Controversial Topics in Abnormal Cervical Cytology: ???See and Treat???

Dainty, Louis A.; Elkas, John C.; Rose, G. Scott; Zahn, Christopher M.

doi:10.1097/01.grf.0000151582.70615.06

Cited by 7 publications

(5 citation statements)

References 31 publications

(66 reference statements)

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“…The motivation for developing optical methods for detection of cancerous and precancerous cervical lesions is that current methods have several short comings including missed lesions [1, 2] and loss of patients to follow up [3]. The diagnositic procedures currently in clinical practice are not suitable for ”See and treat” methods which would allow treatment at the time of diagnosis [4, 5]. …”

Section: Introductionmentioning

confidence: 99%

In vivo light scattering for the detection of cancerous and precancerous lesions of the cervix

et al. 2009

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A non-invasive optical diagnostic system for detection of cancerous and precancerous lesions of the cervix was evaluated, in vivo. The optical system included a fiber optic probe designed to measure polarized and unpolarized light transport properties of a small volume of tissue. An algorithm for diagnosing tissue based on the optical measurements was developed which used four optical properties, three of which were related to light scattering properties and the fourth of which was related to hemoglobin concentration. A sensitivity of ∼77% and specificities in the mid 60's were obtained for separating high grade squamous intraepithelial lesions and cancer from other pathologies and normal tissue. The use of different cross-validation methods in algorithm development is analyzed and the relative difficulties of diagnosing certain pathologies is assessed. Furthermore, the robustness of the optical system for use by different doctors and to changes in fiber optic probe were also assessed and potential improvements in the optical system are discussed.

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Section: Introductionmentioning

confidence: 99%

In vivo light scattering for the detection of cancerous and precancerous lesions of the cervix

et al. 2009

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“…The risk of overtreatment can be minimised if the above strategy is used for a cytological diagnosis of HSIL or when the colposcopic impression is of CIN 2 or higher [10] and is an acceptable treatment for cytological HSIL [11]. The relatively high cure rates and low complication rates associated with ''see and treat'' make it a cost-effective option for high-grade lesions [12]. When used exclusively for high-grade lesions, the overtreatment rate can be lower than 10 % [13].…”

Section: Discussionmentioning

confidence: 99%

Management of Abnormal Pap Smears in a Tertiary Care Hospital

Thomas

Sudrania

Sebastian

et al. 2015

Indian J Gynecol Oncolog

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Aim Cervical cytology is still the mainstay of cervical cancer screening programmes in developed countries, whereas this has not proved to be useful in low-resource settings. Purpose To audit abnormal Pap smears and their management in a tertiary care institution with an intention to improve quality of services rendered. Methods A list of all abnormal Pap smear (liquid-based cytology) reports between June 2012 and June 2013 was obtained from our cytopathology department. Electronic records of these patients were used to fill a proforma. The data were analysed using SPSS 19. Results A total of 11,984 women who attended the gynaecology clinic had Pap smears done, of which 130 were abnormal (1 %). The mean age of these women was 43. The median parity was 2 with a range of 0-6. Five women were previously treated for cancer cervix, 4 for CIN and 10 were HIV positive. ASCUS was reported in 25 (19 %), LSIL in 45 (35 %), HSIL in 41 (32 %), ASC-H in 11 (8 %), cancer in 6 (4 %) and AGC in 2 (2 %). Among those with abnormal smears, 33 women (25 %) were lost to follow up (7 HSIL, 15 LSIL and 11 ASCUS). Treatments offered included LEEP in 20 (15 %), conisation in 4 (3 %) and vaginectomy in 1. Sixteen patients eventually had hysterectomy (12 %). Immediate (see & treat) treatment was done after colposcopy in 10 women where the final biopsy was negative in 3, CIN I in 1, CIN II/III in 4 and invasive cancer in 2.Conclusion The follow-up of patients after Pap smear and treatment needs to be emphasized for the success of any cervical screening programme. See-and-treat methods could be carried out but have a risk of overtreatment.

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“…However, inaccuracies in Pap smear results and colposcopic impression often lead to overtreatment. 5 In order to diagnose undetectable lesions and to reduce the number of unnecessary biopsies, substitute or adjunct methods with higher sensitivity and specificity in cervical intraepithelial neoplasia (CIN) detection are under investigation and development. One of these methods is light spectroscopy.…”

Section: Introductionmentioning

confidence: 99%

Single fiber reflectance spectroscopy on cervical premalignancies: the potential for reduction of the number of unnecessary biopsies

et al. 2013

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We have assessed the value of single fiber reflectance (SFR) spectroscopy in prediction of cervical squamous intraepithelial lesions (SIL). SFR was used to measure reflected light from 32 patients undergoing standard colposcopy. Seven parameters extracted from the spectra in addition to two biographic parameters were compared in biopsy-confirmed SIL versus nonSIL. The significant parameters in the model were determined using stepwise logistic regression. The classification performance was evaluated by a leave-one-out cross-validation method and reported by receiver operating characteristic (ROC) curves. Light absorption properties and biographic characteristics of the patient contributed significantly to the accuracy of the model. Combining important parameters, the best retrospective sensitivity, specificity and area under the ROC curve for SIL sites versus nonSIL were 89%, 80% and 0.89%, respectively. SFR spectroscopy shows promise as a noninvasive, real-time method to guide the clinician in reducing the number of unnecessary biopsies. Discrimination of SIL from other abnormalities compares favorably with that obtained by fluorescence alone and by fluorescence combined with reflectance spectroscopy while the simplicity and low cost of the presented system are dominant.

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Controversial Topics in Abnormal Cervical Cytology: ???See and Treat???

Cited by 7 publications

References 31 publications

In vivo light scattering for the detection of cancerous and precancerous lesions of the cervix

In vivo light scattering for the detection of cancerous and precancerous lesions of the cervix

Management of Abnormal Pap Smears in a Tertiary Care Hospital

Single fiber reflectance spectroscopy on cervical premalignancies: the potential for reduction of the number of unnecessary biopsies

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