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Cytology of Bladder Cancer
Published in George T. Bryan, Samuel M. Cohen, The Pathology of Bladder Cancer, 2017
A systematic preliminary examination of the cellular sample made by the cytotechnologist is of major importance to the quality of results in urinary tract cytology. The cytotechnologist categorizes the types of cells present. Any significant findings are marked for review by the pathologist. The pathologist must then review the slides and clinical information before completing the report on each sample. This is a specialized area of cytopathology requiring considerable experience by all members of the laboratory staff in order to adequately handle the various diagnostic problems that will occur.
Thyroid nodules
Published in Demetrius Pertsemlidis, William B. Inabnet III, Michel Gagner, Endocrine Surgery, 2017
Salem I. Noureldine, Ralph P. Tufano
FNA biopsy has resulted in substantial improvements in diagnostic accuracy and a higher malignancy yield at time of surgery. FNA biopsy is the most cost-effective and reliable technique available to differentiate between benign and malignant diseases of the thyroid. It is estimated that its use reduces the need for diagnostic thyroidectomy by half and the overall cost of thyroid nodule medical care by one-quarter, while doubling the surgical confirmation of carcinoma. Cytopathologic evaluation has improved significantly over the past two decades, but good aspiration technique and an experienced cytopathologist are necessary to reach the modern high standards. Ultrasound-guided FNA biopsy, combined with on-site cytology verification of the adequacy of the specimen by a cytotechnologist or pathologist, may likely provide the highest sensitivity and specificity. Current sensitivity and specificity generally exceed 90% and 70%, respectively. However, negative cytology results should never override strong clinical suspicion of malignancy. After an initial nondiagnostic cytology result, repeat FNA with ultrasound guidance will yield a diagnostic cytology specimen in 75% of solid nodules and 50% of cystic nodules [16]. For patients who proceed to an operation, prior use of FNA biopsy reduces the need for frozen section analysis for diagnosis, reducing operative time and pathology fees.
Challenges in the Statistical Analysis of Biomarker Data
Published in Anthony P. DeCaprio, Toxicologic Biomarkers, 2006
Stephen W. Looney, Joseph L. Hagan
Tockman et al. (63) examined the use of murine monoclonal antibodies to a glycolipid antigen of human lung cancer as a biomarker in the detection of early lung cancer. As part of their assessment of the interrater reliability of scoring stained specimens, they compared the results obtained on 123 slides read by both a pathologist and a cytotechnologist. The authors stated that they used McNemar’s test to test for “significant agreement (p = 1.000)” between the readers. However, what was actually tested for was a significant difference in classification accuracy between the two readers. While such a test is often informative, one should also measure the degree of agreement between the readers (64). The generally accepted method for assessing agreement between two dichotomous biomarkers, neither of which can be assumed to be the gold standard, is Cohen’s kappa (5). When measuring agreement between three or more dichotomous biomarkers, we recommend the methods described in Shoukri (65).
How to integrate screening for cervical cancer into grassroots health services for low income countries: An implementation research
Published in International Journal of Healthcare Management, 2021
Ngan T. K. Nguyen, Linh T. Nguyen, Hoang T. Le, Binh T. Nguyen, Nha Ba Pham, Phuong Lan Pham, Lan T. H. Vu
Pap smear is the most popular screening procedure for cervical cancer. Various international studies identified that this test is effective in examining precancerous lesions that are more treatable [1]. However, some reported that there are some limitations on the implementation of Pap smear in developing nations. Such screening is a complicated procedure that required high technique, established laboratory, well-trained cytotechnologists, and up to three visits for screening [5]. In Vietnam, commune health care centers do not have enough resources, especially well-trained staffs, to conduct Pap smear testing. In contrast to Pap smear that requires well-established infrastructure and high trained staff, visual inspection has been reviewed as one of simple and inexpensive methods to early diagnose precancerous lesions.
Clinical and ultrasound characteristics distinguishing benign and malignant thyroid nodules in Johannesburg, South Africa
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2023
Kershlin Naidu, Victoria Saksenberg, Nasrin Goolam Mahyoodeen
Two to six slides were prepared by the operator who performed the FNA using the ‘classic’ smear technique. One slide was air dried, and the remainder of the slides were fixed with Fencott cytological fixative (Sangene Products, Cape Town, South Africa). The cytology slides were stained with a Papanicolaou stain (Merck, Darmstadt, Germany) and were screened by a cytotechnologist using Olympus (CX31) microscopes (Olympus Corp, Shinjuku City, Tokyo, Japan). Adequate specimens contained ≥ 6 groups of well-visualised follicular cells (≥ 10 per cluster), which is consistent with the Bethesda System for Reporting Thyroid Cytopathology.14
Occupational health issues experienced by UK embryologists: informing improvements in clinical reproductive science practice
Published in Human Fertility, 2022
Helen Priddle, Sarah Pickup, Catherine Hayes
Studies of professions in related settings also identify specific risks for reproductive scientists. Pipetting is associated with work-related upper limb disorders (WRULD; David & Buckle, 1997). Prolonged microscope use contributes to MSD in over 85% of cytotechnologists (Thompson et al., 2003). A study of laboratory technologists showed neck/shoulder problems in approaching 70% of participants (Jay et al., 2015).