ISSN:0956-5507    

DOI:10.1046/j.1365-2303.1995.40882408.x

出版商:Blackwell Science    

年代:1995

数据来源: WILEY

ISSN:0956-5507    

DOI:10.1046/j.1365-2303.1996.40982409.x

出版商:Blackwell Science    

年代:1996

数据来源: WILEY

摘要:

In this retrospective review we assessed the frequency with which atypical glandular cells in cervical smears predict cervical glandular lesions. Asymptomatic patients (n=34) with one or more smears showing atypical glandular cells and subsequent histopathological assessment were studied. Independent cytological and histological review was undertaken. Cytological review confirmed atypical glandular cells in 29 cases, 17 of which had coexisting squamous dyskaryosis. Histological review of these 29 cases revealed glandular neoplasia in 13 (45%) and microglandular hyperplasia (MEH) in an additional four (14%). Initial reporting had underestimated the prevalence of glandular neoplasia.

ISSN:0956-5507    

DOI:10.1046/j.1365-2303.1996.37382373.x

出版商:Blackwell Science    

年代:1996

数据来源: WILEY

摘要:

Two years after introducing mandatory review of cases in which the cervical smear was discrepant with subsequent colposcopic or histological finding, the predictive accuracy of a first abnormal smear and the need for treatment were analysed. The results were compared with performance figures prior to this form of audit policy. Over 12 months 415 women referred for colposcopy were studied. Three per cent of patients with a single borderline smear and 6% with mild dyskaryosis had cervical intraepithelial neoplasia grade III (CINIII) revealed in histopathological examinations after colposcopy. Only 25% with a borderline smear and 33% with mild dyskaryosis required treatment. Of women with moderate dyskaryosis, 18% had a biopsy showing CINIII and 46% were treated. Of women with severe dyskaryosis in their cervical smear, 61% were shown to have CINIII or invasive cancer on biopsy and 90% were treated. Regular audit improved cytological prediction of grade of epithelial abnormality found on biopsy, allowing accurate, safe surveillance for minor smear abnormalities.

ISSN:0956-5507    

DOI:10.1046/j.1365-2303.1996.37582375.x

出版商:Blackwell Science    

年代:1996

数据来源: WILEY

摘要:

The results of an internal quality assurance exercise in one cervical cytology laboratory in England are presented, using differing types of partial percentage re‐screening of cervical smears. An overall false‐negative dyskaryotic rate of up to 4.3% was demonstrated, with the final cytology report diagnosis differing from the primary screening diagnosis in 1.3% of cases. These findings are discussed, with the aim of helping to foster debate on the setting of national laboratory internal quality assurance standa

ISSN:0956-5507    

DOI:10.1046/j.1365-2303.1996.37682376.x

出版商:Blackwell Science    

年代:1996

数据来源: WILEY

摘要:

The management of women with mild dyskaryosis continues to be the subject of debate. The management of cases with such smears could be improved if additional morphological features were found to be indicative of low/high grade cervical intraepithelial neoplasia (CIN). Our own experience in the routine audit of the diagnostic accuracy of cervical smears had suggested that cases of dyskaryosis with koilocytosis were associated with a low risk of CINIII. Two hundred and forty‐four cervical smears reported as showing evidence of wart virus infection were reviewed and their subsequent histories noted. Of these smears, 173 demonstrated clear evidence of koilocytosis. Irrespective of the initial grade of dyskaryosis, only 28 cases (16.2%) had underlying CIN or had progressed to CIN over a minimum follow‐up period of 21 months. Only two cases (1.2%) showed evidence of CINIII. Koilocytosis is associated with a low risk of CIN and an especially low risk of CINIII. The management of women with koilocytic smears should be modified accordin

ISSN:0956-5507    

DOI:10.1046/j.1365-2303.1996.37282372.x

出版商:Blackwell Science    

年代:1996

数据来源: WILEY

摘要:

A retrospective study of oesophageal cytopathology at the Hospital de Clínicas de Porto Alegre (HCPA), RS, Brazil, from 1989 to 1992 was made to assess the sensitivity, specificity, predictive values and accuracy of endoscopic cytology and biopsy; and study the correlation between cytopathological and histopathological diagnosis. Specimens from 94 patients were available for review. The final diagnosis was based on surgical pathology and follow up. The 81 patients with cancer of the oesophagus had the following sex distribution: 64 males and 17 females (a 3.7–1 ratio). No tumour was found in 13 patients. The following conclusions were made: (i) there is excellent correlation between cytology and histology in oesophageal lesions sampled by endoscopy; (ii) a correct positive cytologic report was obtained in 77 (95%) of the 81 proven oesophageal cancers; a false‐negative or unsatisfactory result was given in four patients. A false‐positive diagnosis of cancer was not made. There were 13 true‐negative reports. These findings result in a sensitivity of 95% with 95% confidence intervals (CI) of 90.26–99.74%; a specificity of 100% (CI of 98.5–100%); a positive predictive value of 100% (CI of 99.3–100%); a negative predictive value of 76% (CI of 55.7–96.3%); (iii) a correct positive histological report was obtained in 67 (83%) of the 81 proven oesophageal cancers; a false‐negative or unsatisfactory result was given in 14 patients. A false‐positive diagnosis of cancer was not made. There were 13 true‐negative reports. These findings result in a sensitivity of 83% with 95% CI of 74.82–91.18%; a specificity of 100% (CI of 98.5–100%); a positive predictive value of 100% (CI of 99.25–100%); a negative predictive value of 48% (CI of 29.16–64.84%); (iv) of 81 patients with proven cancer, in 79 (98%) at least one of the methods was positive. In only two patients with cancer were both methods negative. These findings result in a combined sensitivity of 98% (CI of 94.92–100%); a specificity of 100% (CI of 98.5–100%); a positive predictive value of 100% (CI of 99.31–100%); and a negative predictive value of 87% (CI of 70–100%). Our series confirms the value of the combined use of cytology and biopsy for the investigation of oesophageal lesions. However, it should be remembered that even with the combined use of cytology and biopsy there are some tumours that will be negative by both procedures: we had only two such cases,

ISSN:0956-5507    

DOI:10.1046/j.1365-2303.1996.36882368.x

出版商:Blackwell Science    

年代:1996

数据来源: WILEY

ISSN:0956-5507    

DOI:10.1046/j.1365-2303.1996.36082360.x

出版商:Blackwell Science    

年代:1996

数据来源: WILEY

ISSN:0956-5507    

DOI:10.1046/j.1365-2303.1996.35382353.x

出版商:Blackwell Science    

年代:1996

数据来源: WILEY

ISSN:0956-5507    

DOI:10.1046/j.1365-2303.1996.35782357.x

出版商:Blackwell Science    

年代:1996

数据来源: WILEY