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A J van Aspert-van Erp

Publications and source records attributed to A J van Aspert-van Erp.

7 recordsLinked to original sources
PubMedDate not supplied

Identifying cytologic characteristics and grading endocervical columnar cell abnormalities. A study aided by high-definition television.

OBJECTIVE: To test the ability of cytotechnologists to recognize and accurately interpret selected architectural, cellular and nuclear features presented on a high-definition television (HDTV) and to make a reliable diagnosis with HDTV. STUDY DESIGN: A total of 1,122 features considered diagnostic of different endocervical columnar cell abnormalities were selected from 50 smears from 48 women with the help of a motor-driven-stage microscope by five observers who had knowledge of the final diagnosis. The selected and stored features were presented on an HDTV and evaluated in five successive sessions without knowledge of the final diagnosis. RESULTS: Specific types of features were correctly identified in a high number of cases. Considerable interobserver variability was demonstrated in the scoring of grades of expression of features. Overrated and under-rated monitor diagnoses were related to overvalued and undervalued features. From a group of 437 images that were correctly diagnosed by four or five observers, five features proved to be highly related to the correct diagnosis. CONCLUSION: Observers were capable of making a reliable diagnosis on features, selected by other observers, when presented on an HDTV. An overall correct diagnosis was made in 93% of cases.

Adenocarcinoma↗
PubMedDate not supplied

CytosafePLUS. A workstation for screening, supervision, reviewing, quality assurance and education in cytopathology.

In pathology, the subjective cytologic and histologic diagnosis suffers from large observer variability. Effective methods of reducing the effects of this observer variability in cytologic diagnosis are close supervision of the diagnostic process and multiple screening by different observers of cases that have a higher risk of abnormalities as well as closely supervised follow-up procedures for early lesions. Accurate supervision of screening completeness has become possible with the development of computer programs and microscope instrumentation to register the path of the objective over the slide and therefore the fields that have been inspected by the screener (Axio-Home, Carl Zeiss, Oberkochen, Germany; Navigator, Becton Dickinson Cellular Imaging Systems, Leiden, the Netherlands). Based on these technologies, all objects of interest on the microscope slide are marked electronically, and the X,Y coordinates of these marks are stored in the computer. With these coordinates, a motor-driven microscope stage can be redirected to the selected objects, enabling the observer to quickly review the objects. The reviewer can thus reinspect cells or groups of cells, previously identified, in a much more accurate way than is presently possible, by marking objects of interest with ink dots. To these marked objects, specific diagnoses can be attached, as can comments or questions, which are also stored in the computer and are made part of the cytology report. After analysis, all marked objects can be relocated automatically with the help of the computer-directed microscope stage. Using this concept, a subsequent observer or a supervisor can easily and effectively reply to the remarks attached to these objects. It is also possible to reedit the comments made or to attach answers to specific questions. In an interobserver study, encompassing 50 cases of columnar cell abnormalities screened by five observers using the Navigator microscope stage and software, it proved possible to reduce reviewing time significantly. On the basis of marked cytologic characteristics discriminating cellular features in the diagnosis, endocervical columnar abnormalities could be identified. The coordinates of the objects of interest are made part of the laboratory record of the cytology findings (Cytosafe, Omnisys, Hoevelaken, the Netherlands). This development largely facilitates the review of previous findings when evaluating follow-up specimens. With the use of a Navigator motor-driven stage and CCD camera, microscope images can be made of the specimen under study. These images can be stored in the computer in a digitized format, labeled with their X,Y coordinates on the specimen. The CytosafePLUS workstation, encompassing the Navigator automated cell positioning system and CCD attachment, is a highly effective tool in cytologic screening, reviewing and reporting, in surveillance of follow-up, in intralaboratory and interlaboratory consultation, in cytology training, in proficiency testing and in quality assurance.

Female↗
PubMedDate not supplied

Endocervical columnar cell intraepithelial neoplasia. I. Discriminating cytomorphologic criteria.

OBJECTIVE: To identify specific cytomorphologic characteristics of mild, moderate and severe atypia of endocervical columnar cell lesions. STUDY DESIGN: The study group consisted of 55 smears from 53 women known to have columnar cell atypias of variable severity. The smears were reviewed by five observers in terms of 46 architectural, cellular and nuclear features. Review diagnoses were given together with the scoring for a large number of cellular characteristics. RESULTS: Nuclear chromatin distribution, variation in cellular and nuclear size, cytoplasmic eosinophilia and such architectural features as cell crowding, cluster formation, formation of gland-like structures and pseudostratification appeared to be of primary diagnostic importance for discriminating between no abnormalities, different grades of severity of endocervical intraepithelial neoplasia and adenocarcinoma. With acceptance of one grade of difference in grades of severity, a correct diagnosis was made in 87.6% of cases. CONCLUSION: With the application of specific architectural, cellular and nuclear features, the cytologic detection of different grades of endocervical intraepithelial neoplasia and of adenocarcinoma proved to be dependable and reproducible, with accuracy that at least equaled that of detecting squamous (metaplastic) lesions.

Adenocarcinoma↗
PubMedDate not supplied

Endocervical columnar cell intraepithelial neoplasia. II. Grades of expression of cytomorphologic criteria.

OBJECTIVE: To determine the relationship between the grade of expression of discriminating cytomorphologic architectural, cellular and nuclear features and the degree of endocervical columnar cell atypia. STUDY DESIGN: The study group consisted of 55 smears from 53 women known to have endocervical columnar cell atypias of variable severity. The smears were reviewed by five observers by means of 46 architectural, cellular and nuclear features. Seventeen of the 46 evaluated features were scored as revealing three grades of expression: slight, moderate and marked. RESULTS: Grades of expression of cellular and nuclear characteristics used in the evaluation of endocervical columnar cell abnormalities were identical to the characteristics used in the diagnosis of squamous (metaplastic) lesions. As such the features were extremely useful, with the exception of hyperchromasia, which was less prominently expressed. Furthermore, the results on architectural features revealed that the expression grades slight and moderate were indicative of mild and moderate endocervical columnar cell atypia, whereas the marked expression grade was strongly related to the severe intraepithelial lesions and adenocarcinoma. CONCLUSION: Characteristic cytomorphologic features at different grades of expression proved to be reliable light microscopic parameters in the diagnosis of different grades of endocervical columnar cell abnormalities. The accuracy of diagnosis at least equaled that of detecting squamous (metaplastic) lesions.

Adenocarcinoma↗