Atypical Squamous Cells

Abdul‐Karim, Fadi W.; Powers, Celeste N.; Berek, Jonathan S.; Sherman, Mark E.; Tabbara, Sana O.; Sidawy, Mary K.

doi:10.1007/978-3-319-11074-5_4

Cited by 11 publications

(10 citation statements)

References 34 publications

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“…In TBSRCC, in addition to the diagnoses “Insufficient” and “NILM,” there are five different diagnoses in the squamous cell category and altogether 10 different diagnoses in the glandular cell category [2-4]. In routine practice, the combinations of squamous and glandular diagnoses are common resulting into an even larger pool of diagnostic possibilities.…”

Section: Discussionmentioning

confidence: 99%

“…One of the cytopathologists was involved in the study design and knew the total number of the final histological diagnoses. All diagnoses were given using TBSRCC 2014 [2-4].…”

Section: Methodsmentioning

confidence: 99%

“…The cervical cytology-based screening programs have been efficient in reducing cervical cancer mortality [1]. The diagnostic cytopathological criteria for both squamous and glandular lesions are well described in the Bethesda System for Reporting Cervical Cytology (TBSRCC) [2-4]. Nevertheless, in practice, separating atypical endocervical cells from atypical squamous cells as well as from atypical endometrial cells in preneoplastic/neoplastic and non-neoplastic conditions can be challenging [5-7].…”

Section: Introductionmentioning

confidence: 99%

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Endocervical Cytology: Inter- and Intra-Observer Variability in Conventional Pap Smears

Pulkkinen¹,

Huhtala²,

Krogerus³

et al. 2022

Acta Cytologica

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Introduction: Although the cytological diagnostic criteria for cervical squamous and glandular lesions are established by the Bethesda System for Reporting Cervical Cytology, the reproducibility of the diagnosis of these lesions has been shown to be variable in previous studies. At best, occasional good kappa (κ) values were reached both inter- and intra-observerly. Generally, consensus on high-grade lesions has been better compared to milder changes. Methods: Altogether, 167 conventional Pap smears from 50 patients with histologically confirmed endocervical adenocarcinomas (EAC) and adenocarcinomas in situ (AIS) and from 28 patients with histologically proven high-grade intraepithelial lesions were analyzed by four cytopathologists. Twenty of the smears were later re-evaluated by the same cytopathologists. κ-values between cytopathologists in the categories of squamous versus glandular, negative for intraepithelial lesion or malignancy (NILM), atypical, and preneoplastic/neoplastic were calculated. The diagnostic Pap smears of EAC and AIS with best and worst consensus between observers were then morphologically analyzed. Results: The reproducibility ranged from poor to substantial. The overall κ-values between the four cytopathologists were 0.412, 0.314, 0.272, and 0.082, respectively, in the categories of preneoplastic/neoplastic, squamous versus glandular, NILM, and atypical. Overall intra-observer κ-values were correspondingly 0.491, 0.616, 0.345, and 0.241. In the diagnostic smears of AIS and EAC, the nuclear size >2 times the normal and nuclear pleomorphism were the commonest features associated with good diagnostic consensus and the lack of nuclear enlargement and degenerative changes were associated with poor consensus. Conclusions: The reproducibility of preneoplasia/neoplasia diagnoses was better than that of atypia and NILM both in the inter- and intra-observer part in this study. In the smears from AIS and EAC patients, general neoplasia-associated features were more common in samples with good agreement by the four cytopathologists of the neoplastic nature and the endocervical origin of the lesion.

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Section: Discussionmentioning

confidence: 99%

“…One of the cytopathologists was involved in the study design and knew the total number of the final histological diagnoses. All diagnoses were given using TBSRCC 2014 [2-4].…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Endocervical Cytology: Inter- and Intra-Observer Variability in Conventional Pap Smears

Pulkkinen¹,

Huhtala²,

Krogerus³

et al. 2022

Acta Cytologica

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“…All diagnoses on cervical cytological samples were provided according to the Bethesda Classification for Reporting Cervical Cytology 2014 [ 18 , 19 , 20 ]. The Abbot RealTime hrHPV PCR assay (RealTime; Abbot, Wiesbaden, Germany) was used for the detection of the hrHPV DNA.…”

Section: Methodsmentioning

confidence: 99%

Detection and Outcome of Endocervical Atypia in Cytology in Primary HPV Screening Programme

et al. 2021

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Most endocervical adenocarcinomas (EAC) are associated with high-risk HPV (hrHPV) infection, with HPV genotypes 16, 18 and 45 accounting for >90% of the cases. Among endocervical glandular lesions, screening with hrHPV test has previously shown to predict the outcome better than cytology, although around one-fifth of the EAC remain negative both in hrHPV testing and cytology. The study consists of two consecutive HPV-primary screening rounds, conducted in 2012–2015 and 2017–2020. Of the 87 women aged 35 to 60 years of age diagnosed with Atypical endocervical cells, NOS or Atypical endocervical cells, favor neoplastic cytology during the first screening round, 63 (72.4%) were hrHPV positive and 24 (27.6%) were hrHPV negative. Among hrHPV positive patients, three EAC, two adenocarcinomas in situ (AIS), one AIS + high-grade intraepithelial lesion (HSIL) and 13 HSIL were found. Of the histologically verified lesions, 68.4% (13/19) were purely of squamous origin. All the EAC and AIS were HPV16 or HPV 18 positive. No high-grade histological lesions were found among the hrHPV negative patients with cytological glandular atypia. A later database search revealed one HPV-negative, gastric-type mucinous EAC that was missed by the HPV primary screening.

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“…For the cytology, as previously published, we used a thin-layer technology (ThinPrep, Cytyc Corp., Boxborough, USA) from 20 mL vials that contained the collected cells (PreservCyt, Cytyc Corp., Boxborough, USA) as we have previously described [ 3 , 12 , 13 ]. The criteria used for the cytological and histological diagnosis were those reported, respectively, by the Bethesda System for reporting cervical cytology and by the WHO classification of tumor of female reproductive organs [ 14 – 16 ]. In addition, to exclude mimics of CIN2/3 lesions including immature squamous metaplasia, inflammation, or atrophy, an adjunctive p16 immunohistochemistry was also applied for each biopsy as previously published and was strongly positive in all the cases ( Figure 1 ) [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

Limitations on the Detection Rate of High-Risk HPV by Hybrid Capture 2 Methodology in High Grade Intraepithelial (HSIL) or Atypical Squamous Cells-Cannot Exclude HSIL (ASC-H) Cytological Lesions with Proved CIN2+

Noël

Simon

2015

Analytical Cellular Pathology

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Recent literature data suggest that the high-risk human papillomaviruses (HR-HPVs) testing with several molecular techniques could be an alternative to cytology in the detection of cervical intraepithelial neoplasias of grade 2 or worse (CIN2+). However, any molecular techniques have its own limits and may give false negative results which must be clearly known before undertaking a primary HPV screening. This study aims to evaluate the performance of the high-risk HPV hybrid capture II detection kit (HCII) which is considered as a “gold standard technique” in a series of 100 women having proved both cytological lesions of atypical squamous cells-cannot exclude an HSIL (ASC-H) or high-grade squamous intraepithelial lesion (HSIL) and histological lesions of CIN2+. The clinical sensitivity of HCII in women with a cytological diagnosis of ASC-H/HSIL and a diagnosis of CIN2+ is high but not absolute and estimated at 96% (95,6% and 100% of women with a diagnosis of CIN2/3 or invasive squamous cell carcinoma, resp.). These data although they are infrequent must be clearly referred before to start an HPV primary screening of CIN2+ especially with HCII methodology.

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Atypical Squamous Cells

Cited by 11 publications

References 34 publications

Endocervical Cytology: Inter- and Intra-Observer Variability in Conventional Pap Smears

Endocervical Cytology: Inter- and Intra-Observer Variability in Conventional Pap Smears

Detection and Outcome of Endocervical Atypia in Cytology in Primary HPV Screening Programme

Limitations on the Detection Rate of High-Risk HPV by Hybrid Capture 2 Methodology in High Grade Intraepithelial (HSIL) or Atypical Squamous Cells-Cannot Exclude HSIL (ASC-H) Cytological Lesions with Proved CIN2+

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