Consequences of the Introduction of Combined Spatula and Cytobrush Sampling for Cervical Cytology

Boon, Mathilde E.; Kordelaar, Josephine J. M. Alons-Van; Rietveld-Scheffers, Petronella E. M.

doi:10.1097/00006254-198705000-00020

Cited by 26 publications

(29 citation statements)

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“…This finding is also consistent with our recent report, in a study of [9000 patients, that hrHPV DNA test results are independent of the presence or absence of an EC/TZS. 24 These data also must be interpreted in light of the apparent discrepancies between many cross-sectional studies demonstrating an increased risk of SILs in women with an EC/TZS [10][11][12][13][14][15][16][17][18][19][20][21] and longitudinal studies that to our knowledge have not confirmed findings of an increased risk of SILs during longterm follow-up. [4][5][6] Australian investigators have noted that this apparent discrepancy can be explained in 2 ways: 1) the observation that older women are both more likely to lack an EC/TZS in their Pap tests and are also less likely to harbor SILs, and 2) by the hypothesis that many undetected SIL cases in women without an EC/TZS are found to be self-limited and transient, 6 consistent with the regression of both high-grade and low-grade lesions in observational studies and therapeutic trials.…”

Section: Discussionmentioning

confidence: 87%

“…[7][8][9] Nevertheless, many cross-sectional studies have shown that squamous intraepithelial lesion (SIL) cells are more likely to be present on specimens in which EC/TZ cells are present. [10][11][12][13][14][15][16][17][18][19][20][21] In addition, one would logically anticipate that Pap tests lacking EC cells would be less likely than Pap tests with EC cells to detect EC glandular neoplasia. Current guidelines recommend that women with negative Pap test results and no EC/TZS return for screening within 12 months.…”

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confidence: 99%

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Adjunctive high-risk human papillomavirus DNA testing is a useful option for disease risk assessment in patients with negative Papanicolaou tests without an endocervical/transformation zone sample

Zhao

Austin

2008

Cancer

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BACKGROUND. Current guidelines recommend that women with negative Papanicolaou (Pap) test results and no endocervical/transformation zone (EC/TZ) sample return for screening within 12 months. For some women, this represents earlier follow‐up than advocated in several routine screening guidelines. Controversy remains with regard to the correlation between sampling of the EC/TZ, Pap test quality, and disease risk assessment. METHODS. A retrospective study was conducted reviewing the results from 143,438 liquid‐based cervical Pap tests performed at a large academic women's hospital between July 2005 and December 2006. Vaginal Pap tests were excluded from the study. Women with any Pap result, women with low–grade squamous intraepithelial lesions (LSILs), and patients with high–grade squamous intraepithelial lesion (HSIL) Pap test results were stratified by 10‐year age groups and according to the presence or absence of an EC/TZ sample (EC/TZS). Women with LSIL and HSIL Pap test results with and without an EC/TZS were also compared for rates of high–risk human papillomavirus (hrHPV) DNA detection. RESULTS. Of the total of 143,438 cervical Pap tests performed, 27,359 (19.1%) were reported to be lacking an EC/TZS. The absence of an EC/TZS was found to be highest in adolescents and in mature women aged ≥50 years. The overall detection rate of LSIL was 4.29% and that of HSIL was 0.64%. Both the LSIL and HSIL rates were found to be significantly higher in Pap tests with an EC/TZS compared with Pap tests without an EC/TZS (LSIL: 4.51% vs 3.37% and HSIL: 0.72% vs 0.29%). However, when women with LSILs and HSILs were divided into a group in which EC/TZS was present and a group in which EC/TZS was absent, no significant differences were found to be present with regard to hrHPV DNA rates between the 2 groups. CONCLUSIONS. Adjunctive hrHPV DNA testing is effective in stratifying risk for the presence of SIL in women with and without an EC/TZS. This finding is consistent with recently reported data from >9000 patients with negative Pap results, which found that hrHPV DNA–positive test rates are independent of the presence or absence of an EC/TZS. hrHPV DNA results provide a useful new optional adjunctive tool for the objective stratification of disease risk in women with negative Pap tests and no EC/TZS. Cancer (Cancer Cytopathol) 2008. © 2008 American Cancer Society.

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Section: Discussionmentioning

confidence: 87%

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confidence: 99%

Adjunctive high-risk human papillomavirus DNA testing is a useful option for disease risk assessment in patients with negative Papanicolaou tests without an endocervical/transformation zone sample

Zhao

Austin

2008

Cancer

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“…11 The cytologic findings in AIS are now well known. [12][13][14][15][16][17] The specificity of these findings and diagnostic difficulties continue to be elucidated 14 ' 16,18-31 ; to our knowledge, however, there has been no systematic investigation of cytologic findings in previous negative smears in AIS.…”

Section: Discussionmentioning

confidence: 99%

Papanicolaou Smear Sensitivity for Adenocarcinoma In Situ of the Cervix:A Study of 34 Cases

Lee¹,

Minter²,

Granter³

1997

Am J Clin Pathol

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The sensitivity of cervical smears for adenocarcinoma in situ (AIS) is not known, nor is it known whether false-negative smears are due to sampling or to screening or interpretive errors. In 16 of 34 patients with AIS, 38 negative smears were reported 2 weeks to 7 years before biopsy. Thirty-one of these negative smears were rescreened, and 17 (55%) were retrospectively diagnosed as abnormal. The purpose of this study was to obtain an estimate of Pap smear sensitivity for AIS and to uncover difficulties in interpretation of smears that may have led to false-negative diagnoses. MATERIALS AND METHODS The surgical p a t h o l o g y files of Brigham andWomen's Hospital, Boston, were searched for case reports of AIS or AIS combined with squamous cervical intraepithelial neoplasia (CIN) with a complete cone biopsy, hysterectomy, or both for the years 1986 to 1995. All available smears diagnosed as negative before an initial biopsy confirming AIS were confirmed sampling errors. The sensitivity of cervical smears for AIS was 55% to 72%. Improved sampling of the endocervical canal offers cytologists the opportunity to diagnose AIS. This study demonstrates that this opportunity may not be fully exploited. Small "endometrioid" AIS cells and AIS cells resembling reactive endocervical cells may be mistaken for benign cells, thus decreasing sensitivity.

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“…In addition they seem to have been carried out with insufficient sampling tech niques [6]. Recently, a new technique using a brush for cytologic sampling of vaginal smears has been introduced [7]. The aim of the present investigation was to find out if this technique could be used for routine ure thral cytology and evaluation of the effects of oestrogen treatment on the urethral mucosa in women with urinary incontinence.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Urethral Mucosa before and after Oestrogen Treatment in Postmenopausal Women with a New Sampling Technique

Ulmsten

Stormby²

1987

Gynecol Obstet Invest

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Using a new type of nylon brush (Cytobrush®) for sampling of cells, the state of the urethral mucosa was evaluated before and after oestrogen treatment in 10 patients suffering from urinary incontinence. In 4 other patients the results obtained were compared with those using the conventional cotton swab technique. The brush specimens were found to be much more cellular and consequently more informative than those obtained with the conventional technique. The cytologic examination based on brush samples also demonstrated that oestrogen treatment within 3 weeks induced a proliferation of the atrophic urethral mucosa in postmenopausal women suffering from urinary incontinence.

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Consequences of the Introduction of Combined Spatula and Cytobrush Sampling for Cervical Cytology

Cited by 26 publications

References 0 publications

Adjunctive high-risk human papillomavirus DNA testing is a useful option for disease risk assessment in patients with negative Papanicolaou tests without an endocervical/transformation zone sample

Adjunctive high-risk human papillomavirus DNA testing is a useful option for disease risk assessment in patients with negative Papanicolaou tests without an endocervical/transformation zone sample

Papanicolaou Smear Sensitivity for Adenocarcinoma In Situ of the Cervix:A Study of 34 Cases

Evaluation of the Urethral Mucosa before and after Oestrogen Treatment in Postmenopausal Women with a New Sampling Technique

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