Exploiting the Residual of Cervical Thin Layer Brush Samples Through Cytohistology in Cases with Invasive Carcinoma with Application of Antibodies

Objective: To evaluate the diagnostic value and compare morphological features of cell block sections of high-grade squamous intraepithelial lesions (HSIL) and squamous cell carcinomas (SCC). Study Design: A total of 135 cell blocks were prepared from residual Liqui-PREP samples. Of these, 43 biopsy-confirmed cases (24 HSIL and 19 SCC) were reviewed. Morphological features determined included cell clusters, epithelial-stromal interface, stromal invasion and tumor necrosis. Results: Ninety-three percent (40/43) of cell block diagnoses were consistent with histological diagnoses, which was better than the cytological diagnoses (81.4%; 35/43). The mean cell block size was 0.54 cm (range, 0.3–1.0 cm) for HSIL and 0.84 cm (range, 0.4–1.4 cm) for SCC (p < 0.0001). Cell clusters were present in 70.8% (17/24) of HSIL and 100% (19/19) of SCC (p < 0.0001). No epithelial-stromal interface, stromal invasion or tumor necrosis was observed on HSIL cell block sections, which is in contrast to the 84.2% (16/19), 68.4% (13/19) and 42.1% (8/19) on SCC cell blocks, respectively (p < 0.05). Conclusion: Cell blocks may increase the diagnostic accuracy of liquid-based cytology. The presence of stromal invasion, epithelial-stromal interface and tumor necrosis on cell block sections may be useful for accurate SCC diagnosis.

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Morphological Features of Cell Blocks Prepared from Residual Liqui-PREP Samples Can Distinguish between High-Grade Squamous Intraepithelial Lesions and Squamous Cell Carcinomas

Wei

Liu²,

Zhang³

et al. 2011

“…For the ThinPrep slides (Hologic), the general practitioner collected cervical samples using the Cervex Brush Combi (Rovers Medical Devices BV, Oss, The Netherlands) and left the brush in the vial with BoonFix® (Denteck, Zoetermeer, The Netherlands) [2,3]. The vials containing the brush heads were placed in a paint shaker to dislodge the material trapped between the bristles.…”

Section: Methodsmentioning

confidence: 99%

Endometrial Cells in Liquid-Based Cervical Cytology: A Diagnostic Pitfall Solved by Preparing Cytohistology from the Residual Thin Layer Sample

Risse

Ouwerkerk‐Noordam²,

Boon³

2011

Objective: It was our aim to assess the usefulness of cytohistology in cervical thin layer brush samples with problems in the differential diagnosis of endometrial cells. Study Design: This study reveals the cytological, cytohistological and immunohistochemistry findings of 8 cases suspicious of adenocarcinoma in situ (AIS)/adenocarcinoma (AC) in cervical liquid-based cytology (LBC) preparations that turned out to be normal endometrial cells. Results: All 8 cervical LBCs featured endometrial and atypical endocervical-like columnar cells with frequent ragged ‘feathered’ edge appearance and rosette formations. Overlapping atypical glandular cell groups were present on 2 ThinPrep slides as well. In cytohistology of 7 cases, the recognition of endometrial stroma with endometrial glands easily allowed the diagnosis of normal endometrium. In 1 case with very small loose tissue fragments without glands, the diagnosis could be established by positivity for CD10 marker (endometrial stroma) and without proliferative activity in the Ki-67 immunostaining. Conclusion: In cervical LBC preparations, nuclear hyperchromasia, pleomorphism and nucleoli in normal endometrial cells are more obvious than in conventional smears, and their arrangement is sometimes suggestive of AIS or AC. In the 8 cases presented, we could avoid a false-positive diagnosis of AIS or AC through cytohistology/immunohistochemistry, and in consequence, unnecessary colposcopical/histological examination.

“…MIB-1 complements p16 INK4A in the analysis of histological sections by differentiating SIL from atrophic epithelium with atypia [24]. Its complementary role to p16 INK4A in cytology has also been tested [16,30,33,35,36] and is discussed below.…”

Section: What Are the Main Goals For Immunomarkers?mentioning

confidence: 99%

“…The complementary role of p16 INK4A and MIB-1 on LBC and cell block preparations was explored by Yu et al [30], Risse et al [35], Sahebali et al [16], and Longatto et al [33]. The first two studies found that cell blocks (‘cytohistology’) immunostained for p16 INK4A and MIB-1 in combination were complementary to LBC, improving diagnostic accuracy for HSIL [30] and squamous cell carcinoma [30,35] and allowing for an unequivocal and refined diagnosis. Yu et al [30] also called attention to the possibility of combining p16 INK4A with HPV L1 for prediction of progression of cervical lesions.…”

Section: Markers Tested In Series and Combinationmentioning

confidence: 99%

Immunomarkers in Gynecologic Cytology: The Search for the Ideal ‘Biomolecular Papanicolaou Test’

Pinto¹,

Degen

Villa

et al. 2012

Harnessing the knowledge we have gained on the cell cycle disruption caused by human papillomaviruses (HPV) will likely lead to improved screening modalities for cervical cancer and its precursors. An easily applied biomarker that has high specificity and sensitivity would represent an attractive alternative or complement to cytology and HPV testing. To date, a number of promising markers have been investigated. These include p16^INK4A, MIB-1, BD-ProEx C, and L1. Newer possibilities involve a variety of gene products associated with aberrations of chromosome 3q, such as telomerase, p63, and PIK3CA, as well the combination of biomarkers such as p16^INK4A and MIB-1 in the same assay. Although none of them has yet been incorporated into screening algorithms or found its way into routine practice, their performance characteristics remain a focus of current investigations. This review summarizes what we know and where we hope to go in translating basic pathobiology into clinical practice.