Cervical smear interpretations in women with a histologic diagnosis of severe dysplasia

The accuracy of Papanicolaou (Pap) smear testing can be measured using the cytohistological correlation and discrepancy method. This study aimed to evaluate and compare the cytohistological correlation and discrepancy of the conventional Pap test with the corresponding histopathology and to compare the data with other similar studies. A retrospective study was performed at the pathology department of a referral hospital in Muscat, Oman, over a 5-year period. Of 6000 Pap smears, 162 had matching histopathology results (abnormal smear rate 2.7%) but 10 were unsatisfactory for histological diagnosis. Cytohistological correlation was seen in 96/152 (63.2%), while discrepancy was seen in 56/152 (36.8%). False negatives and false positives were found for 7 and 49 cases respectively. The findings of this study confirm the role of conventional Pap testing as a screening test for the diagnosis of cervical lesion but not for management of patients. In comparison with other studies, we also report a low percentage of abnormal Pap smears. ‫ـه:‬ ‫لـ‬ ‫ـة‬ ‫املقابلـ‬ ‫ـتوباثولوجيا‬ ‫اهليسـ‬ ‫ـن‬ ‫وبـ‬ ‫ـدي‬ ‫التقليـ‬ ‫ـوالو‬ ‫بابانيكـ‬ ‫ـحة‬ ‫مسـ‬ ‫ـار‬ ‫اختبـ‬ ‫ـن‬ ‫بـ‬ ‫ـوي‬ ‫اخللـ‬ ‫ـتولوجي‬ ‫اهليسـ‬ ‫ـن‬ ‫والتبايـ‬ ‫ـق‬

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“…The highest number (17) were seen in mild dyskaryosis which turned out to be benign in histopathology (Table 3).…”

Section: Resultsmentioning

confidence: 99%

“…As an alternative, the cytohistological correlation and discrepancy of Pap testing were measured. Many studies too have measured the accuracy of the Pap test using the same method (15)(16)(17)(18)(19)(20)(21). We report 63.2% and 36.8% for the cytohistological correlation and discrepancy of Pap smears respectively.…”

Section: Discussionmentioning

confidence: 99%

Cytohistological correlation and discrepancy of conventional Papanicolaou smear test with corresponding histopathology: a retrospective study over a 5-year period

Alwahaibi

Sulimi

Bai

2015

Easter Mediterr Health J

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“…The majority of the biopsies showing discrepancies in Histology 2a vs 2b presents small areas of metaplastic atypia, difficult to fit into the CIN groups (Geng et al, 1999;Montes et al, 1999;Ng et al, 2002;Zuna et al, 2002). The discrepancy in the relative frequency of 'normals' between Histology 2a and 2b is due to the fact that in 2b the emphasis was on representativeness for the transformation zone.…”

Section: Discussionmentioning

confidence: 99%

Human papillomavirus oncogenic expression in the dysplastic portio; an investigation of biopsies from 190 cervical cones

et al. 2004

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In this study, we investigated the presence of E6/E7 transcripts of seven common high-risk human papillomavirus (HPV) types in 190 cervical biopsies. The RNA-based real-time nucleic acid sequence-based amplification assay (NASBA) and type-specific PCR, both detecting HPV 16, 18, 31, 33, 45, 52, and 58, as well as consensus PCR, were performed on all 190 biopsies. High accordance between type-specific and consensus PCR confirms that the HPV types included in this study are the most common types present in cervical dysplasia. Furthermore, we see a clear increase in the incidence of HPV, both DNA and RNA, along with the histological severity of dysplasia. HPV RNA was detected in all but two PCR-positive cases, confirming that the virus exerts E6/E7 mRNA expression in cases of high-grade dysplasia. Out of 19 women given a normal or borderline diagnosis at conisation, only four were found HPV positive, which may suggest that unnecessary conisations can possibly be reduced by introducing HPV testing into the preoperative routine assessment. Human papillomavirus (HPV) infections are associated with the development of cervical neoplasia and are a necessary factor in the aetiology of cervical carcinoma (Walboomers et al, 1999;Bosch et al, 2002;zur Hausen, 2002). The most frequent HPV types found in high-grade cervical intraepithelial dysplasia (CIN II/III) and in cervical carcinomas are HPV 16, 18, 31, 33, and 45, which are often referred to as high-risk HPV or cancer-associated HPV types. However, the association between a positive HPV DNA test and the risk of subsequent development of dysplasia is partly unknown; the presence of HPV DNA does not necessarily indicate a risk for developing a more severe lesion. In fact, HPV is a very common virus among sexually active women and most infections are transient and asymptomatic (zur Hausen, 1991;Ho et al, 1998;Moscicki et al, 1998). Only very few infections cause morphologic changes in the epithelium and only a small percent of these will eventually develop cervical cancer (Bosch et al, 1995). On the other hand, several studies have shown that in cervical carcinogenesis, the expression of HPV E6 and E7 ORF is required for cell transformation and immortalisation (zur Hausen, 1988;Munger et al, 1989;Stoler et al, 1992). Consequently, persistent expression of these oncogenes may serve as an indicator of progression to CIN and invasive cancer (Sotlar et al, 1998), and detection of E6 and E7 mRNA transcripts may therefore be of higher prognostic value than the detection of HPV DNA. Moreover, new methods for preservation of RNA in cells have made gene expression analysis more feasible.In this study, we investigated the presence of high-risk HPV E6/E7 transcripts in cervical biopsies from patients undergoing conisation. The analysis was performed on a biopsy taken from the ectocervix/transformation zone at the time of conisation, and the pathological diagnosis of this particular biopsy was not always representative for the existing lesion that was later revealed in the cone. This s...

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“…Meanwhile, a good technique usage in DNA proof needs knowledge, standardization from the beginning of the material acquisition and its fixation, to the histochemic marker and reading from computerized equipments, to get precise diagnostics (Zuna et al, 2002). When we compared our findings with Arcuri et al (2002) and Schoolland et al (2002), we found a huge percentage of unused material, for failure to reach a proof of basic conditions, or simply having mistaken diagnostics.…”

Section: Discussionmentioning

confidence: 90%

Morphoquantitative Analysis of the Intraepithelial Neoplasic Uterine Cells by Computer Image System

et al. 2008

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SUMMARY:The purpose of the present research was to detect the DNA variations by Feulgen stained chromatin and the packing degree of the cervical chromatin in the clinical cases of human uterine carcinomas. Scanning microphotometry was carried out on slides prepared from block Feulgen-stained. Accurate control procedures were performed using normal human cell nuclei. The cervical cells was morphometric studied using the Image Lab System for citologic classification. The overall diagnostic accuracy for neoplasia type I (CIN I) and type II (CIN II), demonstrated by stain interpetration values of a sensitive detection of DNA neuroploidy and a significant difference between the two groups in scanning static cytophotometry.

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Cervical smear interpretations in women with a histologic diagnosis of severe dysplasia

Cited by 18 publications

References 18 publications

Cytohistological correlation and discrepancy of conventional Papanicolaou smear test with corresponding histopathology: a retrospective study over a 5-year period

Cytohistological correlation and discrepancy of conventional Papanicolaou smear test with corresponding histopathology: a retrospective study over a 5-year period

Human papillomavirus oncogenic expression in the dysplastic portio; an investigation of biopsies from 190 cervical cones

Morphoquantitative Analysis of the Intraepithelial Neoplasic Uterine Cells by Computer Image System

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