Rapid prescreening in gynecologic cytology

Abstract

Whenever I mention that our laboratory uses rapid prescreening (RPS) instead of the usual 10% random review to improve the detection of false-negative cases in gynecologic cytology, the usual response, with few exceptions, is an assortment of skeptical stares and polite smiles. It is indeed difficult to fathom that someone screening rapidly, that is, for less than 2 minutes, thereby covering only a fraction of the surface area of a slide, could uncover abnormalities not detected by another who has screened the same slide completely for 6 minutes or more. As counterintuitive as it seems, RPS works! Perhaps it is a practical application of the dictum ''two heads are better than one,'' which could be restated as ''four eyes are better than two.'' Indeed, 2 observers viewing independently the same object without knowing the other's opinion may focus on different aspects of that object and end up contributing additional or complementary findings. In the context of RPS, additional false-negative cases do get detected. The study by Tavares et al published in the current issue of Cancer Cytopathology adds strong data to the growing body of evidence that RPS is an excellent internal quality assurance method for improving the performance of gynecologic cytology. 1 Although a mandatory quality assurance technique by CLIA 88 in the United States, the 10% random review of negative gynecologic smears is renowned for its inefficiency and lack of statistical power to detect lowlevel achievement in primary screening. [2][3][4][5][6] Full manual rescreening of all negative gynecologic smears is too time consuming to be of practical value. Therefore, rapid screening, defined as the review of gynecologic smears in a shorter period than usual, generally less than 2 minutes, is an attractive alternative. Two types of rapid screening exist: rapid rescreening (RR) and RPS. Rapid rescreening consists of partial rescreening for a limited duration at low magnification (Â10) of slides previously reported as within normal limits or as inadequate. The rapid rescreener (usually a cytotechnologist who was not the initial screener of the smear) puts aside the smears probably containing missed abnormalities. These are then submitted to a full check by another cytotechnologist and/ or pathologist. Rapid rescreening is currently the preferred method for quality control for gynecologic cytology in the United Kingdom. The second type of rapid screening is RPS, which consists of rapidly screening all routine gynecological smears prior to the routine full screening (instead of doing it after the full screening, as in RR).

Survivin Improves Reprogramming Efficiency of Human Neural Progenitors by Single Molecule OCT4

“…The ability of reprogramming of somatic cells provides great potential for developing personalized treatments for diseases and for drug screening [3, 6]. Here we presented that human iPS cells are reprogrammed by a single factor OCT4, from neural progenitor or stem cells with episomal vector.…”

“…Nonintegration human iPS cells have been generated using adenoviral or plasmid transfection methods [4, 5]. Other DNA-free methods include Sendai virus [6], direct protein delivery, and modified mRNA or microRNA transformations [7]. In this study, considering the key transcription factor, SOX2, is endogenously highly expressed in human neural stem cells (NSCs) or progenitors (NPCs) in the process of reprogramming [8, 9], we applied an episomal vector [10], one of no genome integration method, to reprogram human NPCs to iPS cells with only one factor OCT4 (1F-OCT4).…”