[Problems with the ASCUS (atypical squamous cells of undetermined significance) in the Bethesda system].
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Biomedical subjects
Publications and source records attributed to O Nyklícek.
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The quality of cytodiagnosis depends on a number of operations. It is associated with collection of cellular material, it depends on its processing in the laboratory and on the evaluation of the processed preparation by the cytologist who establishes the diagnosis. In collaboration with three laboratories we tried to evaluate the role of the used nomenclature in the evaluation system. According to the abbreviated classification of Papanicolau 8185 cytological preparations were evaluated which comprised 206 suspect smears, i.e. 2.5%. According to the Munich nomenclature II 22 212 cytologies were evaluated. They comprised 155 suspect ones, i.e. 0.69%. Of 50 540 screening smears evaluated by the Bethesda system, 0.4% were suspect in the category HGSIL. The best results (i.e. agreement with the histological picture, the lowest false positivity and false negativity) was found in the evaluation of cytological smears according to the Bethesda nomenclature (TBS). It will be therefore most probably the best basis for so-called "Quality Assurance".
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The nature of adherent cells obtained from the surface of intrauterine contraceptive devices (IUD) was investigated by immunofluorescence using antibodies directed against tumor necrosis factor alpha (TNF), leukocyte differentiation antigens, immunoglobulin isotypes and J chain. Macrophages/monocytes, lymphocytes and neutrophils were found in all fifty samples. Macrophages were characterized by CD14, CD15 and CD71 positivity, DAKO macrophage antibody and HLA-DR, CD11c and CD45 expression. B cells contained secretory IgA with J chain or IgG and some cells expressed surface IgM. Neither IgD nor IgE were found. T-antigens CD3, CD4 and CD5 were not detected, the CD8 was faintly expressed. The CD56 molecule identifying NK cells was found on small lymphocytes. Cytoplasmic C3 protein was detected in neutrophils. Tumor necrosis factor alpha (TNF) was visualized in 14.3 +/- 8.8% of nucleated IUD cells. This cytokine was localized in the cytoplasm of the macrophages and the lymphocytes.
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Leukocyte membrane markers have been examined within cryostat sections and cell suspensions of human fetuses aged between 4 and 18 weeks of gestation using a panel of monoclonal antibodies. The HLA-DR molecule was present on a population of erythroid cells and macrophages in liver sinuses at 34 days and periarteriolar splenic macrophages at 60 days of gestation. CD5, CD15 and CD45 antigens were detected at 6 weeks of gestation, whereas CD4, CD8, CD10, CD11c, CD14 and IgM were not expressed at this stage. These findings and ultrastructural examination of embryonic liver confirm early differentiation of macrophages in the pre-lymphatic developmental period.
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Cells isolated on the surface of just removed IUD "DANA" were characterized by means of monoclonal antibodies and the avidin-biotin method. Activated macrophages with the membrane sign CD 14 and transferrin receptors (25-72%) and B lymphocytes producing IgA and IgG (14-56%) contained strong transplantation antigens class II. By these glycoproteins macrophages and B cells are able to differentiate alie and thus also paternal antigens. The presence of these cells in the uterus may be the stimulus for triggering an aggressive cytotoxic reaction against the blastocyst and explains the contraceptive action of intrauterine devices.
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The use of marked transparent polyester film as a support of cell monolayer, smears or sections (cryostat or paraffin), makes possible to examine the same cell preselected in the light microscope by electron microscope (EM). Consequently, this technique enables to use histological or immunohistological investigations (using immunofluorescence or peroxidase (Px) labelling) by light microscopy before examination in EM. As example we used herpes simplex virus (HSV) type 1-infected cells grown on the above mentioned polyester film. Visualization of the antigen with hyperimmune serum and Px-labelled antiserum was followed by examination of selected cells in EM, where viral particles were clearly visible.
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