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.
- [Show abstract] [Hide abstract] 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.0Comments 5Citations
- [Show abstract] [Hide abstract] 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.0Comments 40Citations
- [Show abstract] [Hide abstract] ABSTRACT: Basic differences and similarities of flow and static cytophotometric instruments are viewed with regard to technical peculiarities and applicability in the fields of biology and tumor pathology. In flow systems, precision of the information concerning quantities of constituents is high, whereas precision of information concerning morphologic parameters is low. In static systems, morphologic identification by a trained operator can be used advantageously to classify any given cell interactively, thus replacing a large number of flow parameters. This is why the vast majority of automated static machines used in pathology are still more or less semiautomatic or interactive. Carefully performed specimen-adapted cell preparation procedures in which each step is strictly supervised, highly standardized staining methods, and internal controls are prerequisites in order to obtain reliable cytochemical results. In a number of human tumors with well-controlled cytopathologic and/or histopathologic and clinical data, quantitative cytochemical analysis has been demonstrated to provide diagnostic and prognostic information complementary to that obtained by conventional clinical and morphologic methods.0Comments 87Citations
- [Show abstract] [Hide abstract] 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.0Comments 7Citations
- [Show abstract] [Hide abstract] ABSTRACT: This prospective study investigated whether mild maternal stress during pregnancy could influence performance on a variety of developmental measures in rhesus monkey infants (Macaca mulatta). Twenty-four infants were tested during the first month of life for interactive, neuromotor, and temperamental characteristics and capabilities using instruments adapted directly from human neonatal assessments. Twelve infants were derived from mothers exposed during pregnancy to a mild stressor in the form of a daily 10-min removal from home cage and exposure to three unpredictable noise stimuli. Twelve infants were derived from mothers undisturbed during pregnancy. Prenatally stressed infants had lower birthweights, were delayed in self-feeding, were more distractible, and had lower scores on a Motor Maturity composite score when compared to offspring from undisturbed pregnancies. Close inspection of the Motor Maturity score revealed that low muscle tonus, poor coordination, and slow response speed characterized the prenatally stressed offspring.0Comments 83Citations
- [Show abstract] [Hide abstract] ABSTRACT: DNA cytometry—both flow cytometry (FCM) and image cytometry (ICM)—has become an established technique in the field of analytical cellular pathology. These techniques are mainly used to obtain information about the nuclear DNA content of neoplastic parenchymal cells in human malignant tumors. The DNA ploidy pattern and the S-phase fraction offer tumor cell biological data that are supplementary to the often purely descriptive cytodiagnostic and histopathologic techniques. Diverging results among different laboratories have limited the value of DNA cytometry as a supplementary prognosticating tool, and this is the main reason why only a few clinical oncologic trials have the DNA data included in their protocols. The differences of the results seem to depend mainly on the methodological procedures used. In an effort to evaluate and to minimize sources of errors, particularly those originating from technical steps, the results of concomitant FCM and ICM DNA assessments on a large series of normal human cells and of cells of a broad spectrum of malignant tumors have been used to analyze each of the methodological steps in detail. Based on these observations, standardized procedures for sampling, fixation, staining and measurement were developed, as well as for data storage and evaluation of the ICM DNA histograms, together with guidelines for quality assurance.0Comments 1Citation