Biomedical subjects

Christine Bergeron

Publications and source records attributed to Christine Bergeron.

7 recordsLinked to original sources

PubMed2007

Triage of women with ASCUS and LSIL cytology: use of qualitative assessment of p16INK4a positive cells to identify patients with high-grade cervical intraepithelial neoplasia.

BACKGROUND: The identification of a small percentage of high-grade cervical intraepithelial neoplasias (HGCIN) among patients with minor cytological abnormalities (atypical squamous cells of undetermined significance [ASCUS] and/or low-grade squamous intraepithelial lesions [LSIL] group) is a major problem in cytology-based cervical cancer screening. The authors investigated the efficacy of p16INK4a as a biomarker to identify samples of patients with HGCIN among those with an ASCUS or LSIL result in Papanicolaou cytology. METHODS: Consecutive liquid-based cytology specimens of 137 ASCUS and 88 LSIL results were selected from gynecologists who adopted a triage regimen with biopsy under colposcopy 2 months later, independent of the p16INK4a result. p16INK4a stained slides were prepared and independently read by 2 observers, who used a recently described score to categorize p16INK4a stained squamous cells. The endpoint of the study was detection of a biopsy-confirmed HGCIN. RESULTS: The overall sensitivity and specificity of p16INK4a positive cells with a nuclear score >2 for diagnosis of HGCIN in ASCUS and LSIL cases combined was 96% and 83%, respectively. The sensitivity and specificity in the ASCUS group was 95% and 84%, and 100% and 81% in the LSIL group, respectively. Two observers had a high concordance in assessing p16INK4a stained cells (kappa value of 0.841). CONCLUSIONS: These data suggested that the use of p16INK4a as a biomarker combined with nuclear scoring of p16INK4a positive cells in cervical cytology to triage ASCUS and/or LSIL cases allows identification of HGCIN with good sensitivity and specificity.

Adolescent↗

PubMed2006

Pathology and physiopathology of adenomyosis.

Adenomyosis is defined by the presence of endometrial mucosa within the myometrium. This probably occurs by invagination of the basalis endometrium into the myometrium. The process of invagination and intramyometrial spreading may be facilitated by the non-cyclic, anti-apoptotic activity of the basalis associated with relative hyper-oestrogenic states. Most cases of adenomyosis are discovered in multiparous women during the 'transitional' years (40-50 years), and the condition is associated with menorrhagia, dysmenorrhoea, endometrial polyps and leiomyomata uteri. Endometrioid adenocarcinoma is often associated with adenomyosis, is frequently of early stage and low histological grade, is hormone-sensitive, and has an excellent prognosis. Extension of malignant growth into foci of adenomyosis has no adverse effect on prognosis. Definite diagnosis and treatment of adenomyosis are obtained by hysterectomy. Although adenomyotic endometrial glands are hormone-sensitive, exogenous progestogenic agents are ineffective for the treatment of adenomyosis. Anti-oestrogenic danazol and gonadotrophin-releasing hormone (GnRH) analogues induce suppression of adenomyosis, but their use must be of short duration. Surgical extirpation, therefore, is the best therapeutic option.

Adult↗

PubMed2005

Evaluation of a nuclear score for p16INK4a-stained cervical squamous cells in liquid-based cytology samples.

BACKGROUND: The p16INK4a gene product is overexpressed strongly in abnormal cervical epithelia and may serve as a valuable biomarker to identify abnormal cells in cervical smears or liquid-based cytology samples. METHODS: The authors performed p16INK4a immunocytochemistry to locate cells that expressed p16INK4a in liquid-based cytology samples and used a nuclear scoring system based on several morphologic criteria to interpret the degree of abnormality of these cells. RESULTS: Among 108 samples that were scored as normal in Papanicolaou-stained, parallel slides, any p16INK4a-positive cells were observed in 13 samples (12%), but only 1 of 108 samples (1%) was scored abnormal after applying nuclear scoring criteria. In the group of 52 low-grade squamous intraepithelial lesion (LSIL) samples, 19 samples (37%) were positive for any p16INK4a reactivity, but only 5 of those samples (10%) were scored abnormal after applying the nuclear score. Among the 50 high-grade squamous intraepithelial lesion (HSIL) samples, 49 samples (98%) were positive for p16INK4a and were scored as abnormal. Comparison of the scoring results of independent observers revealed good reproducibility of the nuclear score. CONCLUSIONS: The current results suggested that p16INK4a enables the location of potentially abnormal cells on liquid-based cytology samples. The nuclear score facilitated interpretation of the degree of abnormality of p16INK4a-stained cells. Thus, locating potentially abnormal cells by p16INK4a immunocytochemistry and their interpretation based on the nuclear score described here may help to identify patients with HSIL in cytologic screening programs and may represent a new approach for reducing the number of equivocal or misinterpreted cytologic specimens.

Adolescent↗

PubMed2004

[Penile intraepithelial neoplasia].

The increasing incidence of anogenital carcinoma in situ in young adults over the last twenty years is correlated with certain sexually transmissible diseases. This increased incidence of genital lesions requires a review of the clinicopathological classification of penile intraepithelial neoplasia (PIN) to help the clinician differentiate the aetiology in order to propose the least mutilating treatment. Bowen-like or human papillomavirus (HPV)-induced PIN in young men present different clinical features and a different natural history from those of high-grade PIN of elderly men. This distinction between the clinical features and the period of development of the lesions according to their histology, differentiated, undifferentiated or borderline, allows evaluation of the risk of progression of the intraepithelial neoplasia. Lesions corresponding to oncogenic HPV infection, often involving all of the anogenital region, require clinical surveillance to avoid possible carcinomatous transformation. Most importantly, the detection and treatment of these lesions participate in the prevention of cervical cancer.

Carcinoma in Situ↗

PubMed2003

The 2001 Bethesda system.

The Bethesda system is a system of terminology for reporting the results of cervical cytology. It was developed in 1988, and is now widely used in the United States. This system was updated in April 2001. The most important modifications are the following: a) elimination of the category "satisfactory but limited by", b) the reintegration of benign modifications in the normal category, c) "atypical squamous cells of undetermined significance" is now named "atypical squamous cells" and subdivided into "atypical squamous cells of undetermined significance" and "cannot exclude high grade squamous intraepithelial lesion"; and d) endocervical adenocarcinoma in situ which is now a separate entity. Low grade squamous intraepithelial lesions and high grade squamous intraepithelial cells remain unchanged. Recommendations have been proposed concerning automated review and ancillary testing. This paper is available too at: http://www.insp.mx/salud/index.html.

Female↗

PubMedDate not supplied

Human papillomavirus testing with a liquid-based system: feasibility and comparison with reference diagnoses.

OBJECTIVE: To validate the utilization of cervical specimens collected in the fixative liquid used in the CYTO-screen System (SEROA, Monaco) for oncogenic human papillomavirus (HPV) DNA detection by the Hybrid Capture II technique (HCII) (Digene, Gaithersburg, Maryland, U.S.A) by reference to cytologic and/or histologic results. STUDY DESIGN: A technical feasibility study was conducted on 3 modalities of sample preparation before HCII technique, 1 with a proteinase digestion, I with PBS washing and I using the Digene sample conversion kit recommended for ThinPrep medium preparation (Cytyc Corp., Boxborough, Massachusetts, U.S.A.). The stability of cells after storage at days 28, 60 and 90 was tested on 26 positive samples (13 with high initial indices and 13 with low initial indices). Results of HPV testing were compared to cytologic and histologic results on a sample of 98 smears already identified as high grade squamous intraepithelial lesion (HSIL) (48) or low grade squamous intraepithelial lesion (LSIL) (50). A retrospective analysis was then performed on 995 HPV tests perfornmed routinely in 2003 in terms of comparison with the corresponding cytologic and/or histologic results. RESULTS: The HCII technique after direct treatment by proteinase K appeared to be as effective as the Digene sample conversion kit. By using the first technique, all 26 positive cases remained positive at 60 days, but 4 of 13 (30%) with low indices became negative at 90 days. The sensitivity of HPV testing for detecting biopsy- proven cervical intraepithelial neoplasia (CIN) 2 or worse was 100% in the 50 LSIL and 98% in the 48 HSIL samples. In the retrospective study (n = 995), the cytologic diagnoses of atypical squamous cells of undetermined significance (ASC-US) (n=278), LSIL (n = 137) and HSIL (n = 28) were associated with a positive HPVtest in 44%, 75% and 96% of cases, respectively. On a subsample of 156 patients among 278 with a diagnosis of ASC- US, the sensitivity of HPV testingfor detecting CIN 2 or worse was 88%, specificity 57%, positive predictive value 10% and negative predictive value 99%. Performing HPV testing by the HCII technique for cervical specimens collected in the fixative liquid used in the CYTO-screen System is feasible in the context of an ASC-US cytologic diagnosis.

Adolescent↗

PubMedDate not supplied

Performance of a new, liquid-based cervical screening technique in the clinical setting of a large French laboratory.

OBJECTIVE: To compare the performance of liquid-based cytology with the CYTO-screen System (SEROA) with that of conventional smears through a secondary analysis of a large database covering the activity of an independent French laboratory during the period 1998-2002. STUDY DESIGN: The study was performed with a retrospective, comparative, historical design on 2 subgroups of women having been screened by gynecologists who switched from conventional smears to the CYTO-screen System in the period 1998-2002. The first cohort population consisted of women who had at least 4 subsequent screening tests over the period with half conventional and half with the CYTO-screen System. A control group consisted of smears collected by gynecologists who fully maintained activity with a conventional method over the same period. The second group consisted of women who had their first screening test performed over the study period by gynecologists who modified their technique. Specimen adequacy, endocervical cell content and epithelial cell abnormality detection rates were compared between the groups. RESULTS: As compared with the conventional smear, the CYTO-screen System showed a reduction in unsatisfactory reports, especially in the second group of first-screened (0.14% versus 1.3%, P < .0001). The rate of atypical squamous cells of undetermined significance increased significantly after the switch to the CYTO-screen System (2.5% versus 1.3%, P = .004) and in the second group of first-screened women (2.05% versus 1.4%, P = .0014), with higher histologic confirmation in both situations. There was a non-significant increase in the detection rates of low and high grade squamous intraepithelial lesions after the switch to the CYTO-screen System and in the second group of first-screened women. CONCLUSION: The CYTO-screen System gives higher-quality specimens and has a higher detection rate for squamous intraepithelial lesions, but that rate was significant only for atypical squamous cells of undetermined significance.

Case-Control Studies↗