The current status of the Papanicolaou smear

Shingleton, Hugh M.; Patrick, Roman L.; Johnston, William W.; Smith, Robert A.

doi:10.3322/canjclin.45.5.305

Cited by 70 publications

(50 citation statements)

References 26 publications

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“…16,17 However, a single cytological evaluation remains relatively insensitive, hence the need for frequent follow-up investigations. This is attributable to sampling or interpretation errors, and to the fact that some early lesions may not have acquired recognizable phenotypic alterations.…”

Section: Discussionmentioning

confidence: 99%

“…This is attributable to sampling or interpretation errors, and to the fact that some early lesions may not have acquired recognizable phenotypic alterations. 17 Invasive cervical carcinomas develop through increasing stages of cervical dysplasia and advance to CIN3, which is considered a bonafide precancerous lesion that requires surgical intervention. However, only ϳ15% of all low-grade dysplastic lesions follow this path of linear progression.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Genomic Amplification of the Human Telomerase Gene (TERC) in Pap Smears Predicts the Development of Cervical Cancer

Heselmeyer‐Haddad

Sommerfeld

White

et al. 2005

The American Journal of Pathology

144

114

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Invasive cervical carcinomas almost invariably carry extra copies of chromosome arm 3q, resulting in a gain of the human telomerase gene (TERC). This provided the rationale for the development of a multicolor fluorescence in situ hybridization (FISH) probe set as a diagnostic tool for the direct detection of TERC gains in Pap smears. We previously used this probe set to show that cervical intraepithelial neoplasia (CIN) 2 and CIN3 lesions could be distinguished from normal samples, atypical squamous cell of undetermined significance (ASCUS) and CIN1, with a sensitivity and specificity exceeding 90%, independent of the cytomorphological assessment. In the current study, we explored whether gain of 3q and amplification of TERC could predict progression from CIN1/CIN2 to CIN3 and invasive carcinoma. We applied our probe set to a series of 59 previously stained Pap smears for which repeat Pap smears and clinical follow-up were available. The samples included CIN1/ CIN2 lesions that progressed to CIN3 (progressors), CIN1/CIN2 lesions that regressed spontaneously (regressors), and normal Pap smears from women who subsequently developed CIN3 or cervical cancer. Here, we show that progressors displayed a gain of 3q whereas none of the regressors showed this genetic aberration. These data suggest that 3q gain is required for the transition from CIN1/CIN2 to CIN3 and that it predicts progression. Of note, 3q gain was found in 33% of cytologically normal Pap smears from women who were diagnosed with CIN3 or invasive cervical carcinoma after a short latency. The sensitivity of our test for predicting progression from CIN1/CIN2 to CIN3 was 100% and the specificity, ie, the prediction of regression, was 70%. We conclude that the detection of 3q gain and amplification of TERC in routinely collected Pap smears can assist in identifying lowgrade lesions with a high progression risk and in decreasing false-negative cytological screenings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Genomic Amplification of the Human Telomerase Gene (TERC) in Pap Smears Predicts the Development of Cervical Cancer

Heselmeyer‐Haddad

Sommerfeld

White

et al. 2005

The American Journal of Pathology

144

114

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“…However, conventional Pap smears are not perfect: a single Pap smear is associated with false-negative rates of 10-25%, largely because of errors in sampling or interpretation. False-negative Pap smears are associated with 30% of the new cases of cervical cancer each year (NIH 1996;Shingleton et al 1995) Newer Pap smear screening techniques using liquid-based media appear to decrease inadequate smears and also offer the possibility of direct HPV-DNA testing on collected specimens (ACOG 2009). A recent review of over 400 HIV-infected women who underwent both conventional and liquid-based cytologic screening found a significant decrease in the proportion of smears diagnosed as ASCUS/AGUS as well as the ASCUS/SIL ratio, with liquid-based preparations (Swierczynski 2002).…”

Section: Cervical Cancer Screening In Developed Countriesmentioning

confidence: 99%

Cervical Cancer Screening and Prevention for HIV-Infected Women in the Developing World

Anderson¹,

Lu²,

Sanghvi³

et al. 2012

Cancer Prevention - From Mechanisms to Translational Benefits

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“…The Papanicolaou test (also called the Pap test, Pap smear, or smear test) is a screening method which allows detection of infections and abnormalities of the cervix. The Pap smear test is the most widespread screening method for cervical neoplasia 2 and is 35 based on visual evaluation of the morphology of cells collected from the cervix under light microscopy. Microscopic examination brings subjectivity to the screening results, therefore, the smear test has a hugely variable sensitivity (17% -99%) and specificity (9% -100%) 3 .…”

Section: Introductionmentioning

confidence: 99%

Investigation of the influence of high-risk human papillomavirus on the biochemical composition of cervical cancer cells using vibrational spectroscopy

Ostrowska¹,

Malkin²,

Meade³

et al. 2010

Analyst

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The main aetiology of cervical cancer is infection with high risk human papillomavirus (HPV). Cervical cancer is almost 100% curable if detected in the early stages. Thus, information about the 10 presence and levels of HPV in patient samples has high clinical value. As current screening methods, such as the Pap smear test, are highly subjective and in many cases show low sensitivity and specificity, new supportive techniques are desirable to improve the quality of cervical cancer screening. In this study, vibrational spectroscopic techniques (Raman and Fourier Transform Infra Red absorption) have been applied to the investigation of four cervical cancer cell lines, HPV 15 negative C33A, HPV-18 positive HeLa with 20-50 integrated HPV copies per cell, HPV-16 positive SiHa with 1-2 integrated HPV strands per cell and HPV-16 positive CaSki containing 60-600 integrated HPV copies per cell. Results show that vibrational spectroscopic techniques can discriminate between the cell lines and elucidate cellular differences originating from proteins, nucleic acids and lipids. Similarities between C33A and SiHa cells were exhibited in the Raman 20 and infrared spectra and were confirmed by Principal Component Analysis (PCA). Analysis of the biochemical composition of the investigated cells, with the aid of PCA showed a clear discrimination between the C33A-SiHa group and HeLa and CaSki cell lines indicating the potential of vibrational spectroscopic techniques as support to current methods for cervical cancer screening. 25 IntroductionCervical cancer is second only to breast cancer as the most common malignancy in women worldwide 1 . The gradual progression of cervical cancer allows the application of screening and diagnostic programmes to detect neoplastic 30 changes before invasive cancer develops. The Papanicolaou test (also called the Pap test, Pap smear, or smear test) is a screening method which allows detection of infections and abnormalities of the cervix. The Pap smear test is the most widespread screening method for cervical neoplasia 2 and is 35 based on visual evaluation of the morphology of cells collected from the cervix under light microscopy. Microscopic examination brings subjectivity to the screening results, therefore, the smear test has a hugely variable sensitivity (17% -99%) and specificity (9% -100%) 3 . 40 The probability of developing cervical dysplasia is much higher for women infected with human papillomavirus (HPV) than those free of infection 4 . Infection with oncogenic or high-risk HPV is the main risk factor for cervical cancer 5 with 99.7% of invasive cervical neoplasia 45 associated with HPV infection 6 . Thus, HPV testing has been added to the range of clinical options for cervical cancer screening. Detection of HPV (HPV testing) is based on detecting the DNA of the virus. It has been found that the DNA of high risk strains of HPV are assimilated within the 50 cellular DNA of the host 7 . A drawback to HPV testing is that it is more expensive and time-consuming than other screening tes...

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The current status of the Papanicolaou smear

Cited by 70 publications

References 26 publications

Genomic Amplification of the Human Telomerase Gene (TERC) in Pap Smears Predicts the Development of Cervical Cancer

Genomic Amplification of the Human Telomerase Gene (TERC) in Pap Smears Predicts the Development of Cervical Cancer

Cervical Cancer Screening and Prevention for HIV-Infected Women in the Developing World

Investigation of the influence of high-risk human papillomavirus on the biochemical composition of cervical cancer cells using vibrational spectroscopy

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