Infectious Organisms on Papanicolaou Smears Should Not Influence the Diagnosis of Atypical Squamous Cells of Undetermined Significance

Nasser, Haitham; Hayek, Sylvia; Balasubramaniam, M.; Kuntzman, Tomi

doi:10.1159/000323320

Cited by 3 publications

(5 citation statements)

References 39 publications

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“…and ASC in our study, but another report described a predominance of this pathogen in ASC-US smears prepared by the ThinPrep automated method [14] . Interestingly, the finding of TV showed statistical significance for the ASC-H group.…”

Section: Discussioncontrasting

confidence: 57%

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Atypical Squamous Cells in Liquid-Based Cervical Cytology: Microbiology, Inflammatory Infiltrate, and Human Papillomavirus-DNA Testing

Oliveira

Eleutério²,

Gonçalves³

et al. 2017

Acta Cytologica

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Objective: The aim of this study was to assess the correlation between atypical squamous cells (ASC) and inflammatory infiltrate and vaginal microbiota using cervical liquid-based cytological (SurePath®) and high-risk human papillomavirus (HR-HPV) tests. Study Design: A cross-sectional study was conducted using a 6-year database from a laboratory in Fortaleza (Brazil). Files from 1,346 ASC cases were divided into subgroups and results concerning inflammation and vaginal microorganisms diagnosed by cytology were compared with HR-HPV test results. Results: An absence of specific microorganisms (ASM) was the most frequent finding (ASC of undetermined significance, ASC-US = 74%; ASC - cannot exclude high-grade squamous intraepithelial lesion, ASC-H = 68%), followed by bacterial vaginosis (ASC-US = 20%; ASC- H = 25%) and Candida spp. (ASC-US = 6%; ASC-H = 5%). Leukocyte infiltrate was present in 71% of ASC-US and 85% of ASC-H (p = 0.0040), and in these specific cases HR-HPV tests were positive for 65 and 64%, respectively. A positive HR-HPV test was relatively more frequent when a specific microorganism was present, and Candida spp. was associated with HR-HPV-positive results (p = 0.0156), while an ASM was associated with negative HR-HPV results (p = 0.0370). Conclusion: ASC-US is associated with an absence of inflammation or vaginosis, while ASC-H smears are associated with Trichomonas vaginalis and inflammatory infiltrate. A positive HR-HPV is associated with Candida spp. in ASC cytology.

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Section: Discussioncontrasting

confidence: 57%

“…Cervicitis and vaginitis are among the main confounding factors for the diagnosis of squamous cellular atypia [13] . Few studies have examined the potential risks of infectious agents that induce ASC cytology [14] .…”

Section: Introductionmentioning

confidence: 99%

Atypical Squamous Cells in Liquid-Based Cervical Cytology: Microbiology, Inflammatory Infiltrate, and Human Papillomavirus-DNA Testing

Oliveira

Eleutério²,

Gonçalves³

et al. 2017

Acta Cytologica

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“…Nasser y colaboradores en 2011 encontraron que el grupo de pacientes con diagnóstico citológico de ASCUS más infección tuvo una proporción significativamente mayor de pruebas HPV positivas que el grupo ASCUS sin infección. 25 De las seis pacientes positivas para algún genotipo DNA viral oncogénico, dos declararon dos compañeros sexuales, mientras que uno las restantes cuatro. Se ha descrito en la literatura una relación proporcional directa entre el riesgo de lesión intraepitelial y el número de parejas sexuales, al aumentar la probabilidad de exposición al HPV.…”

Section: Resultsunclassified

Frecuencia de DNA-HPV-HR por método automatizado PCR (COBAS®) en nuestras cervicouterinas de una población en Proboquilla-Cartagena, Colombia

Amaya¹,

Olaya²,

Pérez³

et al. 2014

Repert. Med. Cir.

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Objetivo: determinar ADN-HPV-HR por método automatizado PCR (cobas®) en muestras cervicouterinas de una población en Proboquilla, Cartagena, Colombia. Métodos: serie de casos de mujeres que asistieron a la campaña donde se tomó citología convencional y una segunda muestra en un vial para determinar DNA del HPV-HR mediante la reacción en cadena de la polimerasa (PCR). Resultados: se recolectaron 31 muestras de citología cérvico-uterina, la prueba PCR fue positiva en seis; 4 casos con infección simple y 2 con infección múltiple. Una de estas últimas fue positiva para los tres grupos (HR-HPV, HPV-16, HPV-18) y la otra para dos (HR-HPV y HPV-18). Conclusión: se detectó un grupo de mujeres infectadas por HPVs clasificados de alto riesgo, con infección simple y múltiple, que fueron remitidas a ginecología. Se confirmó la infección por HPV-HR en 5:7 resultados de citología clasificados como ASC-US.

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“…According to the Bethesda system, Pap smear specimens exhibiting RCC are classified as negative for intraepithelial lesion or malignancy (NILM). The presence of enlarged nuclei leads to a diagnostic dilemma when differentiating NILM changes from those of atypical squamous cells of undetermined significance (ASC‐US) specimens or other intraepithelial lesions …”

Section: Introductionmentioning

confidence: 99%

“…changes from those of atypical squamous cells of undetermined significance (ASC-US) specimens or other intraepithelial lesions. [2][3][4] The Bethesda system clearly defines the nuclear enlargement criteria for ASC-US as 2.5-3 times the size of a normal intermediate squamous cell nucleus (approximately 35 μm 2 ). 5 Nonetheless, the nuclear enlargement in some NILM cells may be similar to the enlargement defined as ASC-US.…”

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confidence: 99%

A study of the relationship between nuclear contour thickening, nuclear enlargement and human papillomavirus infection in squamous cells

et al. 2019

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Objective To investigate the relationship between the morphological features of nuclear enlarged cells and human papillomavirus (HPV) infection in negative for intraepithelial lesion or malignancy (NILM) and atypical squamous cells of undetermined significance (ASC‐US). Methods In total, 128 Papanicolaou specimens comprising 41 ASC‐US cases and 87 NILM cases were examined. Cell morphological analysis was performed using both area ratio (nuclear area in cells with nuclear enlargement/nuclear area in normal intermediate cells) and nuclear contour thickening. High‐risk HPV was detected using the Uniplex E6/E7 polymerase chain reaction assay and logistic regression analyses of factors related to high‐risk HPV infection were performed. Results Nuclear contour thickening was present in 57.7% (64/111 cells) of high‐risk HPV positive cases and 21.8% (69/317 cells) of high‐risk HPV negative cases. There was a statistically significant association (P = 0.01) between high‐risk HPV infection and nuclear contour thickening. Nuclear contour thickening was approximately one‐third higher in NILM cases than in ASC‐US cases (odds ratio, 0.371; 95% confidence interval, 0.208–0.662) and three times higher in high‐risk HPV‐positive cases than in high‐risk HPV‐negative cases (odds ratio, 2.831; 95% confidence interval, 1.591–5.039). Conclusion Our results suggest that nuclear contour thickening in nuclear enlarged cells in NILM and ASC‐US cases may be a cellular finding associated with HPV infection.

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Infectious Organisms on Papanicolaou Smears Should Not Influence the Diagnosis of Atypical Squamous Cells of Undetermined Significance

Cited by 3 publications

References 39 publications

Atypical Squamous Cells in Liquid-Based Cervical Cytology: Microbiology, Inflammatory Infiltrate, and Human Papillomavirus-DNA Testing

Atypical Squamous Cells in Liquid-Based Cervical Cytology: Microbiology, Inflammatory Infiltrate, and Human Papillomavirus-DNA Testing

Frecuencia de DNA-HPV-HR por método automatizado PCR (COBAS®) en nuestras cervicouterinas de una población en Proboquilla-Cartagena, Colombia

A study of the relationship between nuclear contour thickening, nuclear enlargement and human papillomavirus infection in squamous cells

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