Cytomorphologic and cytochemical analysis in the different diagnosis of cervical epithelial lesions
There is an increasing tendency to eradicate all cytologically diagnosed cervical epithelial lesions. A considerable number of the milder atypias are, however, known to originate from benign reactive cell populations. In nine women with initial mild or moderate dysplasia who had been followed by cytologic controls for 5 to 15 years, DNA analysis was retrospectively performed in characteristic smears from the follow-up. Progression to carcinoma in situ in six patients was invariably accompanied by a sequence of increasing DNA pattern deviations. In three patients with cervicitis as the final diagnosis, DNA patterns were constantly within normal limits. Although DNA analysis cannot conclusively determine whether a cell population is truly neoplastic, the method can establish the DNA pattern in a cell population as within normal limits or as clearly deviating from normal. A combination of cytomorphologic and cytophotometric diagnostic methods is suggested as a means to improve the differential diagnosis in cervical lesions between cell populations representing true dysplasias, i.e., premalignant lesions, and those resulting from reactive lesions and thus to avoid unnecessary overtreatment of nonneoplastic cervical abnormalities.
Available from: Ingemar Näslund
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ABSTRACT: The efficacy of a new sampling technique performed for early detection of cervical carcinoma is compared with Pap smears with the swab-and-wooden spatula technique in 312 women. In this new method, sampling of cytologic material is achieved by using a pulse wash instrument described in a previous article. Cells are rinsed and detached by liquid jets of 0.2 mm in diameter which are produced by a spray nozzle connected with a pressure hose to a high pressure pump. The liquid molecules pass through the spray nozzle at a speed of 20 m/s thus creating a successful rinsing effect on cervical epithelium due to high kinetic energy. Rinsed cells are mixed with the small amount of the flushing liquid. The suspension of cells and liquid accumulated in the speculum is then transported to a small container by a suction pump. The results of this work suggest that the pulse wash technique gives a more representative cell sample than the Pap smear sampling technique, thus offering a simple method to decrease false negative diagnoses in the detection of carcinoma of the uterine cervix. Samples by the new technique give an abundance of cells for slide preparation for cytodiagnostic techniques as well as for additional cytochemical, immunocytochemical and microbiologic diagnostic techniques.
Acta radiologica. Oncology 01/1986; 25(2):131-6. DOI:10.3109/02841868609136391
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ABSTRACT: This study presents the results of cytophotometric (CPM) and flow cytometric (FCM) DNA ploidy measurements in cervical intraepithelial neoplasias grade III (CIN III) with and without synchronous invasive squamous cell carcinoma. Hysterectomy and biopsy material from 21 patients 35 years of age or younger and from 18 patients age 50 years or older was studied. The DNA analysis was performed in nuclei isolated from specific areas of paraffin-embedded tissue. There were significant differences in the distribution of DNA patterns between the two age groups. About 80% of CIN III lesions in women 50 years of age or older, with or without a coexisting invasive cancer were aneuploid. In the group of younger women a diploid DNA pattern was found in about 60% of CIN III with concomitant invasive cancer. In the absence of an invasive cancer, CIN III lesions were mostly polyploid. The DNA pattern of invasive cancers was generally identical with the adjacent CIN, thus suggesting that the two lesions were related. Although the prognostic value of DNA ploidy measurements in cervical intraepithelial lesions in women in these two age groups has to be further evaluated, these results are at considerable variance with previously published data on DNA values in CIN and invasive carcinoma. In four CIN III lesions without invasive cancer, in women of the group of 35 years of age or younger, human papilloma virus common antigen could be demonstrated by immunochemical procedure. In three of these cases a polyploid DNA pattern was present; the fourth case showed a bimodal aneuploid pattern.
Cancer 01/1989; 62(12):2537-45. DOI:10.1002/1097-0142(19881215)62:12<2537::AID-CNCR2820621215>3.0.CO;2-W · 4.89 Impact Factor
Available from: informahealthcare.com
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ABSTRACT: Nuclear DNA content was determined by microphotometry in 27 cases of moderate dysplasia of the uterine cervix. All these cases were followed from one to ten years to study the biological behavior of moderate dysplasia in relation to cervical carcinogenesis. Ten of them showed progression to carcinoma in situ during a period of one to six years (median 34.8 months) and 17 cases showed regression to inflammation and normalcy during a period of one to ten years (median 44.2 months). DNA analysis was performed both on initial cervical smear and on representative smears collected during follow-up. Amongst ten cases which progressed to malignancy, nine had aneuploid DNA pattern and one had polyploid DNA pattern throughout the follow-up period. Amongst 17 cases which regressed to inflammation, 11 had euploid and six polyploid DNA pattern. The observation that moderate dysplasia with aneuploid DNA value often develops into carcinoma in situ in contrast to dysplasia with euploid or polyploid DNA value strengthens the conception that DNA aneuploidy may be considered as 'high risk indicator' for cervical precancerous lesions.
Acta Oncologica 02/1990; 29(6):755-9. DOI:10.3109/02841869009092995 · 3.00 Impact Factor
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