Cervical cytology has a high false negative rate, especially for adenocarcinoma and its precursors. This study compares the traditional spatula with the cytobrush. Both the modified Ayre spatula and the cytobrush were found to be inadequate in a significant number of patients with known cytological atypia. It is concluded that inadequate sampling instruments make a contribution to false negative rates and that brush cytology is superior to rigid instrument cytology in routine cervical screening.
Seventy cases of invasive adenocarcinoma of the uterine cervix were predicted on cytological grounds and confirmed by histopathology. The cervical smears from these cases were further analysed and classified into well and poorly differentiated adenocarcinoma on the basis of the pattern of the cells in the smear and their nuclear detail. Using this method of analysis it is possible to increase the accuracy of cytology for the diagnosis of adenocarcinoma of the uterine cervix.
Two hundred women with abnormal Pap smears and/or vulvar symptoms and 30 with normal Pap smears were investigated to determine the association between symptoms and (i) human papilloma virus infection of the vulva, and (ii) a spongiotic tissue reaction or a spongiotic dermatitis of the vulva. All had vulvar colposcopy and biopsy Human papilloma virus infection was diagnosed by histopathology and in situ hybridisation technique. HPV infection was present in biopsies of 48% of asymptomatic women and 33% with symptoms (p = 0.13) and HPV DNA in 37% of asymptomatic women and 31% with symptoms (p = 0.72). Spongiotic tissue reaction was diagnosed in 53.5% of asymptomatic women compared to 74% of symptomatic women (p = 0.007). This study suggests that vulvar symptoms are not clinical manifestations of HPV infection, but may be caused by dermatitis rather than HPV infection per se.
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