Association between cervical lesion grade and micronucleus frequency in the Papanicolaou test

Bueno, Caroline Tanski; Silva, Cláudia Maria Dornelles da; Barcellos, Regina Bones; Silva, Juliana da; Santos, Carla Rossana dos; Menezes, João Evangelista Sampaio; Menezes, Honório Sampaio; Rossetti, Maria Lúcia Rosa

doi:10.1590/s1415-47572014000400004

Cited by 16 publications

(10 citation statements)

References 22 publications

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“…Among all known types of cancer, the prospects for preventing or curing cervical cancer are among the best because it can be diagnosed early when it is still curable. About 80% of cervical cancer cases occur in developing countries, and it is the most common cause of death in women ( 2 , 3 ). The Papanicolaou (Pap) test is the most common and cost-effective screening method for detecting cervical cancer, and it has been effective in reducing the prevalence of this cancer and the associated mortality rates among women ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Pap Smear and Colposcopy in Screening for Cervical Cancer in Patients with Secondary Immunodeficiency

et al. 2015

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IntroductionCervical cancer is the second most common cancer among women worldwide. The sensitivity of conventional Pap smear in detecting cervical lesions before cervical cancer is 51%, which means the false negative value is 49%. The aim of this study was to compare two methods for screening for cervical cancer in patients with secondary immunodeficiency, i.e., the conventional Pap smear and colposcopy.MethodsThis cross-sectional study was conducted on 101 immunodeficient patients who were referred to the Gynecologic Clinic at Shahid Sadughi Hospital in Yazd from March 2011 to August 2012. All patients underwent the Pap test, a colposcopy, and a cervical biopsy, with the latter being considered as the gold-standard test.ResultsThe most frequency of immunodeficiency was noted among patients with rheumatoid arthritis (53.3%), and this was followed by patients who were undergoing chemotherapy (30.7%), patients with lupus erythematosus (12.9%), and patients with AIDS (3%). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the Pap smear were 18.2, 98.5, 85.5, 71.3, and 72.2%, respectively. The respective values for colposcopy were 66.7, 98.94, 80, 97.9, and 97%, respectively.ConclusionIn this study the accuracy, sensitivity, specificity, and negative predictive values of colposcopy were higher than those for the Pap smear in detecting high-grade, cervical, pre-malignant lesions (cervical intraepithelial neoplasia: CIN ≥ 2). Therefore, an annual colposcopy is advised for secondary immunodeficient patients instead of a Pap smear.

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Section: Introductionmentioning

confidence: 99%

Comparison of Pap Smear and Colposcopy in Screening for Cervical Cancer in Patients with Secondary Immunodeficiency

et al. 2015

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“…A study by Bueno et al 18 in 2014 showed that the MN frequencies in the different groups were 0.95 ± 1.12 (n = 223) in the control group (NILM), 2.98 ± 1.20 (n = 50) in ASCUS, 4.04 ± 1.45 (n = 52) in Cervical intraepithelial neoplasia (CIN) I, 5.97 ± 1.83 (n = 30) in CIN II, 7.29 ± 1.55 (n = 17) in CIN III and 8.64 ± 1.55 (n = 25) in cervical cancer. 18 These frequencies were significantly higher in precancerous and cancer groups than that of the control group (p<0.001). It should however, be noted that CIN is a diagnosis on histopathological sections.…”

Section: Discussionmentioning

confidence: 99%

Does Micronucleus Score Really Indicate Dysplasia in Cervical Pap Smears? If So, How Far?

Roy¹,

Mahanta²,

Saha³

2019

jebmh

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BACKGROUNDThe grade of dysplasia on cervical pap smears may be indicated by micronucleus (MN) scoring, much like cancers of oral cavity, urinary bladder and esophagus. METHODSThis is a cross sectional study. MN scores of 106 subjects comprising of all major diagnostic categories included in 'The Bethesda system, 2014 for reporting cervical pap smears' were taken. High grade squamous intraepithelial lesion (HSIL) and invasive carcinoma (IC) were further grouped as 'high-risk' and the rest, 'low-risk' to construct Receiver Operating Characteristic (ROC) curve to seek a cut-off delineating the two classes. Analysis of variance was used to determine significance of differences in MN scoring between the various groups. RESULTSDifference of mean MN scores of HSIL (9.4) and IC (10.7) was significant from the low-risk group but not within themselves. A huge difference in MN scores between low grade squamous intraepithelial lesion and HSIL is notable. The difference of mean age was significant between high and low risk groups. ROC curve delivered a cut-off of 5.15 to distinguish between the two categories with 85.7% sensitivity, 97.2% specificity and 93.3% accuracy. CONCLUSIONSSequential and significant increase of MN score from low to high grade dysplasia is established by current study. A cut-off of 5.15 MN score adequately detects HSIL and IC. Despite its performance, MN scoring is time-consuming, labour intensive and strenuous process, which might make it difficult to impose on laboratories and pathologists. HOW TO CITE THIS ARTICLE:Roy P, Mahanta TN, Saha D. Does micronucleus score really indicate dysplasia in cervical pap smears? if so, how far? J. Evid. Based Med.

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“…5,6 Among all known types of cancer, cervical cancer has some of the best chance for prevention and cure when diagnosed early, in the preinvasive stage. 7 Screening for cervical cancer has been implemented in many countries, starting in the 1960s and led to reduction in cervical cancer burden. 8 The optimal screening strategy should identify those cervical cancer precursors likely to progress to invasive cancers (maximizing the benefits of screening) and avoid the detection and unnecessary treatment of transient HPV infection and its associated benign lesions that are not destined to become cancerous (minimizing the potential harms associated with screening.…”

Section: Introductionmentioning

confidence: 99%

The use of HPV-DNA testing combined with Pap smear in detection of pre-invasive disease of the cervix

Nwesar¹,

Salam²,

Hanafi³

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Cancer cervix constitutes a major health problem worldwide. It is one of the most common female malignancy in both incidence and mortality. Cancer cervix has many risk factors, the most important one is persistent infection with one of HPV high risk types. Its morbidity and mortality can be reduced by frequent screening and early diagnosis. So that, several studies have been conducted in recent years in order to find better tests for screening for pre-invasive disease of the cervix and so early intervention and better prognosis. This study aimed to compare the sensitivity of Pap test and HPV DNA test as screening tests for pre-invasive disease of the cervix.Methods: 100 females from those attending Alexandria University gynaecologic clinic for causes rather than cancer cervix were subjected to Pap smear and cervical swab for HPV-DNA testing at the same setting. Cases of HSIL or positive HPV were subjected to VIA test, colposcopy and cervical punch biopsy was taken if aceto-whitening of the cervix or any other abnormality was found. Cases with ASCUS or LSIL were re-smeared after 3-6 months, if persistent or progressive pathology, colposcopy and punch biopsy from acetowhite areas were taken.Results: 21 cases (21%) were HPV positive and 66 cases (66%) were positive for intraepithelial lesions (37% ASCUS, 18% LSIL and 11% HSIL) with re-smearing there were 3 persistent ASCUS cases (8.1%) and 5 LSIL cases (27.78%). Colposcopy done, and biopsies were taken from 10 HSIL cases (90.1%), 5 LSIL (27.8%), 3 ASCUS (8.1%) and 10 HPV positive cases (62.5%). With significant relationship between colposcopic findings and HPV-DNA positivity and abnormal cytology. Biopsies were 18; 14 were CIN I and 4 were CIN II.Conclusions: HPV-DNA positivity has positive association with HSIL. Pap smear is an easy cheap method for screening. HPV-DNA test is less sensitive than cytology as a method for screening.

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Association between cervical lesion grade and micronucleus frequency in the Papanicolaou test

Cited by 16 publications

References 22 publications

Comparison of Pap Smear and Colposcopy in Screening for Cervical Cancer in Patients with Secondary Immunodeficiency

Comparison of Pap Smear and Colposcopy in Screening for Cervical Cancer in Patients with Secondary Immunodeficiency

Does Micronucleus Score Really Indicate Dysplasia in Cervical Pap Smears? If So, How Far?

The use of HPV-DNA testing combined with Pap smear in detection of pre-invasive disease of the cervix

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