BACKGROUND The value of DNA image cytometry in the differential diagnosis of endocervical adenocarcinoma was tested on a series of 65 cases of normal endocervical cells (n = 25), inflammatory changes (n = 18), and endocervical adenocarcinoma (n = 22). METHODS The investigation was performed on gynecologic routine smears by using a television image analysis system MIAMED‐DNA (Leica, Wetzlar, Germany), combined with an automated Leica Medilux microscope. First, the Papanicolaou stained specimens were rescreened, and the x/y coordinates of at least 150 endocervical nuclei were stored per case by using a scanning program. After restaining according to Feulgen, the epithelial cells were relocalized and the DNA content, and the nuclear area were determined. The DNA content of 25–30 squamous epithelial cells of intermediate type served as an internal standard for the normal diploid value in each case. Various DNA cytometric parameters and the mean nuclear area were calculated. For statistical analysis, the cases of adenocarcinoma (n = 22) were defined as positive, and the cases with normal endocervical epithelium or inflammatory changes (n = 43) were defined as negative. RESULTS The presence of nuclei with a DNA content greater than 9c was observed exclusively in adenocarcinoma (sensitivity, 95.9%; specificity, 100%), indicating that this parameter is suited best for the differentiation between malignant and nonmalignant endocervical epithelium. High sensitivity rates at a specificity level of 100% also were calculated for the 2.5cER (95.5%), the mean ploidy (90.9%), 5cER (90.9%), and the diploid deviation quotient (90.9%). For the 2cDI (86.4%), the entropy (81.8%) and the ploidy imbalance (77.3%) lower values were obtained. CONCLUSIONS DNA single cell cytometry represents a highly relevant tool in the identification of malignant transformation in endocervical lesions that could be used as a complementary diagnostic method in cytologically difficult cases. Investigations on endocervical adenocarcinoma in situ should be performed in the near future. Cancer (Cancer Cytopathol) 2001;93:160–164. © 2001 American Cancer Society.

The emphasis of the EFCS Congress held in Venice in October 2006 was on the future of Cytopathology in relation to events in Europe. Much of the discussion centred on the role of human papilloma virus testing and its impact on the provision of cervical screening. The following is a transcript of the discussion that took place at the Advisory Board Meeting for the journal Cytopathology, with some additional written comments received prior to the meeting. A brief summary has been provided as a conclusion by Dr A. Herbert.

Following lymphography, 76 lymph nodes were punctured percutaneously using a fine needle in 23 patients and an aspiration biopsy was performed. This simple procedure provided cytological comfirmation in cases of doubtful lymphograms. Systematic puncture of representative lymph nodes in the area of metastatic spread may at times be able to replace a staging operation.

Zusammenfassung Während bei Krebsvorsorgeuntersuchu ngen in der Regel ein Zer vixabstric h entnommen wird, wurden hier von dem Zellmaterial eines Watteträgers rou tinemäßig zwei gekennzeichnete Abstriche angefertigt. Ziel der Untersuchung war es, die Ze llbilder dieser Erst-und Zwe itabstr iche auf Unterschiede im Zellgeha lt zu prüfen. Von 1691 Patienti nnen der Universitätsf rauenklinik rechts der Isar aus dem Jah re 1976 konnten 1840 zervika le Doppela bstriche gewonnen werden. Die nach dem M ünchner Schema beurt eilten Abstr iche verglich ein Arzt auf Zellge haltsunterschiede. Es wurden die entspr echenden Erst-und Zweitbefunde gegenübe rgestellt. Von 1840 Doppel abstrichen war en 1717 (93,3%) im Ze llgehalt gleich, 123 (6,7%) zeigten Unterschiede. 79 (64,2%) Erst-und Zweitabstrich e differierten im zytologischen Befund, 44 (35,8%) ebenfalls in der Gruppenbe urteilung. Davon wiesen 19 Doppelabst riche zytologisc he Befund e der Gruppen "V", " IVa" , ,,111 0" oder ,,111" auf (T abelle 1). Eine histo logische Diagnose lag von 155 (9,2%) Patienti nnen vor. 36mal (2, 1%) lautete die Diagnose "positiv". Sechs histo logisch geklärte Dopp elabstr iche zeigten Unterschiede im Z ellgehalt. Falsch negat ive Befunde kön nen z. B. du rch Fehler der Entnahme und/o der du rch Fehler der Weiterverarbeitu ng bedingt sein. Vergleiche des Zellmaterials von zwei gleichzeitig angefertigten Ze rvixabs rrichen weisen auf eine Fehlerquelle bei der Oberrragun g des Zellmarerials mit den Ent nahmeutensilien hin. Besond ers unsere Ergebni sse mit dem entsc heidenden Zellma ter ial in den Zwei tabst richen zeigen, wie wichtig sor gfält iges Abro llen des Watteträg ers beim Auftr agen des zytolog ischen Untersuchu ngsmaterials auf den O bjektträger ist.

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