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Clinical Record: Oncological Screening
Published in Paloma Tejero, Hernán Pinto, Aesthetic Treatments for the Oncology Patient, 2020
According to published studies, the number of FNs is very high. Screening tests have a specificity of 98%; however, in low-prevalence populations, they have a sensitivity of about 50% [31]. In order to improve accuracy and minimize errors in sample gathering and handling and interpretation of results, new methods, such as liquid-based cytology and automated sample reading, have been developed. Although there are no randomized studies proving the efficacy of Papanicolaou cytology, observational, case, and control studies show a significant reduction in mortality that can exceed 70% in countries where screening has been massively applied [32].
Cervical Cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Georgios Imseeh, Alexandra Taylor
CIN precedes virtually every case of invasive squamous carcinoma of the cervix. Pre-invasive disease is commonly asymptomatic but may be detected by cytological examination of exfoliated cells. The Pap smear test is named after Greek doctor Georgios Papanicolaou, who developed the technique in 1927. Cells are taken from the transformation zone of the cervix with a spatula and spread on a glass slide. Liquid-based cytology is now the preferred method, where a suspension of cells is produced by shaking the spatula or brush in a transport medium, and a thin layer of the solution is then analyzed. The cells are studied microscopically using the Papanicolaou stain and an assessment made of the size, shape, and mitotic activity of the nuclei and the nuclear–cytoplasmic ratio. On the basis of this assessment, the cells will be reported as being normal, inflammatory, or showing mild atypia, as showing low-grade or high-grade dyskaryosis, or as being characteristic of invasive disease. Those patients with moderate or severe changes require biopsy of the cervix for histological assessment.12
Screening
Published in William Bonnez, Guide to Genital HPV Diseases and Prevention, 2019
In the liquid-based cytology approach, the sample is collected with a tool called a cervical broom. The device is placed in the cervix and rotated two to four times. The collected material is transferred in a liquid transport medium. There are two commercial systems available, Sure-Path (BD-TriPath Imaging) and Thin-Prep (Hologic Corp). The processing varies according to the system, but the cells end up being spread on a glass slide for examination by the technician or a computer, if appropriate. This liquid-based collection system combined with automated reading overcomes drawbacks such as excess blood or clumps of cells from conventional approach, which can obscure the slide. Another advantage of the liquid based method is that the transport media containing the remaining cells is stored and these cells are available for HPV DNA testing with the commercially available Hybrid Capture II assay. This testing without having to re-sample the patient is called reflex testing, and is done after an equivocally abnormal cytology.
Comparison of conventional and liquid-based Pap smear methods in the diagnosis of precancerous cervical lesions
Published in Journal of Obstetrics and Gynaecology, 2022
Zahra Honarvar, Zahra Zarisfi, Saideh Salari Sedigh, Maryam Masoumi Shahrbabak
Of 31,513 women examined by CN and LBC, CN was performed for more than half of subjects (n = 17,074, 54.2%) and others were examined by LBC. According to Pap smear findings, 2330 people with abnormal Pap smear again checked with colposcopy. For 17 persons with the normal Pap smear result, the colposcopy also performed due to the observation of gross tissue during Pap smear procedures. The mean (±SD) age of subjects with abnormal Pap smear was 40.60 (10.38) years (age range: 21–82). The liquid-based Pap smear was positive for more than half of the subjects (n = 1470, 62.6%) and other positive results were reported by the conventional method (n = 878, 37.4%). Unsatisfactory smear was seen in little of subjects (n = 15, 0.6%) and the ASCUS+ was more prevalent among them (n = 968, 41.2%). The results showed that conventional methods in comparison to liquid-based cytology had more unsatisfactory smears (1.4% vs. 0.2%, p ≥ .001) and reported frequent ASCUS+ (45.1% vs. 35.4%, p ≥ .001). In contrast, LSIL+ was more reported by LBC versus conventional method (38.9% vs. 33.1%, p = .005). There was no significant difference based on Pap smear findings between the two methods (Table 1).
Analysis of the prevalence of human papillomavirus and abnormal anal cytology in women at risk
Published in Journal of Obstetrics and Gynaecology, 2021
Belen Lopez-Cavanillas, Cristina G. Benitez, Maria Serrano, Elena Sendagorta, Alicia Hernandez, Jose L. Bartha
Cervical and anal HPV genotyping and cytologies were performed on all women who accepted being included in the study and who signed the informed consent form. Both cervical and anal cytologies were collected by clinicians. We followed the recommended technique for the performance of anal cytology: in dorsal lithotomy position, a Dacron swab was blindly inserted 5–6 cm into the anal canal to adequately sample the anorectal transformation zone; the swab was rotated in a spiral pattern while maintaining firm pressure against the mucosa (Palefsky et al. 1997). Both cytologies were processed in a liquid medium for liquid-based cytology: Thin PrepTM (Cytyc Corporation Boxborough, MA). The terminology of the Bethesda System for Reporting Cervical Cytology in 2014 was used to report the results (Solomon et al. 2015).
The impact of cryotherapy for symptomatic cervical ectropion on female sexual function and quality of life
Published in Journal of Obstetrics and Gynaecology, 2021
Sukru Yildiz, Ismail Alay, Ecem Eren, Ibrahim Karaca, Gul Gultekin, Cihan Kaya, Huseyin Cengiz
This prospective observational study was conducted in the gynaecology outpatient clinic of a tertiary training and research hospital between December 2017 and December 2018 after obtaining ethics approval from our hospital’s local ethics committee (Approval number: 2017-403). Patients who were sexually active, who had symptomatic cervical ectropion, and who accepted cryotherapy as a treatment were included in the study. Patients with symptomatic cervical ectropion were defined as those with leukorrhoea, excessive vaginal discharge, recurrent cervicitis, postcoital bleeding, pelvic pain, and dyspareunia symptoms and those in whom cervical ectropion had been observed (observation of cervical columnar epithelium extending from external cervical os at least 0.5 cm) on vaginal examination. Written informed consent was obtained from all of the women who agreed to participate in the study. All of the patients were screened for cervical premalignant lesions with liquid-based cytology or a human papillomavirus (HPV) test. The exclusion criteria included pregnancy, abnormal cytology results and/or a positive HPV test, a history of cervical preinvasive lesions, presence of genital warts, history of sexual penetration disorders, presence of severe cervical anatomical distortion, presence of a cervical polyp, inability to tolerate vaginal examination with a speculum, cervical ectropion exceeding the diameter of the cryoprobe, refusal to participate in the study after reading the informed consent form, failure to admit for the control visit after six months, and failure to complete the questionnaires.