Biomedical subjects

M Fortier

Publications and source records attributed to M Fortier.

39 records · Page 3Linked to original sources

PubMedDate not supplied

Cytologic predictors of cervical intraepithelial neoplasia in women with an ASCUS Pap smear.

OBJECTIVE: To identify cytologic parameters on Pap smears of women with an atypical squamous cells of undetermined significance (ASCUS) diagnosis that could help cytologists to indicate whether a particular ASCUS case is most likely related to cervical intraepithelial neoplasia (CIN) grade 1 or 2/3. STUDY DESIGN: A total of 360 eligible women diagnosed with ASCUS and referred to the colposcopy clinic of Saint-Sacrement Hospital participated in the study. Eligible women were those aged 18-50 years, newly diagnosed with ASCUS, with no history of cervical biopsies or treatment, and not pregnant at the time of the visit. Colposcopically directed biopsies of lesions were obtained. All Pap smears were reviewed according to 36 different cytomorphologic criteria. The regression logistic model was used to estimate the odds ratios (ORs) for the associations between cytologic criteria observed in smears and the diagnosis of CIN made on biopsies. All cytologic criteria significantly (P < .05) associated with CIN were entered in the models, and a backward selection was done to determine independent cytologic predictors of CIN 1 and 2/3. RESULTS: Biopsies revealed that 22.2% of the study population had concurrent CIN. CIN I and 2/3 were identified in 61 (16.9%) and 19 women (5.3%), respectively. Clear perinuclear spaces (OR = 2.5, P = .002) and moderate nuclear atypia (OR = 4.4, P = .02) were two cytologic criteria independently associated with CIN 1. Four independent predictors of CIN 2/3 were identified: the presence of clear perinuclear spaces (OR = 5.9, P = .004), hyperchromasia (OR = 3.9, P = .04), moderate anisokaryosis (OR = 13.1, P = .01 and increased nuclear volume of metaplastic cells (OR = 5.1, P = .007). CONCLUSION: These observations may help cytologists to better categorize ASCUS lesions as intraepithelial ones and will also contribute to improving the Bethesda definition of ASCUS. Further studies are planned to validate these observations.

Adolescent↗

PubMedDate not supplied

Human papillomavirus infection of the cervix: the atypical condyloma.

We report on 162 cases of human papillomavirus (HPV) infection of the cervix seen in a two-year period in which the cell sample showed such marked atypia that errors of interpretation could easily have been made. These atypical condylomata are difficult to diagnose cytologically as well as histologically because they mimic dysplasia or carcinoma in situ and, on smears, even invasive squamous carcinoma. HPV particles associated with fibrillar material were found within nuclei of these lesions; their nature was further proved by the immunoperoxidase test. This new form of HPV infection of the cervix showed a 9.1% rate of progression to more advanced cervical lesions. The cytologic finding of atypical condylomata is an indication for colposcopy, confirmative biopsy and appropriate treatment.

Adult↗

PubMedDate not supplied

Origin of the koilocyte in condylomata of the human cervix: ultrastructural study.

Twelve biopsies from condylomatous lesions of the human cervix were examined by transmission electron microscopy in order to study koilocytotic cells. The ultrastructure of koilocytes, revealed mainly cytoplasmic changes in the perinuclear area. These changes first appeared in cells of the intermediate layers and extended to the surface of the epithelium. The cells involved showed small perinuclear areas, with a fine granular material, which appeared as a lysis of the cytoplasmic matrix, forming microvacuolelike structures that gradually enlarged and fused together, ending with the formation of a large clear zone (koliocytosis). Binucleation and polylobulation were constant features. Intranuclear virus particles were often associated with koilocytes. Tubules and large bundles or single filamentous structures were also observed in koilocytes detected in smears and biopsies. This study provides further evidence that the koilocytes is the result of a process characterized by cellular changes due to cytopathogenic effect of the human papillomavirus.

Cell Nucleus↗