was reported by the LBC test. Among women who were younger than 40 years, the CIN2+ that was found by LBC was significantly more than the CN method (37.4% versus 31.7, p=.04) and among older women (older than 40 years) the CIN1+ was significantly more as well (18% versus 13.6%, p=.05). The present study showed that, although LBC had many advantages, CN is still useful. Further studies are to be suggested as a clinical trial in another population with a large number of participants to compare the diagnosing methods of cervical cancers. Impact StatementWhat is already known on this subject? The conventional Pap smear (CN) and liquid-based cytology (LBC) methods are the most common methods for screening cervical cancers. Previously, in some studies, LBC was reported as a better method and in some studies, traditional method was preferred. Conflicting results were found in previous articles.What do the results of this study add? LBC compared to CN could find truer abnormal cases. The superiority of the LBC method is seen in cases such as reducing unsatisfactory cases, etc. LBC compared to CN could find more CIN+. Also, LBC could find more CIN1+ among women older than 40 years and more CIN+ ≥2 among younger women.What are the implications of these findings for clinical practice and/or further research? Although LBC has many advantages and it is easier, CN is still useful and both methods are suitable for cervical abnormality and cancer detection. CN cannot be declared an outdated method.
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Affiliation(s)
- Zahra Honarvar
- Department of Obstetrics and Gynecology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.,Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Zahra Zarisfi
- Department of Obstetrics and Gynecology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Saideh Salari Sedigh
- Department of Obstetrics and Gynecology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Masoumi Shahrbabak
- Department of Obstetrics and Gynecology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
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Chandrasekhar Srinivasamurthy B, Pulavarthi S, Bhat R, Mathiyazhagan D. Role of Ki-67 and Comparison of Conventional-with Liquid-Based–Cytology in Postmenopausal Women. J Gynecol Surg 2020. [DOI: 10.1089/gyn.2020.0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
| | - Sabita Pulavarthi
- Department of Obstetrics and Gynaecology, Indira Gandhi Medical College and Research Institute, Puducherry, India
| | - Ramachandra.V. Bhat
- Department of Pathology, Indira Gandhi Medical College and Research Institute, Puducherry, India
| | - Dharanya Mathiyazhagan
- Department of Pathology, Indira Gandhi Medical College and Research Institute, Puducherry, India
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12
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Lilliecreutz C, Karlsson H, Spetz Holm AC. Participation in interventions and recommended follow-up for non-attendees in cervical cancer screening -taking the women's own preferred test method into account-A Swedish randomised controlled trial. PLoS One 2020; 15:e0235202. [PMID: 32614875 PMCID: PMC7332065 DOI: 10.1371/journal.pone.0235202] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 06/09/2020] [Indexed: 11/25/2022] Open
Abstract
Background Cervical cancer is a highly preventable disease. To not attend an organized cervical cancer screening program increases the risk for cervical dysplasia and cervical cancer. The aim was to investigate the participation rate in three different intervention groups for non- attendees in the Swedish national program for cervical screening. The participation in the recommended follow up, and the histology found were also examined. Method Population-based randomized control trial. It included10,614 women that had not participated in the cervical cancer screening programme during the last six years (ages 30–49) and the last eight years (ages 50–64) were randomised 1:1:1(telephone call from a midwife (offering the choice between a visit for a pap smear or an HPV self-sampling test); an HPV self-sampling test only; or the routine procedure with a yearly invitation). Results In the intention to treat analysis the participation rates were 25.5% (N = 803/3146) vs 34.1% (N = 1047/3068) and 7.0% (N = 250/3538) (p<0.001) for telephone, HPV self-test and control groups respectively. In the by protocol analysis including women that answered the phone call the participation rates were 31.7% (N = 565/1784) vs 26.1% (N = 788/3002) and 7.0% (N = 250/3538) (p<0.001) for telephone, HPV self-test and control groups. The corresponding results in the by protocol analysis including women that did not answer the phone call was 19.7% (N = 565/2870) vs 26.1% (N = 788/3002) and 7.0% (N = 250/3538) (p< 0.001). The majority of the women 63,4% (1131/1784) who answered the telephone wanted to participate either by booking a visit for pap smear (38,5%) or to be sent a HPV self- sampling test (24,9%) (p<0.001). Women who chose an HPV self-test were older and gave anxiety/ fear as a reason to decline participation, and they were also less likely to participate in the follow-up if found to be HPV-positive compared to the women who chose a Pap smear. The attendance to the recommended follow-up after abnormality was in total 87%. The non-attendees had a three or eight times higher risk of having a cytology result of HSIL or suspected SCC respectively, in the index sample compared to women screened as recommended (OR 3.3 CI 95% 1.9–5.2, OR 8.6 CI 1.6–30). A total of ten SCC and one adenocarcinoma were found in the histopathology results from the non-attendee group with a study intervention, while there was only one SCC in the non-attendee group without any study intervention (p = 0.02, OR 8.1 CI 95% 1.2–350). Conclusions Our study suggests, according to intention to treat analysis, that the best intervention to get as many non-attendees as possible to participate is to send an HPV self-sampling test together with an invitation letter. Almost 90% of women in the study with an abnormal index sample attended follow-up. This is high enough to indicate that interventions to increase the participation among non-attendees are meaningful. Registry International Standard Randomised Controlled Trial Number (ISRCTN) Registration number ISRCTN78719765.
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Affiliation(s)
- Caroline Lilliecreutz
- Department of Obstetrics and Gynaecology and Division of Children’s and Women’s Health, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
- * E-mail:
| | - Hanna Karlsson
- Department of Obstetrics and Gynaecology and Division of Children’s and Women’s Health, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Anna-Clara Spetz Holm
- Department of Obstetrics and Gynaecology and Division of Children’s and Women’s Health, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
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13
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de Oliveira ACA, Domingues MF, Neufeld PM, Fleury M, Nogueira Neto JF. Comparison between Conventional Cytology and Liquid-Based Cytology in the Tertiary Brazilian Navy Hospital in Rio de Janeiro. Acta Cytol 2020; 64:539-546. [PMID: 32516778 DOI: 10.1159/000508018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 04/18/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Cervical cancer screening is an important tool in public health. Liquid-based cytology (LBC) has been performed at the studied hospital for 7 years. The present study compares the performance of 2 LBC techniques with conventional cytology. OBJECTIVE Our objective is to verify the sensitivity for the detection of neoplastic and preneoplastic epithelial atypia, as well as the positive predictive value of the 3 methodologies. METHODS We analyzed retrospectively 24,529 cases and evaluated the conventional cytology, ThinPrep®, and BD SurePath® performance categorizing the results according to the Bethesda system. We also compared the level of unsatisfactory samples, the presence of elements from the squamocolumnar junction, and the detection of pathogenic microorganisms. RESULTS ThinPrep® (1.43%) showed superior sensitivity over BD SurePath® (0.91%) and conventional cytology (0.71%) in terms of the detection of high-grade lesions; however, in terms of squamous atypia as a whole (ASC-US+), BD SurePath® (6.44%) proved to be more sensitive than conventional cytology (5.28%) and ThinPrep® (3.73%). CONCLUSIONS The results show the advantage of implementing LBC in routine screening for cervical lesions. In this study, BD SurePath® achieved the overall best performance considering the studied variables.
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Affiliation(s)
- Antônio Carlos Almeida de Oliveira
- Laboratory Medicine and Forensic Technology, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil,
- Hospital Naval Marcílio Dias, Pathology Service, Rio de Janeiro, Brazil,
| | | | - Paulo Murilo Neufeld
- Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcos Fleury
- Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - José Firmino Nogueira Neto
- Lipids Laboratory-LabLip, Faculty of Medical Sciences, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
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14
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Armstrong SF, Guest JF. Cost-Effectiveness and Cost-Benefit of Cervical Cancer Screening with Liquid Based Cytology Compared with Conventional Cytology in Germany. CLINICOECONOMICS AND OUTCOMES RESEARCH 2020; 12:153-166. [PMID: 32256090 PMCID: PMC7085949 DOI: 10.2147/ceor.s234385] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 01/22/2020] [Indexed: 12/24/2022] Open
Abstract
Objective To assess the health economic impact of cervical screening with liquid based cytology (LBC) compared with conventional cytology (CC) in Germany. Methods An economic model was constructed depicting the management of a hypothetical cohort of women aged ≥20 years who undergo cervical screening in Germany. The model estimated the cost-effectiveness and cost-benefit of LBC compared with CC at 2017/18 prices over a time-horizon of 70 years. Results Performing cervical screens with LBC instead of CC is expected to increase the probability of detecting a true positive over a subject's lifetime by 73% (0.038 versus 0.022) and of diagnosing a subject with stage 3 cervical intraepithelial neoplasia (CIN3) (0.019 versus 0.011). Women screened with LBC instead of CC are expected to have a 57% reduction in the probability of having undetected CIN3 (0.006 versus 0.014) and to experience a 44% reduction in the probability of transitioning into disease progression (from 0.018 to 0.010). The mean discounted lifetime cost of healthcare resource use associated with performing cervical screens with LBC and CC was estimated at €4852 and €7523 per subject respectively. For every Euro invested in cervical screening with LBC instead of CC, the German healthcare system could potentially save ~€170 over a subject's lifetime. Conclusion Within the study's limitations, the analysis showed that LBC affords a cost-effective cervical screening test compared with CC in Germany, since it improves detection rates and has the potential to lead to a reduction in disease progression for less cost.
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Affiliation(s)
| | - Julian F Guest
- Catalyst Consultants, Rickmansworth, UK.,Faculty of Life Sciences and Medicine, King's College, London, UK
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15
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Ito K, Kimura R, Konishi H, Ozawa N, Yaegashi N, Ohashi Y, Suzuki M, Kakizoe T. A comparison of liquid-based and conventional cytology using data for cervical cancer screening from the Japan Cancer Society. Jpn J Clin Oncol 2020; 50:138-144. [PMID: 31735963 DOI: 10.1093/jjco/hyz161] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 10/03/2019] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Liquid-based cytology has replaced conventional cytology in cervical cancer screening in many countries. However, a detailed comparison of liquid-based cytology with conventional cytology has not been reported in Japan. Therefore, the aim of the study is to evaluate efficacy of liquid-based cytology in Japan. METHODS We first evaluated the prevalence of use of liquid-based cytology and then examined the efficacy of liquid-based cytology and conventional cytology for detecting CIN and the rate of unsatisfactory specimens using data from cancer screening collected by the Japanese Cancer Society from FY2011 to FY2014. A Poisson regression model with random effects analyses was used to classify histological outcomes and unsatisfactory specimens using liquid-based cytology compared to conventional cytology. RESULTS A total of 3 815 131 women were analyzed in the study. The rate of liquid-based cytology increased from approximately 8% in FY2011 to 37% in FY2014. Compared to conventional cytology, the detection rates with liquid-based cytology were significantly higher (1.42 times) for CIN1+ [detection rate ratio (DRR) = 1.42, 95% confidence interval (CI) 1.35-1.48, P < 0.001] and CIN2+ (DRR = 1.16, 95% CI 1.08-1.25, P < 0.001). Positive predictive value ratios of CIN1+ and CIN2+ were also significantly higher for liquid-based cytology than for conventional cytology. However, there was no significant difference between liquid-based cytology and conventional cytology for detection rates and positive predictive values of CIN3+ and cancer. The rate of unsatisfactory specimens was significantly lower with liquid-based cytology compared to conventional cytology (DRR = 0.07, 95% CI 0.05-0.09, P < 0.001). CONCLUSIONS In order to avoid the unsatisfactory specimens in cervical cancer screening, the results of this study did indicate that liquid-based cytology was more useful than conventional cytology in practical standpoints.
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Affiliation(s)
- Kiyoshi Ito
- Department of Disaster Obstetrics and Gynecology, International Research Institute of Disaster Science (IRIDeS), Tohoku University, Sendai, Japan.,Department of Disaster Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ryusei Kimura
- Graduate School of Interdisciplinary Information Studies, The University of Tokyo, Tokyo, Japan
| | | | | | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuo Ohashi
- Department of Integrated Science and Engineering for Sustainable Society, Chuo University, Tokyo, Japan
| | - Mitsuaki Suzuki
- Department of Cancer Center, Shin-Yurigaoka General Hospital, Kanagawa, Japan
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Lewitowicz P, Nasierowska-Guttmejer A, Rokita W, Adamczyk-Gruszka O, Gluszek S, Chrapek M, Kolos M, Wrona-Cyranowska A, Misiek M. HPV genotyping and p16/Ki-67 test significantly improve detection rate of high-grade cervical squamous intraepithelial lesion. Arch Med Sci 2020; 16:87-93. [PMID: 32051710 PMCID: PMC6963143 DOI: 10.5114/aoms.2018.80697] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 11/09/2018] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Liquid-based cytology allows to apply modern and specific analyses of hrHPV genotyping in p16/Ki-67 test. All of these together could raise accuracy ratio for high-grade squamous intraepithelial lesion above 90%. The purpose of this study was to evaluate the diagnostic accuracy of LBC, hrHPV testing, and p16/Ki-67 testing in diagnosis of high-grade cervical intraepithelial lesions. MATERIAL AND METHODS The study consisted of 176 women, out of which 50 presented with HSIL (CIN2) SCC (cervical intraepithelial lesion grade 2 squamous cell carcinoma). 126 women with a negative Pap test were pooled into the second group of the study. All patients were resampled for LBC, HPV genotyping, and for the p16/Ki-67 test. The research was carried out between May and December 2017, and second sampling were taken from 1 to 4 months. RESULTS We reported a strong correlation between positive Pap test and hrHPV (p < 0.05) that met accuracy close to 90%. We noted correlations between a positive p16/Ki-67 with a positive Pap test: p < 0.001; 66% sensitivity (95% CI: 51.2-78.8%), 87.8% specificity (95% CI: 75.2-95.4%), 76.8% accuracy (95% CI: 67.2-84.7%), and OR 13.9 (95% CI: 4.9-39.2), especially HSIL and HPV16: p < 0.001; sensitivity (95% CI) 64.0, specificity (95% CI) 98.4, accuracy (95% CI) 88.6, OR (95% CI) 109.3. CONCLUSIONS The results of our study indicate hrHPV genotyping as a good biomarker for the triage of patients with an abnormal cytological report. In our opinion, the hrHPV test reaches the highest level of sensitivity, specificity, and accuracy, and should be considered as crucial diagnostic test in cervical screening.
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Affiliation(s)
- Piotr Lewitowicz
- Department of Pathology, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Anna Nasierowska-Guttmejer
- Department of Pathology, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Wojciech Rokita
- Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
- Department of Obstetrics and Gynecology Province Hospital, Kielce, Poland
| | - Olga Adamczyk-Gruszka
- Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
- Department of Obstetrics and Gynecology Province Hospital, Kielce, Poland
| | - Stanisław Gluszek
- Department of Surgery and Surgical Nursing, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Magdalena Chrapek
- Department of Probability Theory and Statistics, Institute of Mathematics, the Faculty of Mathematics and Natural Sciences, Jan Kochanowski University, Kielce, Poland
| | - Małgorzata Kolos
- Department of Pathology, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | | | - Marcin Misiek
- Clinic of Gynecology, Holy-Cross Oncology Centre, Kielce, Poland
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Norimatsu Y, Yanoh K, Hirai Y, Kurokawa T, Kobayashi TK, Fulciniti F. A Diagnostic Approach to Endometrial Cytology by Means of Liquid-Based Preparations. Acta Cytol 2019; 64:195-207. [PMID: 31473735 DOI: 10.1159/000502108] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 07/15/2019] [Indexed: 12/12/2022]
Abstract
The adoption of endometrial cytology as a diagnostic procedure has been hampered in the past by difficulties arising in interpreting the cellular findings due to a number of factors (such as excess blood, cellular overlapping, and the complex physiology of endometrium). Recently, the use of liquid-based cytology (LBC), with its ability to remove blood and mucus and to distribute cells uniformly in a thin layer on the slide, has provided an opportunity to reevaluate the role of endometrial cytology. LBC samples are easier to screen compared to conventional ones, due to a smaller screening area and an excellent quality of cell preparations. LBC by using peculiar cytoarchitectural features is a useful tool in the cellular diagnosis and follow-up of abnormalities, which, however, remains complementary to histopathology and to the emerging molecular diagnostic cytopathology. This review discusses these various entities and takes into consideration the ancillary techniques that may be useful in the diagnostic procedure. Herein, we also summarize the process and rationale by which updates were made to the standardized terminology in 2018 and outline the contents of the new Bethesda-style classification (the Yokohama system) for the endometrial cytology.
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Affiliation(s)
- Yoshiaki Norimatsu
- Department of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health Sciences, Iyo-gun, Japan,
| | - Kenji Yanoh
- Department of Obstetrics and Gynecology, JA Suzuka General Hospital, Suzuka, Japan
| | - Yasuo Hirai
- Department Obstetrics and Gynecology, Faculty of Medicine, Dokkyo Medical University, Mibumachi, Japan
- Department of Cytology, PCL Japan Pathology and Cytology Center, PCL Inc., Kawagoe, Japan
| | - Tetsuji Kurokawa
- Department of Gynecology and Obstetrics, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Tadao K Kobayashi
- Cancer Education and Research Center, Osaka University Graduate School of Medicine, Suita, Japan
| | - Franco Fulciniti
- Clinical Cytopathology Service, Istituto Cantonale di Patologia, Locarno, Switzerland
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18
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Tao X, Zhang H, Zhang H, Xiao J, Li J, Zhou X, Wang L, Zhao C. Follow‐up with histopathology and HPV testing on LSIL cytology in China’s largest academic woman’s hospital. Cancer Cytopathol 2019; 127:258-266. [PMID: 30892831 DOI: 10.1002/cncy.22119] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 02/26/2019] [Accepted: 02/27/2019] [Indexed: 12/24/2022]
Affiliation(s)
- Xiang Tao
- Department of Pathology Obstetrics and Gynecology Hospital of Fudan University Shanghai China
| | - Huina Zhang
- Department of Pathology University of Rochester Medical Center Rochester New York
| | - Hao Zhang
- Department of Pathology Obstetrics and Gynecology Hospital of Fudan University Shanghai China
| | - Jianan Xiao
- Department of Pathology Obstetrics and Gynecology Hospital of Fudan University Shanghai China
| | - Juan Li
- Department of Pathology Jinan Maternity and Child Care Hospital Shandong China
| | - Xianrong Zhou
- Department of Pathology Obstetrics and Gynecology Hospital of Fudan University Shanghai China
| | - Li Wang
- Department of Pathology Obstetrics and Gynecology Hospital of Fudan University Shanghai China
| | - Chengquan Zhao
- Department of Pathology Obstetrics and Gynecology Hospital of Fudan University Shanghai China
- Department of Pathology University of Pittsburgh Medical Center Pittsburgh Pennsylvania
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19
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Pyo JS, Kang G, Yoon HK, Kim HJ. Diagnostic Test Accuracy Review of Cytology for Squamous Intraepithelial Lesion and Squamous Cell Carcinoma of Uterine Cervix. J Korean Med Sci 2019; 34:e16. [PMID: 30636946 PMCID: PMC6327093 DOI: 10.3346/jkms.2019.34.e16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 10/25/2018] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Even though cervico-vaginal smears have been used as a primary screening test for cervical carcinoma, the diagnostic accuracy has been controversial. The present study aimed to evaluate the diagnostic accuracy of cytology for squamous intraepithelial lesion (SIL) and squamous cell carcinoma (SqCC) of the uterine cervix through a diagnostic test accuracy (DTA) review. METHODS A DTA review was performed using 38 eligible studies that showed concordance between cytology and histology. In the DTA review, sensitivity, specificity, diagnostic odds ratio (OR), and the area under the curve (AUC) on the summary receiver operating characteristic (SROC) curve were calculated. RESULTS In the comparison between abnormal cytology and histology, the pooled sensitivity and specificity were 93.9% (95% confidence interval [CI], 93.7%-94.1%) and 77.6% (95% CI, 77.4-77.8%), respectively. The diagnostic OR and AUC on the SROC curve were 8.90 (95% CI, 5.57-14.23) and 0.8148, respectively. High-grade squamous intraepithelial lesion (HSIL) cytology had a higher sensitivity (97.6%; 95% CI, 94.7%-97.8%) for predicting HSIL or worse histology. In the comparison between SqCC identified on cytology and on histological analysis, the pooled sensitivity and specificity, diagnostic OR, and AUC were 92.7% (95% CI, 87.3%-96.3%), 87.5% (95% CI, 87.2%-87.8%), 865.81 (95% CI, 68.61-10,925.12), and 0.9855, respectively. Geographic locations with well-organized screening programs had higher sensitivity than areas with insufficient screening programs. CONCLUSION These results indicate that cytology had a higher sensitivity and specificity for detecting SIL and SqCC of the uterine cervix during primary screening.
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Affiliation(s)
- Jung-Soo Pyo
- Department of Pathology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
| | - Guhyun Kang
- Department of Pathology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Hye Kyoung Yoon
- Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Hyun Jung Kim
- Department of Pathology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
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20
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Singh U, Qureshi S, Negi N, Singh N, Goel M, Srivastava K. Comparative study between liquid-based cytology & conventional Pap smear for cytological follow up of treated patients of cancer cervix. Indian J Med Res 2018; 147:263-267. [PMID: 29923515 PMCID: PMC6022377 DOI: 10.4103/ijmr.ijmr_854_16] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background & objectives: Cancer cervix is one of the most common forms of genital malignancy among Indian women. Recurrence is seen in a significant number of cases. The conventional cervical smear technique has inherent problems and screening and interpretation errors. This study was undertaken to assess the efficacy of liquid-based cytology (LBC) as a method for cytological follow up and detection of recurrence in treated cases of cancer cervix and to compare it with conventional Pap smear technique to find the best screening method for detection of recurrence in these patients. Methods: This cross-sectional study was conducted over a period of one year. Patients attending Gynecology and Radiotherapy outpatient departments for follow up after treatment of cancer cervix were included. Pap smear and LBC were taken in all cases. Colposcopy and biopsy were done for those having epithelial cell abnormality in cytology report. Colposcopy and biopsy were taken as gold standard for diagnosis of cancer cervix recurrence. Results: Ninety four treated patients of carcinoma cervix were studied. The diagnostic accuracy for detection of recurrence of conventional Pap smear was 79.16 per cent, and that of LBC was 97.6 per cent. The difference between the two methods was significant (P<0.001). Interpretation & conclusions: Our findings showed that LBC performed better than the conventional method of cytology to detect recurrence of squamous cell carcinoma. Its sensitivity, specificity as well as accuracy were much higher than conventional method. LBC can be a better method of cytological follow up of post-treated patients of cancer cervix.
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Affiliation(s)
- Uma Singh
- Department of Obstetrics & Gynecology, King George's Medical University, Lucknow, India
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- Department of Obstetrics & Gynecology, King George's Medical University, Lucknow, India
| | - Sabuhi Qureshi
- Department of Obstetrics & Gynecology, King George's Medical University, Lucknow, India
| | - Neha Negi
- Department of Obstetrics & Gynecology, King George's Medical University, Lucknow, India
| | - Nisha Singh
- Department of Obstetrics & Gynecology, King George's Medical University, Lucknow, India
| | - Madhumati Goel
- Department of Pathology, King George's Medical University, Lucknow, India
| | - Kirti Srivastava
- Department of Radiotherapy, King George's Medical University, Lucknow, India
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Thamsborg LH, Napolitano G, Larsen LG, Lynge E. Impact of HPV vaccination on outcome of cervical cytology screening in Denmark-A register-based cohort study. Int J Cancer 2018; 143:1662-1670. [PMID: 29707775 PMCID: PMC6175001 DOI: 10.1002/ijc.31568] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 04/04/2018] [Accepted: 04/19/2018] [Indexed: 12/12/2022]
Abstract
4vHPV vaccination has been tested in randomized controlled trials under almost ideal conditions, and studies of real-life use have compared outcome between vaccinated and unvaccinated women from the same birth cohort and mostly before screening age. Here we present the first-to our knowledge-evaluation of the impact of the 4vHPV vaccination in real life without selection bias in the reported data. The study has been carried out by comparing the results after first cervical screening between an HPV-vaccinated and an unvaccinated birth cohort, consisting of women born in Denmark in 1993 and 1983, respectively. Cytology data covering an 8-year period, from the age of 15 (age of HPV-vaccination) to age 23 (age of invitation to first cervical screening), were retrieved from the Danish National Pathology Register. Abnormal cytology, defined as atypical squamous cell of undetermined significance and worse (ASCUS+) was detected in 9.4% of women born in 1993 as compared with 9.0% of women born in 1983; RR = 1.04 (95% CI 0.96-1.12), p = .29. Detection of high-grade squamous intraepithelial lesion (HSIL) was statistically significantly lower in the 1993 than in the 1983 cohort, RR = 0.6 (95% CI 0.5-0.7), p < .0001, while the opposite pattern was seen for ASCUS RR = 1.4 (95% CI 1.2-1.6), p < .0001. The decrease in HSIL means that more women can be spared referral for colposcopy and biopsy. The increase of ASCUS could be explained by transition from conventional to liquid-based cytology, but this observation requires further monitoring.
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Affiliation(s)
| | - George Napolitano
- Department of Public HealthUniversity of CopenhagenCopenhagen1014Denmark
| | - Lise Grupe Larsen
- Department of PathologyZealand University HospitalRoskilde4000Denmark
| | - Elsebeth Lynge
- Nykøbing Falster HospitalUniversity of CopenhagenEjegodvej 63DK‐4800Denmark
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Leite KRM, Silva T, Naum B, Canavez F, Canavez J, Pimenta R, Reis S, Camara-Lopes LH. Validation of a New Low-Cost, Methanol-Based Fixative for Cervical Cytology and Human Papillomavirus Detection. Acta Cytol 2018; 62:393-396. [PMID: 29913440 DOI: 10.1159/000489873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 05/08/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To test the performance of a new fixative for pap smear collection for liquid-based cervical cytology, CellPreserv® and compare it with the commercially available, PreservCyt® used in the diagnosis and detection of human papillomavirus (HPV). METHODS Seven hundred twenty five women participated in this study after signing an informed consent. The specimens were collected using a traditional device, agitated in PBS, and equally divided in both fixatives. The slides were prepared routinely, stained by Papanicolaou, examined blindly by 2 cytologists, and reviewed by one cytopathologist. To search for HPV, 1,000 μL from each fixative was taken and processed by polymerase chain reaction. RESULTS Considering the adequacy of samples, both fixatives had similar results - 0.33 and 0.32% of the cases unsatisfactory for PreservCyt® and CellPreserv®, respectively. Considering the 701 satisfactory cases and comparing the new fixative to the traditional fixative, there was 99.3% concordance between both. The results regarding the HPV detection was 100% concordant between the 2 fixatives. CONCLUSION The new methanol-based fixative, CellPreserv®, is cheaper and equally efficient for treating cervical cancer screening and for HPV detection, and can be safely used by the health system prevailing in low-income countries.
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Affiliation(s)
- Katia Ramos Moreira Leite
- Laboratorio Genoa/LPCM, São Paulo,
- Faculdade de Medicina da Universidade de São Paulo LIM 55, São Paulo,
| | | | - Bruna Naum
- Laboratorio Genoa/LPCM, São Paulo, Brazil
| | | | | | - Ruan Pimenta
- Laboratorio Genoa/LPCM, São Paulo, Brazil
- Faculdade de Medicina da Universidade de São Paulo LIM 55, São Paulo, Brazil
| | - Sabrina Reis
- Faculdade de Medicina da Universidade de São Paulo LIM 55, São Paulo, Brazil
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Hosono S, Terasawa T, Katayama T, Sasaki S, Hoshi K, Hamashima C. Frequency of unsatisfactory cervical cytology smears in cancer screening of Japanese women: A systematic review and meta-analysis. Cancer Sci 2018; 109:934-943. [PMID: 29478281 PMCID: PMC5891182 DOI: 10.1111/cas.13549] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 02/06/2018] [Accepted: 02/13/2018] [Indexed: 11/30/2022] Open
Abstract
The Bethesda system (TBS) has been used for cervical cytological diagnosis in Japan since 2008. Evaluation of specimen adequacy is the most important aspect of quality assurance and for precise diagnosis in TBS. A systematic review and meta‐analysis were carried out to assess the unsatisfactory specimen rate in the primary cervical cancer screening setting in Japan. Ovid Medline and Ichushi‐Web databases were searched from inception through to May 2017. Prospective and retrospective studies that reported the proportion of unsatisfactory specimens in healthy asymptomatic Japanese women in a cervical cancer screening program were eligible for inclusion; 17 studies were included in the meta‐analysis. The random‐effects model meta‐analysis calculated summary estimates of the unsatisfactory rate of 0.60% (95% confidence interval [CI], 0.18‐1.96%; I2 = 99%) for conventional cytology and 0.04% (95% CI, 0.00‐0.35%; I2 = 99%) for liquid‐based cytology (LBC). However, comparative results between conventional and liquid‐based cytology, based on four direct and nine comparative studies, showed no significant difference (summary odds ratio = 3.5 × 10−2 favoring LBC [95% CI, 6.9 × 10−4‐1.7]; I2 = 98%). In the subgroup analyses and meta‐regressions, use of non‐cotton devices for conventional cytology and use of a particular platform for LBC were associated with lower unsatisfactory rates. Meta‐regression also suggested chronological improvement in unsatisfactory rates for both tests. In Japanese cervical cancer screening programs, conventional cytology remains prevalent. Future research needs to focus on evaluating the impact of screening programs using LBC by comparing the accuracy, performance, and cost‐effectiveness with conventional cytology in the Japanese population.
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Affiliation(s)
- Satoyo Hosono
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.,All Japan Labour Welfare Foundation, Tokai Clinic, Nagoya, Japan
| | - Teruhiko Terasawa
- Section of General Internal Medicine, Department of Emergency and General Internal Medicine, Fujita Health University School of Medicine, Toyoake, Japan
| | - Takafumi Katayama
- Department of Statistics and Computer Science, College of Nursing Art and Science, University of Hyogo, Hyogo, Japan
| | - Seiju Sasaki
- St. Luke's International Hospital Affiliated Clinic, Center for Preventive Medicine, Tokyo, Japan
| | - Keika Hoshi
- Department of Hygiene, Kitasato University School of Medicine, Sagamihara, Japan
| | - Chisato Hamashima
- Division of Cancer Screening Assessment and Management, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
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Takamatsu R, Nabandith V, Pholsena V, Mounthisone P, Nakasone K, Ohtake K, Yoshimi N. Cervical cytology and human papillomavirus among asymptomatic healthy volunteers in Vientiane, Lao PDR. BMC Cancer 2017; 17:872. [PMID: 29258466 PMCID: PMC5738160 DOI: 10.1186/s12885-017-3900-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 12/08/2017] [Indexed: 12/03/2022] Open
Abstract
Background Cervical cancer is the most common cancer in women living in Vientiane, Lao People’s Democratic Republic (PDR). This study examines cervical cytology using a liquid-based cytology (LBC) method and reports the presence of high-risk (HR) human papillomavirus (HPV). Methods We collected cervical samples from 1475 asymptomatic and healthy volunteers from six hospitals in Lao PDR. A total of 1422 volunteers (mean age 39.1 ± 6.4 years, range 30-54 years) were included in the final analysis. We performed HPV typing using the polymerase chain reaction technique to detect HR-HPV samples with abnormal cytology. Results The overall rates of abnormal cytology and HR-HPV–positive in the samples were 9.3% (132/1422) and 47.7% (63/132), respectively. The samples with abnormal cytology included 13 high-grade squamous intraepithelial lesions and one squamous cell carcinoma case. The results showed that the most common type of HPV was HPV16 (20.5%) followed by HPV58 (9.1%). Conclusions Healthy women in Vientiane, the capital of Lao PDR, have high rates of abnormal cervical cytology and are likely to be HR-HPV-positive. A system for detection and prevention of cervical cancer in these women should be developed in the near future. Electronic supplementary material The online version of this article (10.1186/s12885-017-3900-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Reika Takamatsu
- Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Nakagami-gun, Okinawa, 903-0215, Japan.
| | - Viengvansay Nabandith
- Setthathirath Hospital, Donekoi Village, Sisatthanak District, P.O.Box 527, Vientiane, Lao PDR
| | - Vatsana Pholsena
- Setthathirath Hospital, Donekoi Village, Sisatthanak District, P.O.Box 527, Vientiane, Lao PDR
| | - Phouthasone Mounthisone
- Mittaphab Hospital, Phonsavang Village, Chanthabouly District, P.O.Box 6035, Vientiane, Lao PDR
| | - Katsu Nakasone
- Department of Pathology, Ryukyu University Hospital, 207 Uehara, Nishihara-cho, Nakagami-gun, Okinawa, 903-0215, Japan
| | - Kentarou Ohtake
- Clinical Laboratory, Medical Examination Center of Chubu Medical Association, 1-584 Miyagi, Chatan-cho, Nakagami-gun, Okinawa, 904-0113, Japan
| | - Naoki Yoshimi
- Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Nakagami-gun, Okinawa, 903-0215, Japan
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Rozemeijer K, Naber SK, Penning C, Overbeek LIH, Looman CWN, de Kok IMCM, Matthijsse SM, Rebolj M, van Kemenade FJ, van Ballegooijen M. Cervical cancer incidence after normal cytological sample in routine screening using SurePath, ThinPrep, and conventional cytology: population based study. BMJ 2017; 356:j504. [PMID: 28196844 PMCID: PMC5421440 DOI: 10.1136/bmj.j504] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objective To compare the cumulative incidence of cervical cancer diagnosed within 72 months after a normal screening sample between conventional cytology and liquid based cytology tests SurePath and ThinPrep.Design Retrospective population based cohort study.Setting Nationwide network and registry of histo- and cytopathology in the Netherlands (PALGA), January 2000 to March 2013.Population Women with 5 924 474 normal screening samples (23 833 123 person years).Exposure Use of SurePath or ThinPrep versus conventional cytology as screening test.Main outcome measure 72 month cumulative incidence of invasive cervical cancer after a normal screening sample for each screening test. Cox regression analyses assessed the hazard ratios, adjusted for calendar time, age, screening history, and socioeconomic status and including laboratories as random effects.Results The 72 month cumulative cancer incidence was 58.5 (95% confidence interval 54.6 to 62.7) per 100 000 normal conventional cytology samples, compared with 66.8 (56.7 to 78.7) for ThinPrep and 44.6 (37.8 to 52.6) for SurePath. Compared with conventional cytology, the hazard of invasive cancer was 19% lower (hazard ratio 0.81, 95% confidence interval 0.66 to 0.99) for SurePath, mainly caused by a 27% lower hazard (0.73, 0.57 to 0.93) of a clinically detected cancer. For ThinPrep, the hazard was on average 15% higher (hazard ratio 1.15, 0.95 to 1.38), mainly caused by a 56% higher hazard of a screen detected cancer (1.56, 1.17 to 2.08).Conclusions These findings should provoke reconsideration of the assumed similarity in sensitivity to detect progressive cervical intraepithelial neoplasia between different types of liquid based cytology and conventional cytology.
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Affiliation(s)
- Kirsten Rozemeijer
- Department of Public Health, Erasmus MC, University Medical Center, 3000 CA Rotterdam, Netherlands
| | - Steffie K Naber
- Department of Public Health, Erasmus MC, University Medical Center, 3000 CA Rotterdam, Netherlands
| | - Corine Penning
- Department of Public Health, Erasmus MC, University Medical Center, 3000 CA Rotterdam, Netherlands
| | - Lucy I H Overbeek
- PALGA, the nationwide network and registry of histo- and cytopathology in the Netherlands, Houten, Netherlands
| | - Caspar W N Looman
- Department of Public Health, Erasmus MC, University Medical Center, 3000 CA Rotterdam, Netherlands
| | - Inge M C M de Kok
- Department of Public Health, Erasmus MC, University Medical Center, 3000 CA Rotterdam, Netherlands
| | - Suzette M Matthijsse
- Department of Public Health, Erasmus MC, University Medical Center, 3000 CA Rotterdam, Netherlands
| | - Matejka Rebolj
- Clinical Research Centre and Department of Pathology, Copenhagen University Hospital, Hvidovre, Denmark
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Arul P, Shetty S, Masilamani S, Akshatha C, Naveen Kumar BJ. Evaluation of Micronucleus in Exfoliated Buccal Epithelial Cells Using Liquid-based Cytology Preparation in Petrol Station Workers. Indian J Med Paediatr Oncol 2017; 38:273-276. [PMID: 29200672 PMCID: PMC5686965 DOI: 10.4103/ijmpo.ijmpo_26_16] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: Liquid-based cytology (LBC) can be used for the evaluation of micronucleus (MN) in exfoliated buccal epithelial cells of populations occupationally exposed to potentially carcinogenic agents. Aim: This study was undertaken to evaluate the frequency of MN of exfoliated buccal epithelial cells using LBC preparation in petrol station workers. Materials and Methods: Fifty petrol station workers (cases) and fifty hospital administrative staffs (controls) were recruited and evaluated for MN by May-Grunwald Giemsa, Hematoxylin and Eosin, and Papanicolaou stains using LBC preparation. Statistical analysis was performed with Student's t-test, and P < 0.05 was considered statistically significant. Results: Regardless of staining method used, the mean frequency of MN for cases was significantly higher than that of controls (P < 0.001). Conclusion: The present study concluded that petrol station workers are under risk of significant cytogenetic damage. The MN in exfoliated buccal epithelial cells found to be a useful biomarker of occupational exposure to genotoxic chemicals. LBC can be used for sample preparation to evaluate the frequency of MN in those who are occupationally exposed to potentially carcinogenic agents in view of overall improvement on sample preservation and visualization of cell morphology.
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Affiliation(s)
- P Arul
- Department of Pathology, Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur, Tamil Nadu, India
| | - Smitha Shetty
- Department of Pathology, Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur, Tamil Nadu, India
| | - Suresh Masilamani
- Department of Pathology, Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur, Tamil Nadu, India
| | - C Akshatha
- Department of Pathology, Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur, Tamil Nadu, India
| | - B J Naveen Kumar
- Department of Pathology, Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur, Tamil Nadu, India
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27
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The advantages of incorporating liquid-based cytology (TACAS™) in mass screening for cervical cancer. Hum Cell 2016; 29:83-90. [PMID: 26739336 DOI: 10.1007/s13577-015-0130-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 12/17/2015] [Indexed: 10/22/2022]
Abstract
We incorporated liquid-based cytology (LBC) in population-based screening for cervical cancer. The usefulness of using LBC in mass screening for cervical cancer was examined. From 2009 to 2014, 157,061 individuals underwent mass screening for cervical cancer in Aomori Prefecture. From 2009 to 2011, cells were collected from 82,218 individuals and the specimens were conventionally prepared (CP). From 2012 to 2014, cells were collected from 74,843 individuals and the specimens were prepared using LBC (TACAS™). Cytology results for the 2 sets of specimens were compared and differences in cytologic features were examined. ASC-US and more severe lesions were detected at a rate of 1.13 % by CP and 1.44 % by LBC, so LBC had a 1.3-fold higher rate of detection. LBC had a 1.6-fold higher rate of LSIL detection and a 1.2-fold higher rate of HSIL detection. CP detected cancer in 20 cases at a rate of 0.024 % while LBC detected cancer in 18 cases at a rate of 0.024 %. Cytodiagnosis of the 18 cases of SCC that LBC identified revealed that 7 were SCC, 8 were HSIL, and 3 were ASC-H. Atypical cells tended to be smaller with TACAS™. LBC reduced the time needed for microscopic examination of a single specimen by 42 % in comparison to CP. LBC using TACAS™ allowed the detection of slight lesions and slight changes in cells. LBC can lessen the burden on medical personnel and may lead to improved accuracy.
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28
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Rozemeijer K, Penning C, Siebers AG, Naber SK, Matthijsse SM, van Ballegooijen M, van Kemenade FJ, de Kok IMCM. Comparing SurePath, ThinPrep, and conventional cytology as primary test method: SurePath is associated with increased CIN II+ detection rates. Cancer Causes Control 2015; 27:15-25. [PMID: 26458884 PMCID: PMC4703623 DOI: 10.1007/s10552-015-0678-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 09/23/2015] [Indexed: 12/20/2022]
Abstract
Purpose Within the last decade, SurePath and ThinPrep [both liquid-based cytology (LBC) tests] have replaced conventional cytology (CC) as primary test method in cervical cancer screening programs of multiple countries. The aim of our study was to examine the effect in the Dutch screening program. Methods All primary smears taken within this program from 2000 to 2011 were analyzed using the nationwide registry of histo- and cytopathology (PALGA) with a follow-up until March 2013. The percentage of smears classified as borderline/mildly dyskaryotic (BMD) and >BMD as well as CIN and cervical cancer detection rates were compared between SurePath and ThinPrep versus CC by logistic regression analyses (adjusted for age, screen region, socioeconomic status, and calendar time). Results We included 3,118,685 CC, 1,313,731 SurePath, and 1,584,587 ThinPrep smears. Using SurePath resulted in an increased rate of primary smears classified as >BMD [odds ratio (OR) = 1.12 (95% confidence interval (CI) 1.09–1.16)]. CIN I and II+ detection rates increased by 14 % [OR = 1.14 (95% CI 1.08–1.20)] and 8 % [OR = 1.08 (95% CI 1.05–1.12)]. Cervical cancer detection rates were unaffected. Implementing ThinPrep did not result in major alterations of the cytological classification of smears, and it did not affect CIN detection rates.
While not significant, cervical cancer detection rates were lower [OR = 0.87 (95% CI 0.75–1.01)]. Conclusions The impact of replacing CC by LBC as primary test method depends on the type of LBC test used.
Only the use of SurePath was associated with increased CIN II+ detection, although it simultaneously increased the detection of CIN I.
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Affiliation(s)
- Kirsten Rozemeijer
- Department of Public Health, Erasmus MC, University Medical Center, Room Na-2223, PO Box 2040, 3000, CA, Rotterdam, The Netherlands.
| | - Corine Penning
- Department of Public Health, Erasmus MC, University Medical Center, Room Na-2223, PO Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Albert G Siebers
- Department of Pathology, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands.,PALGA, The Nationwide Network and Registry of Histo- and Cytopathology in The Netherlands, Randhoeve 231A, 3995, GA, Houten, The Netherlands
| | - Steffie K Naber
- Department of Public Health, Erasmus MC, University Medical Center, Room Na-2223, PO Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Suzette M Matthijsse
- Department of Public Health, Erasmus MC, University Medical Center, Room Na-2223, PO Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Marjolein van Ballegooijen
- Department of Public Health, Erasmus MC, University Medical Center, Room Na-2223, PO Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Folkert J van Kemenade
- Department of Pathology, Erasmus MC, University Medical Center, PO Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Inge M C M de Kok
- Department of Public Health, Erasmus MC, University Medical Center, Room Na-2223, PO Box 2040, 3000, CA, Rotterdam, The Netherlands
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Costa MOLP, Heráclio SA, Coelho AVC, Acioly VL, Souza PRE, Correia MTS. Comparison of conventional Papanicolaou cytology samples with liquid-based cervical cytology samples from women in Pernambuco, Brazil. ACTA ACUST UNITED AC 2015; 48:831-8. [PMID: 26247400 PMCID: PMC4568811 DOI: 10.1590/1414-431x20154252] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 03/09/2015] [Indexed: 11/22/2022]
Abstract
In the present study, we compared the performance of a ThinPrep cytological method
with the conventional Papanicolaou test for diagnosis of cytopathological changes,
with regard to unsatisfactory results achieved at the Central Public Health
Laboratory of the State of Pernambuco. A population-based, cross-sectional study was
performed with women aged 18 to 65 years, who spontaneously sought gynecological
services in Public Health Units in the State of Pernambuco, Northeast Brazil, between
April and November 2011. All patients in the study were given a standardized
questionnaire on sociodemographics, sexual characteristics, reproductive practices,
and habits. A total of 525 patients were assessed by the two methods (11.05% were
under the age of 25 years, 30.86% were single, 4.4% had had more than 5 sexual
partners, 44% were not using contraception, 38.85% were users of alcohol, 24.38% were
smokers, 3.24% had consumed drugs previously, 42.01% had gynecological complaints,
and 12.19% had an early history of sexually transmitted diseases). The two methods
showed poor correlation (k=0.19; 95%CI=0.11–0.26; P<0.001). The
ThinPrep method reduced the rate of unsatisfactory results from 4.38% to 1.71%
(χ2=5.28; P=0.02), and the number of cytopathological changes diagnosed
increased from 2.47% to 3.04%. This study confirmed that adopting the ThinPrep method
for diagnosis of cervical cytological samples was an improvement over the
conventional method. Furthermore, this method may reduce possible losses from
cytological resampling and reduce obstacles to patient follow-up, improving the
quality of the public health system in the State of Pernambuco, Northeast Brazil.
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Affiliation(s)
- M O L P Costa
- Laboratório Central de Saúde Pública do Estado de Pernambuco, Recife, PE, BR
| | - S A Heráclio
- Laboratório Central de Saúde Pública do Estado de Pernambuco, Recife, PE, BR
| | - A V C Coelho
- Departamento de Genética, Universidade Federal de Pernambuco, Recife, PE, BR
| | - V L Acioly
- Laboratório Central de Saúde Pública do Estado de Pernambuco, Recife, PE, BR
| | - P R E Souza
- Departamento de Biologia, Universidade Federal Rural de Pernambuco, Recife, PE, BR
| | - M T S Correia
- Departamento de Bioquímica, Universidade Federal de Pernambuco, Recife, PE, BR
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30
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Maia LB, Marinho LC, Wanderley Paes Barbosa T, Batalha Filho ES, Ribeiro Velasco LF, Garcia Costa PG, Carneiro FP, de Oliveira PG. A comparative study between conventional and liquid-based cytology in screening for anal intraepithelial lesions in HIV-positive patients. Diagn Cytopathol 2014; 42:840-5. [PMID: 24591207 DOI: 10.1002/dc.23130] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 02/16/2014] [Indexed: 11/05/2022]
Abstract
Anal intraepithelial neoplasia (AIN) is associated with HPV infection and can be detected by cytological screening. While conventional exfoliative cytology (CC) is a low-cost and nonaggressive method, liquid-based cytology (LBC) tends to give clearer readings. Although studies of the efficacy of anal cancer screening methods would be of great importance for groups at high risk for AIN, few such studies have been conducted. The aim of the present study was to assess the concordance of CC and LBC in diagnosing anal pre-neoplastic lesions, and to compare cytological results with anoscopy, histopathological, and molecular biology findings. Comparative study involving 33 HIV-positive patients, who underwent anoscopy and biopsy of suspected lesions. Concordance between the two cytology methods was calculated, as were the associations between cytology results and findings from other screening methods. A total of 54.5% of cases were considered AIN-negative by CC and LBC, and concordance between the two methods was statistically significant (P < 0.05). Anoscopy was negative in 15 of the 18 CC- and LBC-negative cases. CC identified 75% of patients with positive biopsy, while LBC identified 85.71% of these patients. Molecular biology results showed that patients with LSIL tested positive for the highest number of HPV subtypes. The associations between positive biopsy and high grade HPV, HPV 16, and multiple HPV infections were not statistically significant. Conventional and liquid-based cytology are equally effective in screening for anal preneoplastic lesions.
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Affiliation(s)
- Livia Bravo Maia
- Department of Pathology, Hospital Universitário de Brasília (HUB), Brasília, DF, Brazil
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Filipi K, Xhani A. Assessment of Cervical Cytological Data in Albanian Females. Asian Pac J Cancer Prev 2014; 15:2129-32. [DOI: 10.7314/apjcp.2014.15.5.2129] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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32
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Sangkarat S, Laiwejpithaya S, Rattanachaiyanont M, Chaopotong P, Benjapibal M, Wongtiraporn W, Laiwejpithaya S. Performance of Siriraj Liquid-Based Cytology: a Single Center Report Concerning over 100,000 Samples. Asian Pac J Cancer Prev 2014; 15:2051-5. [DOI: 10.7314/apjcp.2014.15.5.2051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Ethical, Socioeconomic, and Cultural Considerations in Gynecologic Cancer Care in Developing Countries. ACTA ACUST UNITED AC 2014. [DOI: 10.1155/2014/141627] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Gynaecologic cancers contribute significantly to the cancer burden in developing countries, resulting in higher mortality and morbidity rates among women in these nations. This situation is further compounded by the occurrence of wars, famine, poverty and natural disasters, and infectious diseases like hepatitis B and HIV/AIDS. In addition, merge resources and manpower lack in these countries further compound this very delicate situation. Often times, socioeconomic, cultural, and ethical factors such as truth-telling, choice of place of care, place of death, treatment choices, medication use, and terminal sedation can interfere in patient management. Availability and use of oral morphine for pain relief, spiritual care and availability of palliative care services, the individuals’ autonomy, and family and community participation in care, end of life issues, and preservation of fertility are also big issues that determine the course of care. This review discusses these pertinent factors, discusses how they affect cancer care in women, and proffers ideas for healthcare workers and policy makers on implementation of sustainable models for cancer care in developing countries. Addressing socioeconomic, cultural, and ethical issues affecting gynaecologic cancer care will aid in ensuring development of viable models of cancer care in resource-limited countries.
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Norimatsu Y, Ohsaki H, Masuno H, Kagawa A, Teramoto N, Kobayashi TK. Efficacy of CytoLyt® hemolytic action on ThinPrep® LBC using cultured osteosarcoma cell line LM8. Acta Cytol 2014; 58:76-82. [PMID: 24157542 DOI: 10.1159/000354960] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 07/29/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The removal of blood components is necessary to improve the quality of the liquid-based cytology (LBC) preparations. In ThinPrep® (TP) samples a cell suspension in a methanol-based fixative undergoes a vacuum filtration method, whereas in SurePath™ (SP) samples a cell suspension in an ethanol-based fixative is processed through a density gradient centrifugation system prior to gravity deposition of the specimen onto a glass slide. We compared the cyto-architectural features for the cytologic diagnosis of endometrial adenocarcinoma using parallel TP and SP preparations in a previous publication. STUDY DESIGN We performed our study on LM8 cells (a cultured osteosarcoma cell line). LM8 cells at a concentration of 1.25 × 10(3) cell/cm(2) were seeded on a 35-mm plate in culture medium, which contained 10% fetal bovine serum (FBS), 100 units/ml penicillin, and 100 μ/ml streptomycin in Dulbecco's modified Eagle's medium (DMEM), and aliquots of the cell suspension obtained in this way were compared after the addition of a hemolytic agent, i.e. Cytolyt® (CyL). LBC preparations were then obtained on cell suspensions treated with CyL after different time intervals of hemolysis. RESULTS Treatment with CyL did not alter the cellularity of the preparation, but reduction of the nuclear area and a tendency towards nuclear chromatin condensation with a subsequent higher brightness were found. Because CyL is a 25% methanol-buffered solution, its alcoholic concentration is low; it was our impression that, while its fixative effect was weak, its hemolytic effect was high. Water influx or efflux through the cell membrane is controlled by osmotic pressure changes induced by the buffer solution in the CyL solution. While CyL was not shown to alter the cell shape, nuclear shrinkage was thought to be probably due to the increasing cell dehydration caused by longer exposure intervals to methanol. CONCLUSION This study has allowed us to make significant observations on the hemolytic properties of CyL, and on its combined effects with PreservCyt on the cytomorphology of cells suspensions.
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Affiliation(s)
- Yoshiaki Norimatsu
- Department of Medical Technology, Ehime Prefectural University of Health Sciences, Ehime, Japan
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Ramos MA, Cury FDP, Scapulatempo Neto C, Marques MMC, Silveira HCS. Micronucleus evaluation of exfoliated buccal epithelial cells using liquid-based cytology preparation. Acta Cytol 2014; 58:582-8. [PMID: 25402342 DOI: 10.1159/000366224] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 07/29/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Micronuclei (MN) are biomarkers that can be applied to buccal epithelial cells to assess populations occupationally exposed to potentially carcinogenic agents. Liquid-based cytology (LBC) is a way to improve and refine the results obtained by this test. STUDY DESIGN Exfoliated buccal cells were collected from 40 subjects (20 construction workers from the Barretos Cancer Hospital and 20 administrative staff from the same institution). LBC and three stains (Feulgen/fast green, Papanicolaou and Giemsa) were used to prepare the slides. Student's t test was applied for statistical comparisons of the data. A p value of <0.05 was considered statistically significant. RESULTS Regardless of the stain employed, the frequency of MN was greater in the case group (Feulgen/fast green: 5.15; Papanicolaou: 29; Giemsa: 26) than in the control group (Feulgen/fast green: 2.30; Papanicolaou: 17; Giemsa: 15). CONCLUSIONS Using LBC to prepare slides and evaluate the frequency of MN potentially serves as a screening option for more comprehensive studies of cancer risk among populations occupationally exposed to potentially carcinogenic agents. In addition, the residual fluid enables the preparation of slides for DNA-specific stains that can be compared to those with Papanicolaou stain.
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Bassal R, Schejter E, Bachar R, Shapira H, Sandbank J, Supino Rosin L, Schvimer M, Cohen D, Keinan-Boker L. Cervical Pap screening among Israeli women, 2005-2010. Arch Gynecol Obstet 2013; 289:615-22. [PMID: 24085583 DOI: 10.1007/s00404-013-3045-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 09/19/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE This study describes the distribution and the trends of cervical abnormalities in Israel, based on Pap smear results. METHODS A retrospective analysis of cervical smears received by the Central Pathology Laboratory of Maccabi Healthcare Services between January 2005 and December 2010. RESULTS In total, 711,541 Pap smears were screened in the study period. Cytological abnormalities were observed in 4.78% of the total smears screened. An increase was observed in the rate of positive results from 2.63% in 2005 to 6.78% in 2010 (p = 0.0026). The cervical abnormalities in the study period distributed as follows: atypical squamous cell (ASC)-2.72%, low-grade squamous intraepithelial lesion (LSIL)-1.54%, high-grade squamous intraepithelial lesion (HSIL)-0.34%, squamous cell carcinoma-0.01%, atypical glandular cells (AGC)-0.10%, adenocarcinoma in situ (AIS)-0.06% and invasive adenocarcinoma-0.01%. The increase was statistically significant for ASC (p = 0.0028), LSIL (p = 0.0069) and for HSIL (p = 0.0260). The mean ages at diagnosis of women with ASCUS, LSIL, HSIL, squamous cell carcinoma, AGC, AIS and adenocarcinoma were 37.8, 33.2, 38.6, 55.4, 41.1, 49.9 and 57.1 years, respectively. CONCLUSIONS The increase in the rate of squamous cell abnormalities demonstrated in this study emphasizes the need of implementing an education and a screening program among Israeli women. HPV vaccine, sexual behavior, cytology performance and HPV test are primary and secondary prevention tools which may reduce morbidity and mortality in the future. In addition, based on the age at diagnosis of the different pathologies, the age group in which Pap test is performed in Israel should be expanded from 35-54 to 25-65 years.
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Affiliation(s)
- Ravit Bassal
- Department of Epidemiology and Preventive Medicine, Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel,
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Norimatsu Y, Sakamoto S, Ohsaki H, Ozaki S, Yokoyama T, Shimizu K, Yanoh K, Akiyama M, Bamba M, Kobayashi TK. Cytologic features of the endometrial adenocarcinoma: Comparison of ThinPrep and BD surepath preparations. Diagn Cytopathol 2013; 41:673-81. [DOI: 10.1002/dc.22921] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Accepted: 08/03/2012] [Indexed: 11/09/2022]
Affiliation(s)
- Yoshiaki Norimatsu
- Department of Medical Technology; Ehime Prefectural University of Health Sciences; Ehime; Japan
| | - Shingo Sakamoto
- Department of Pathology; Matsuyama Red Cross Hospital; Ehime; Japan
| | - Hiroyuki Ohsaki
- Department of Medical Technology; Ehime Prefectural University of Health Sciences; Ehime; Japan
| | - Satoru Ozaki
- Department of Pathology; Kanazawa University Hospital; Ishikawa; Japan
| | - Toshiro Yokoyama
- Department of Pathology; Kurume University Medical Center; Fukuoka; Japan
| | - Keiko Shimizu
- Department of Pathology; Saiseikai Noe Hospital; Imperial Gift Foundation Inc.; Osaka; Japan
| | - Kenji Yanoh
- Department of Gynaecology; Suzuka General Hospital; Mie; Japan
| | - Minoru Akiyama
- Department of Obstetrics and Gynecology; Saiseikai Shiga Hospital; Imperial Gift Foundation Inc.; Shiga; Japan
| | - Masamichi Bamba
- Department of Pathology; Saiseikai Shiga Hospital; Imperial Gift Foundation Inc.; Shiga; Japan
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Stabile SAB, Evangelista DHR, Talamonte VH, Lippi UG, Lopes RGC. Comparative study of the results from conventional cervico-vaginal oncotic cytology and liquid-based cytology. EINSTEIN-SAO PAULO 2013; 10:466-72. [PMID: 23386088 DOI: 10.1590/s1679-45082012000400013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Accepted: 12/09/2011] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To compare two oncotic cervical cytology techniques, the conventional and the liquid-based cytology, in low risk patients for uterine cervical cancer. METHODS Comparative prospective study with 100 patients who came to their annual gynecological exam, and were submitted simultaneously to both techniques. We used the McNemar test, with a significance level of p < 0.05 to compare the results obtained related to adequacy of the smear quality, descriptive diagnosis prevalence, guided biopsy confirmation and histology. RESULTS Adequacy of the smear was similar for both methods. The quality with squamocolumnar junction in 93% of conventional cytology and in 84% of the liquid-based cytology had statistical significance. As for the diagnosis of atypical cells they were detected in 3% of conventional cytology and in 10% of liquid-based cytology (p = 0.06). Atypical squamous cells of undetermined significance were the most prevalent abnormality. The liquid-based cytology performance was better when compared with colposcopy (guided biopsy), presenting sensitivity of 66.7% and specificity of 100%. There was no cytological and histological concordance for the conventional cytology. CONCLUSIONS Liquid-based cytology had a better performance to diagnose atypical cells and the cytohistological concordance was higher than in the conventional cytology.
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Norimatsu Y, Yanoh K, Kobayashi TK. The role of liquid-based preparation in the evaluation of endometrial cytology. Acta Cytol 2013; 57:423-35. [PMID: 24021666 DOI: 10.1159/000353148] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 05/09/2013] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Liquid-based preparation (LBP) of the endometrial lesions is an important diagnostic tool for a variety of endometrial abnormalities because of its simplicity and high quali-quantitative diagnostic yield. We aimed to investigate the LBP method for endometrial cytology to evaluate both benign and abnormal endometrial lesions. STUDY DESIGN LBP is a semiautomated methodology that has recently become widely available and has gained popularity as a method of collecting and processing both gynecologic and nongynecologic cellular specimens. RESULTS Some peculiar endometrial cytoarchitectural features were described using LBPs. These were advantageous to screen as compared to conventional slides due to a smaller screening area and an excellent quality of cell preparations. CONCLUSIONS LBP is a useful tool in the cellular diagnosis and follow-up of endometrial abnormalities, which remains complementary to the emerging molecular diagnostic cytopathology. The study of LBPs from endometrial cytology could be challenging since it is affected by numerous look-alikes and diagnostic pitfalls. This review discusses these various entities and takes into consideration the ancillary techniques that may be useful in the diagnostic procedure.
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Affiliation(s)
- Yoshiaki Norimatsu
- Department of Medical Technology, Ehime Prefectural University of Health Sciences, Tobe, Japan
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de Bekker-Grob EW, de Kok IMCM, Bulten J, van Rosmalen J, Vedder JEM, Arbyn M, Klinkhamer PJJM, Siebers AG, van Ballegooijen M. Liquid-based cervical cytology using ThinPrep technology: weighing the pros and cons in a cost-effectiveness analysis. Cancer Causes Control 2012; 23:1323-31. [PMID: 22706692 DOI: 10.1007/s10552-012-0011-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Accepted: 06/05/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE Cervical cancer screening with liquid-based cytology (LBC) has been developed as an alternative to the conventional Papanicolaou (CP) smear. Cost-effectiveness is one of the issues when evaluating LBC. Based on the results of a Dutch randomised controlled trial, we conducted cost-effectiveness threshold analyses to investigate under what circumstances manually screened ThinPrep LBC is cost-effective for screening. METHODS The MISCAN-Cervix microsimulation model and data from the Dutch NETHCON trial (including 89,784 women) were used to estimate the costs and (quality-adjusted) life years ((QA)LYs) gained for EU screening schedules, varying cost-effectiveness threshold values. Screening strategies were primary cytological screening with LBC or CP, and triage with human papillomavirus (HPV) testing. RESULTS Threshold analyses showed that screening with LBC as a primary test can be cost-effective if LBC is less than <euro>3.2 more costly per test than CP, if the sensitivity of LBC is at least 3-5 % points higher than CP, if the quality of life for women in triage follow-up is only 0.39, or if the rate of inadequate CP smears is at least 16.2 %. CONCLUSIONS Regarding test characteristics and costs of LBC and CP, only under certain conditions will a change from CP to manually screened ThinPrep LBC be cost-effective. If none of these conditions are met, implementation of manually screened ThinPrep LBC seems warranted only if there are advantages other than cost-effectiveness. Further research is needed to establish whether other LBC systems will be more favorable with regard to cost-effectiveness.
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Affiliation(s)
- Esther W de Bekker-Grob
- Department of Public Health, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, The Netherlands.
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Currens HS, Nejkauf K, Wagner L, Raab SS. Effectiveness of rapid prescreening and 10% rescreening in liquid-based Papanicolaou testing. Am J Clin Pathol 2012; 137:150-5. [PMID: 22180489 DOI: 10.1309/ajcp6lw4sybtisow] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
Although rapid prescreening (RPS) has been shown to be an effective quality control procedure for detecting false-negative conventional Papanicolaou (Pap) tests, RPS has not been widely implemented in the United States. In our laboratory, cytotechnologists performed RPS in 3,567 liquid-based Pap tests: 1,911 SurePath (BD Diagnostics-TriPath, Burlington, NC) preparations that were manually screened and 1,656 ThinPrep Pap tests (Hologic, Bedford, MA) that were imaged using the ThinPrep Imaging System (Hologic). We compared the sensitivity of RPS, 10% rescreening (R-10%), and routine screening (RS). In contrast with previously published findings, we found that RS + RPS did not improve screening sensitivity compared with RS + R-10%. These results support the following hypotheses: (1) Higher baseline RS sensitivity as a result of Pap test diagnoses standardization implemented for quality improvement purposes decreases the performance impact of RPS. (2) R-10% and RPS quality assurance methods detect diagnostic failures caused by different types of cognitive errors.
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Fontaine D, Narine N, Naugler C. Unsatisfactory rates vary between cervical cytology samples prepared using ThinPrep and SurePath platforms: a review and meta-analysis. BMJ Open 2012; 2:e000847. [PMID: 22505312 PMCID: PMC3332241 DOI: 10.1136/bmjopen-2012-000847] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To compare unsatisfactory rates between the two major liquid-based cytology (LBC) platforms, namely ThinPrep (Hologic) and SurePath (Becton Dickinson). DESIGN The authors performed both a systematic review and a meta-analysis. Inclusion criteria were English language, data presented on unsatisfactory rates for either ThinPrep or SurePath, utilising actual patient samples (ie, not laboratory manipulated samples) and no manipulation using acetic acid to increase the satisfactory rate. The authors searched PubMed for articles using the keywords 'SurePath' or 'ThinPrep' and 'unsatisfactory'. References of retrieved studies were searched for additional articles. Key researchers in the field were also contacted. PARTICIPANTS AND INTERVENTIONS Eligible studies were reviewed for rates of unsatisfactory cervical cytology smears processed on either the ThinPrep or SurePath platforms (compared with a general linear model) or data on unsatisfactory rates for both platforms for the same laboratory and the same patient population (compared with a meta-analysis using a random effects model and pooled RR). PRIMARY OUTCOME MEASURE Unsatisfactory rate of cervical cytology smears. RESULTS A total of 1 120 418 cervical cytology smears were reported in 14 different studies using the SurePath platform for an overall unsatisfactory rate (weighted average) of 0.3%. 28 studies reported on 1 148 755 smears prepared using the ThinPrep platform for an overall unsatisfactory rate (weighted average) of 1.3%. The general linear model did not show a difference between LBC platforms when other variables were controlled for; however, the power to detect a difference (0.087) was very low. The meta-analysis performed on four studies where both ThinPrep and SurePath results were reported from the same laboratory showed fewer unsatisfactory tests from the SurePath platform (RR 0.44, 95% CI 0.25 to 0.77, p=0.004). CONCLUSIONS Multiple factors affect LBC unsatisfactory rates. In a meta-analysis, cervical cytology samples prepared on the SurePath platform show significantly fewer unsatisfactory smears than those prepared on the ThinPrep platform.
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Affiliation(s)
- Daniel Fontaine
- Department of Pathology and Laboratory Medicine, University of Calgary and Calgary Laboratory Services, Calgary, Alberta, Canada
| | - Nadira Narine
- Cytology Department, Central Manchester Hospitals NHS Foundation Trust, Manchester, UK
| | - Christopher Naugler
- Department of Pathology and Laboratory Medicine, University of Calgary and Calgary Laboratory Services, Calgary, Alberta, Canada
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Smith JHF. Cytology, liquid-based cytology and automation. Best Pract Res Clin Obstet Gynaecol 2011; 25:585-96. [PMID: 21632286 DOI: 10.1016/j.bpobgyn.2011.04.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2011] [Revised: 03/31/2011] [Accepted: 04/26/2011] [Indexed: 11/15/2022]
Affiliation(s)
- John H F Smith
- Department of Histopathology and Cytology, Royal Hallamshire Hospital, Sheffield, UK.
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Norimatsu Y, Shigematsu Y, Sakamoto S, Ohsaki H, Yanoh K, Kawanishi N, Kobayashi TK. Nuclear characteristics of the endometrial cytology: Liquid-based versus conventional preparation. Diagn Cytopathol 2011; 41:120-5. [PMID: 23335453 DOI: 10.1002/dc.21784] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Accepted: 06/22/2011] [Indexed: 11/08/2022]
Affiliation(s)
- Yoshiaki Norimatsu
- Department of Medical Technology, Ehime Prefectural University of Health Sciences, Ehime, Japan
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Zhao FH, Hu SY, Bian JJ, Liu B, Peck RB, Bao YP, Pan QJ, Frappart L, Sellors J, Qiao YL. Comparison of ThinPrep and SurePath liquid-based cytology and subsequent human papillomavirus DNA testing in China. Cancer Cytopathol 2011; 119:387-94. [PMID: 21774094 DOI: 10.1002/cncy.20177] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2010] [Revised: 04/28/2011] [Accepted: 05/06/2011] [Indexed: 11/10/2022]
Abstract
BACKGROUND Liquid-based cytology (LBC) has been compared with conventional cytology in numerous studies. In the current study of 2 LBC systems, the accuracy, rates of unsatisfactory cytology, and sufficiency of residual LBC specimens for Hybrid Capture 2 (HC2) HPV DNA testing were compared. METHODS Eligible women ages 30 to 49 years were recruited for this cross-sectional population-based study in rural China. Women were assessed by visual inspection with acetic acid (VIA), LBC, and high-risk HPV HC2 DNA assay. Cervical specimens were preserved according to SurePath or ThinPrep protocols. LBC results were manually read. HC2 testing was performed on specimens with sufficient residual volume. Colposcopies and biopsies were performed on women who were VIA positive at the time of initial screening. Women with abnormal LBC or HC2 test results were called back for colposcopies and 4-quadrant cervical biopsies. RESULTS Of 2005 eligible women, 972 were tested by SurePath and 1033 by ThinPrep. Compared with SurePath samples, ThinPrep samples had higher rates of unsatisfactory cytology (0.2% for SurePath and 1.5% for ThinPrep) and insufficient residual volume for HC2 (0.0% for SurePath and 18.2% for ThinPrep). SurePath samples yielded higher sensitivities and similar specificities for LBC and HC2 testing of residual specimens, but these differences were not determined to be significant by area-under-the-curve analysis (LBC performance: 0.89 for SurePath and 0.85 for ThinPrep; HC2 performance: 0.91 for SurePath and 0.89 for ThinPrep). CONCLUSIONS Both methods yielded similar validity in detecting significant cervical lesions. However, SurePath samples yielded higher rates of satisfactory LBC slides and sufficient residual volume for HC2.
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Affiliation(s)
- Fang-Hui Zhao
- Cancer Institute/Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China
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Newly developed liquid-based cytology. TACAS™: cytological appearance and HPV testing using liquid-based sample. Hum Cell 2011; 24:115-20. [DOI: 10.1007/s13577-011-0020-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2011] [Accepted: 05/09/2011] [Indexed: 10/18/2022]
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Schiettecatte A, Bourgain C, Breucq C, Buls N, De Wilde V, de Mey J. Initial axillary staging of breast cancer using ultrasound-guided fine needle aspiration: a liquid-based cytology study. Cytopathology 2011; 22:30-5. [DOI: 10.1111/j.1365-2303.2010.00738.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Taoka H, Yamamoto Y, Sakurai N, Fukuda M, Asakawa Y, Kurasaki A, Oharaseki T, Kubushiro K. Comparison of conventional and liquid-based cytology, and human papillomavirus testing using SurePath preparation in Japan. Hum Cell 2010; 23:126-33. [PMID: 21166883 DOI: 10.1111/j.1749-0774.2010.00093.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We compared the detection rate of cervical neoplasias between a liquid-based cytology (LBC) method using SurePath and the conventional method. We also studied the feasibility of human papillomavirus (HPV) typing by linear array assay. Cytological specimens from 1551 Japanese women were prepared using the conventional and SurePath methods; the cytological and histological results from biopsy samples were compared. HPV typing using an HPV linear array assay was carried out on residual specimens using the SurePath method. The cytodiagnostic results showed a concordance rate of 85.3% (Κ= 0.46) between the two methods. The sensitivity of lesions histopathologically diagnosed as CIN1 or above was not significantly different between the two methods (P = 0.575-1.000). The receiver operating characteristic curve analysis of the detectability in CIN2 or above revealed no significant difference between the two methods (P = 0.096). Among the 44 patients who underwent HPV typing using a linear array assay, 33 samples were eligible for HPV testing and were stored at ambient temperature. In conclusion, the SurePath and conventional methods have equivalent abilities for detecting cervical lesions. After preparation for cytological diagnosis, use of the remaining cells from the SurePath specimens to perform HPV typing using the linear array method could be feasible.
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Affiliation(s)
- Hideki Taoka
- Departments of Obstetrics and Gynecology, Toho University School of Medicine Ohashi Medical Center, Tokyo, Japan
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High-risk HPV DNA detected in less than 2% of over 25,000 cytology negative imaged liquid-based Pap test samples from women 30 and older. Gynecol Oncol 2009; 115:257-61. [DOI: 10.1016/j.ygyno.2009.07.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2009] [Revised: 07/06/2009] [Accepted: 07/08/2009] [Indexed: 11/21/2022]
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HPV testing in combination with liquid-based cytology in primary cervical screening (ARTISTIC): a randomised controlled trial. Lancet Oncol 2009; 10:672-82. [DOI: 10.1016/s1470-2045(09)70156-1] [Citation(s) in RCA: 287] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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