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At least 19 recordsLinked to original sources
PubMed1977

Papanicolaou testing and hysterectomy prevalence in low-income communities: a survey in Los Angeles County.

A survey of the prevalence of Papanicolaou (Pap) testing and of hysterectomy and a feasibility study were conducted in low-income communities with high rates of cervical cancer, identified by an analysis of mortality and case rates. Although about 90% of the women reported having had a Pap regular testing. For example, in the 5 years preceding the study (1971--75), about a quarter of the women had been tested only once and about a third not at all. No evidence of a secular change in hysterectomy prevalence in these communities was found.

Adult↗
PubMed1979

Cervical cytologic evaluation. And what to do when findings are abnormal.

Detection and treatment of cervical carcinoma in the preinvasive stage have increased substantially as a result of the widespread cytologic screening made possible by development of the Papanicolaou test. The numerical system of reporting has been abandoned, and reports are now descriptive and more specific than formerly. Outpatient evaluation of the patient with abnormal cytologic findings has been improved by the use of colposcopy and directed biopsies. Cold cone biopsy is used less frequently than in the past but still has specific indications. Therapy depends on histologic diagnosis and cannot be based on cytologic or colposcopic findings alone.

Adult↗
PubMedDate not supplied

Awareness and use of cervical cancer tests in a southern Appalachian community.

The knowledge and use of cervical cancer screening (Papanicolaou smear test) by female members of a prepaid health plan (Health Maintenance Organization--foundation-type) based in souther Appalachia were surveyed. Of the 105 members of the plan interviewed, 81 indicated that they had experienced one or more Papanicolaou tests. This percentage (77.1%) was greater than might have been expected on the basis of a review of previous research. Factors contributing to this higher percentage were the subjects' membership in the prepaid health care plan and the increasing tendency of physicians to perform cervical cancer screening tests on patients who visit them for reasons unrelated to cancer detection. The latter phenomenon, coupled with inadequate patient education at the time of the service, is viewed as a major cause of the discrepancy found between the women's Papanicolaou test experience and their Papanicolaou test awareness. Of the 81 women in the study reporting one or more previous cervical cancer screening tests, only 49 were able to identify a specific test for detecting cervical cancer. Most of the results of previous research concerning the relationship of Papanicolaou test experience to age, to education, to economic, employment, and marital status, or to number of children were supported by the current study. The results of this study, conducted in a relatively isolated American community, suggest that the nationwide cervical cancer educational efforts of a multitude of agencies and individuals have met with considerable success.

Adult↗
PubMedDate not supplied

Sensitivity and specificity of diagnostic tests for genital infection with herpesvirus hominis.

Three smear techniques for diagnosis of Herpesvirus hominis infection were evaluated by study of 168 unselected patients with genital lesions attending a venereal disease clinic. A tissue culture and results of three smear techniques were obtained for each patient in random order. H. hominis was recovered from 101 patients (60%). All three smear tests (immunofluorescence, Papanicolaou, and crystal violet) were highly specific, but the sensitivity of each was smaller than or equal to 40% among patients who had ulcerative lesions. Because H. hominis is a common cause of genital lesions and the clinical manifestations of disease are highly variable, future research must identify accurate diagnostic aids that are suitable for clinic use.

Blister↗
PubMed1977

"Pap" testing and hysterectomy prevalence: a survey of communities with high and low cervical cancer rates.

There is an inverse relation between cervical cancer rates and income in Los Angeles County communities, and there is a positive association between level of Papanicolaou (Pap) testing and income. Ethnic differences in cervical cancer rates and Pap testing are dependent on income. The relatively high rate of cervical cancer and low level of systematic screening in low income communities suggest that a community trial to assess the value of cytologic screening in reducing cervical cancer rates is feasible. Information on hysterectomy prevalence by type of procedure supports the idea that the long-observed decline in cervical cancer rates is in part attributable to a concomitant decrease in the ratio of subtotal to total hysterectomy.

Adult↗
PubMed2026

Assessment of atypical glandular cell interpretation in Pap tests using the Hologic Genius Digital Diagnostics System.

Atypical glandular cells (AGC) are a diagnostic challenge. The aim of this study was to evaluate the efficacy and diagnostic performance of AGC detection on the Hologic Genius Digital Diagnostics System (HGDDS). A retrospective analysis of 451 ThinPrep Pap cases was conducted, including 207 cases of AGC, 27 cases of high-grade squamous intraepithelial lesion (HSIL), 25 cases of low-grade squamous intraepithelial lesion (LSIL), and 192 benign cases. All AGC cases had follow-up histologic diagnoses, with 66 cases subsequently diagnosed as adenocarcinoma. The slides were randomized, scanned, and analyzed by the HGDDS. Patient age and HPV test results were provided to reviewers, an experienced cytologist, who screened the cases, followed by two cytopathologists who independently examined the cases on the HGDDS. Diagnostic concordance between the two cytopathologists indicated strong agreement (κ = 0.829). Sensitivity of AGC on Papanicolaou (Pap) tests for adenocarcinoma detection on HGDDS was 98.5% and 95.5%, respectively, comparable to the original ThinPrep interpretation (OTPI). Specificity for adenocarcinoma detection was significantly higher (84.6% and 85.6%) with the HGDDS than 27.7% with OTPI. Overall, the diagnostic performance for AGC/HSIL interpretation to detect CIN2/3/adenocarcinoma appeared to have improved with HGDDS compared with OTPI, particularly for specificity and positive predictive value (PPV). This is the first study evaluating AGC diagnosis using the HGDDS. The findings demonstrate that the sensitivity of adenocarcinoma detection as AGC on HGDDS is comparable to the ThinPrep Imaging System, but the specificity and PPV are improved. This suggests the potential of artificial intelligence to augment the performance of cervical cancer screening.

Humans↗
PubMed1977

[Epidemiology and diagnosis of vaginal discharge. First Report (author's transl)].

In 700 patients, 1336 tests of vaginal discharge were performed by culture, wet mount with the phase contrast microscope and the Papanicolaou stain. The diagnosis of yeast is best done by culture. Yeast was found only in 68% of the culture positive cases by the wet mount method and in 47% of the cases by the Papanicolaou stain. Wet mount and Papanicolaou stain results for yeast are therefore only useful if they are positive. In the diagnosis of trichomonas, culture and wet mount are of the same effeciency. The incidence of yeast and trichomonas was dependant upon the age of the patients. In pregnancy and in cases with diabetes, yeast was found more often but no increase of yeast was found in cases on oral contraception. The diagnosis of bacterial mixed infections poses the most difficult problem and can only be improved by expensive culture methods.

Candidiasis, Vulvovaginal↗
PubMed1979

[Use of phase-contrast and interference-contrast microscopy for immediate cytological tests in gynaecological practice (author's transl)].

Vital cytological tests of cervical smears obtained from 1,083 patients in a gynaecological practice are reported. The smears had been taken in search for malignant changes, in addition to the need for appraisals of ovarian function and vaginal flora. Smears which produced suspicious colposcopic and vital cytological findings were restained by means of Papanicolaou stain. The diagnoses based on both methods were compared. The results have confirmed the vital cytological technique to be extremely suitable for functional and flora diagnosis, while the Papanicolaou method was found to be superior to vital cytology in cancer screening.

Cytodiagnosis↗
PubMed1979

[Methodical investigations for quantitative image analysis on cells of the female genital tract (author's transl)].

An earlier published [8] image analysis system for cytology is tested on gynecological material. At first the question for the staining method which is optimal for scanning-photometrical measurements is investigated. In addition the wavelength of the light which reproduces best the nuclear structure must be found. Feulgen-stained preparations scanned at 570nm allow a more secure sorting of superficial cells against intermediary cells than those in the classical Papanicolaou-stain at white light. Discoloring of Papanicolaou-preparations and Feulgen staining afterwards was accomplished without technical problems and there were not detectable any qualitative differences with directly Feulgen-stained preparations by means of image analysis. With this method it is possible to recognize structural changes in nuclei of vaginal epithelium during cell differentation.

Cell Nucleus↗
PubMed1979

Flow cytometric prescreening of cervical smears.

One-parameter (nuclear DNA) and two-parameter (nuclear DNA and protein or cellular light scatter) measurements of cervical smears were performed using an ICP 11 and a cytofluorograf 4800 respectively. A total of about 1000 cases was analyzed. For the estimation of nuclear DNA alone two fluorochromes were tested (ethidium bromide (EB) and mithramycin (MMC)) combined with three different methods of cell preparation. For the two-parameter measurements cells were double stained with EB and fluorescein isothiocyanate (FITC). Red fluorescence (EB) versus green fluorescence (FITC) or red fluorescence versus scatter were recorded. A computer analysis of the one-parameter histograms was performed using discriminant analysis and the results were compared with the cytodiagnosis of microscopic specimens stained with the Papanicolaou technique. The error rates of the flow cytometric (FCM) data were as follows: (a) standard EB staining, 11% false negative, 26% false positive, 6% unsatisfactory results; (b) pepsination of vital cells and EB staining, 12% false negative, 14% false positive and 4% unsatisfactory results; (c) MMC staining, 10% false negative, 65% false positive and 5% unsatisfactory results. Our two-parameter measurements prove that, as confirmed by cell sorting, red fluorescence versus scatter allows separation of at least three subpopulations in most analyzed samples: (a) anucleated cells; (b) leukocytes; and (c) intermediate and superficial cells.

Cell Nucleus↗
PubMed1977

Carcinoma of the cervix: present status and future.

The incidence of invasive carcinoma of the cervix is decreasing in Puerto Rico and Continental U.S.A. This appears to be related to improvements in socioeconomic level and adequate utilization of the Pap smear in the population. Mortality from carcinoma of the cervix has shown a 60% reduction in the last 20 years. Most likely this is related to the observed reduction in the incidence of the invasive forms of the disease, earlier diagnosis, and improvements in therapy. Optimal therapy of the clinically evident invasive forms of the disease is a combination of external irradiation and intracavitary brachytherapy. Surgery would be of value for specific clinical situations as an adjuvant to irradiation (barrel-shaped types), in post-irradiation recurrences, inadequate brachytherapy, etc. The yield in terms of survival and disease-free status in the pelvis is high for the early stages of the disease (approximately 90% 5-year survival and 97% control of pelvic tumor for stage I), but stage IIIB and IV cases show a failure rate of close to 50% or more in the irradiated volume and a high incidence of metastases to the para-aortic nodes and elsewhere.

Adult↗
PubMed1978

Intraepithelial neoplasia of the uterine cervix in the teenager.

One hundred and seventeen teenagers with abnormal cervical cytology were evaluated using colposcopy and directed biopsies. Eighty-eight cases of cervical intraepithelial neoplasia were discovered including 24 cases of severe dysplasia or carcinoma in situ. Erradication of these lesions is essential as a preventative measure. The importance of routine cytologic screening and early evaluation of abnormal Papanicolaou smears in the teenager is emphasized.

Adolescent↗
PubMed1977

Metastatic choriocarcinoma of the nasal mucosa.

A patient with a chief complaint of epestaxis coughed persistently during her visit to the emergency room. Questioning revealed she also had vaginal bleeding and occasional bloody sputum. Gynecological examination, a Pap smear, and pathological evaluation showed choriocarinoma. A chest X ray disclosed metastatic pulmonary choriocarcinoma. An ENT examination was carried out and showed a suspected area in the nasal mucosa which was bleeding. A Pap smear and biopsy taken from the suspected area also revealed choriocarcinoma.

Adult↗
PubMed1976

Outpatient evaluation of patients with atypical Papanicolaou smears: contribution of endocervical curettage.

A series of 603 patients referred with atypical Papanicolaou smears was evaluated by repeat smears, colposcopically directed cervical biopsies, and endocervical curettage. These techniques as a unit can establish an accurate outpatient diagnosis superior to any of these modalities used alone and comparable with findings in conization and hysterectomy specimens. Endocervical curettage has made a unique contribution to the evaluation of such patients; these curettings have allowed examination of tissue fragments and are more reliable in diagnosing neoplasia than are endocervical smears. Invasive carcinoma and its precursors confined to the anatomic endocervical canal can be recognized by this technique, and conversely the absence of neoplastic epithelium in adequate endocervical curettings rules out occult carcinoma. Indications for conization of the cervix are discussed in reference to the other biopsy and cytologic findings, and guidelines are presented for patient management, stressing clinicopathologic correlation and cooperation.

Biopsy↗
PubMed1977

False positive cervical cytology: an important reason for colposcopy.

Over an 18 month period, 352 patients with a report of abnormal cervical cytology ranging from mild dysplasia to invasive carcinoma were evaluated with colposcopy and, if indicated, directed biopsies. From the group, there were 26 women in which a lesion consistent with the cytologic diagnosis was not found in each of these cases, an error in the interpretation of the Papanicolaou smear, resulting in a false positive report, was suspected. The cytology was reviewed and the results were compared to the original reports. Twelve cases were reinterpreted as negative for cervical neoplasia. A similar review of the histology failed to reveal a previously missed lesion. Cervical conization in four patients and repeat cytology and colposcopy in 22 patients confirmed the false positive interpretations of the original cervical cytology. The importance of colposcopy as a means of recognizing false positive cytology and avoiding an unnecessary cervical conization is emphasized.

Cervix Uteri↗
PubMed1978

Cytologic detection and clinical significance of Actinomyces israelii in women using intrauterine contraceptive devices.

Pancervicovaginal (Papanicolaou) smears exhibiting pseudomycilial-like clumps of organisms obtained from 35 women employing IUD's were studied by direct immunofluorescent technique for identification of A. israelii and A. naeslundi. In every case the specific fluorescence was achieved with species-specific antiserum against A. israelii. The clinical profile of these 35 women was retrospectively analyzed.

Actinomyces↗