Cytopathology Test Research Articles

Profile of Cervical Cancer Screening in a Family Health Unit in Salvador, Bahia State, Brazil: an Evaluative Study of the 2020-2023 Period

Objective: The objective of this study is to outline the profile of cervical cancer screening at the Family Health Unit (FHU) San Martin 3, in the municipality of Salvador, Bahia, Brazil, from 2020 to 2023, in order to analyze the coverage of the preventive exam or Pap smear. Theoretical Framework: Brazil performs opportunistic screening of women with pre-neoplastic lesions or precursor lesions of Cervical Cancer (CC), through the performance of the Preventive Exam (PE) or Pap smear. Where the woman occasionally seeks the health service. The recommendation of the Brazilian Ministry of Health (BMH) is to screen primarily women in the age group at risk, from 25 to 64 years, delimited by the highest incidence and mortality rate of CC. Method: This is a descriptive ecological study, where the trend of the historical series of cytopathological tests performed for cervical cervical cancer screening in women at FHU San Martin 3, in the municipality of Salvador, Bahia, Brazil, between 2020 and 2023, from the date of inauguration of the unit until December 2023, was analyzed. The data were taken from the electronic medical record, Sistema Vida, and from the unit's PE record book, in February 2024. Results and Discussion: The results obtained revealed [synthesize the main results of the research]. In the discussion section, these results are contextualized in light of the theoretical framework, highlighting the implications and relationships identified. Possible discrepancies and limitations of the study are also considered in this section. Research Implications: The cytopathological examination of the cervix performed by the unit is the procedure chosen by the World Health Organization (WHO) and adopted by the BMH for cervical cancer screening, in the study in question most of the reports with precursor alterations for this type of cancer are in the standardized age range for PE, from 25 to 64 years old. The altered results in women under 25 years of age were low-grade intraepithelial lesions, a common alteration in women under 25 years of age, usually associated with the HPV virus, which in most cases regress without treatment. Originality/Value: The research on the profile of cervical cancer screening in a family health unit in Salvador presents significant originality and value for public health.

Importância da análise histopatológica no diagnóstico de sarcoma de tecidos moles

The present work aimed to inform the importance of diagnosis through histopathological analysis of a grade II soft tissue sarcoma in a mixed breed bitch. Soft tissue sarcoma (STS) is a type of malignant neoplasm that originates from mesenchymal tissues, affecting several species, but is more prevalent in medium and elderly dogs. Clinical signs are variable and depend on the location of the tumor, generally occurring in the pelvic limbs. In the present report, the patient in question had a history of a subcutaneous mass measuring 30 cm in diameter, weighing 5 kg, located on the right flank and pelvic limb. Therefore, the diagnosis was initiated through laboratory and cytopathological tests; however, definitive confirmation was obtained through histopathological analysis, confirming the diagnosis. That said, histopathological diagnosis is extremely important for determining the prognosis and choosing the most effective treatment, with surgical resection being the most indicated treatment for these cases. Although the prognosis is generally favorable after complete removal of the neoplastic mass, factors such as size, location and grade of the tumor significantly influence clinical results as in the case discussed. Reinforcing the need for a multidisciplinary approach in the diagnosis and treatment of STS, in order to promote quality of life for patients.

Cell representation in cytopathological examinations of the cervix

The objective of this study was to analyze the relationship between the representation of JEC/ZT in cervical cytopathological tests with the age and clinical variables of women. A retrospective study was carried out, with data collected from the Cancer Information System, referring to cytopathological tests collected in public health services. Most of the tests (60%) showed representation of JEC/ZT cells. It was observed that the younger the woman, the higher the proportion of tests with JEC/ZT cells, and as age advanced, the representation decreased. Most women using oral contraceptives or hormone replacement therapy, as well as most pregnant women, also had JEC/ZT cells in the test. All examinations with the result of squamous intraepithelial lesion or with atypical squamous cells, not excluding lesions of the present grade, showed JEC/ZT cells. The results found corroborate the importance of sample quality in the identification of precursor lesions of cervical cancer, and it is evident that more attention should be paid to collections carried out in older women in order to be successful in representing JEC/ZT.

Implementation of the Milan System for Reporting Salivary Gland Cytology: A Two-Year Outcome Cytopathology Data of a Tertiary Care Center.

In 2015, the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was implemented to eliminate overlapping and disparate morphologies in salivary gland lesions. This approach helps track diagnostic findings, describethe risk of malignancy for each group, and advance therapy based on the results. The research aimed to classify fine-needle aspiration (FNA) smears, analyze malignancy risk, correlate cytology with histological diagnosis, and reduce unnecessary surgeries. We evaluated 217 individuals using FNA, classified their conditions using the Milan System, and followed up on 149 cases through histopathology. Both the risk of malignancy in each cluster and the total risk of malignancy were noted. The most recent studies, as reported by the MSRSGC, found almost universal agreement about this grouping. The FNA cytopathology test demonstrated a sensitivity of 75% for identifying salivary gland abnormalities and a specificity of 93.16%. The findings indicated that the test had an accuracy of 89.66%, with a positive predictive value of 72.41% and a negative predictive value of 93.97%. The MSRSGC offers a standardized technique for examining the results and assists the physician in determining the treatment plan that will be most beneficial.

The importance of health education in relation to cytopathology testing

The uterine cervix, also known as the cervix, is the lower and narrower part of the uterus, establishing the connection between the vaginal canal and the internal organs of the female reproductive system. This type of cancer is mostly associated with persistent infection by the Human Papillomavirus (HPV) and is the third most common type of cancer among women. The role of the nursing professional is crucial in the process of detecting and diagnosing cervical neoplasia. Nursing actions include advising the population on the importance of regular preventive examinations. The aim of this study is to analyze the importance of health education in the context of the cytopathological examination, exploring the relationship between health education and the performance of this examination. Methodologically, this is an integrative literature review, using the following databases: PUBMED, SCIELO and BVS, using the following descriptors: "cytopathological examination", and "pap smear", "health education", and "patient adherence". A total of 120 articles were found and 11 were selected for analysis based on the inclusion and exclusion criteria. It was concluded that raising awareness about testing is essential and should be done with humanized care and proximity to the woman. Health education is a tool that should be used by the entire multi-professional team. Its benefits include the dissemination of quality information to more people, increased demand for health services, counseling, thus reducing the incidence of cervical cancer, early diagnosis and effective treatment of these patients.

Estudo retrospectivo e espacial de diagnósticos anatomopatológicos da criptococose canina e felina em municípios do estado de São Paulo

ABSTRACT Cryptococcosis is a systemic mycosis caused by the genus Cryptococcus that affects humans and animals. The present study aimed to describe the epidemiological and anatomopathological profiles, occurrence, and distribution of the infection by Cryptococcus spp. in 30 dogs and 110 cats residing in the State of São Paulo, from 2014 to 2020. The study evaluated the results from 140 necropsies and histopathology and cytopathology tests provided by Veterinary Pathology services. A higher occurrence of positive diagnosis was observed in females of both cats and dogs, adults, and mixed breeds of both species. The main diagnostic method used was histopathology, with a predominance of integumentary lesions in dogs and cats (skin pattern), with no significant difference between species and lesion location (p≤ 0.827). The time-spatial distribution showed a significant increase in the diagnoses in dogs and cats over the seven years, the identification of areas with a higher rate of diagnosis of cryptococcosis such as Campinas and São José do Rio Preto, and the positive correlation of a diagnosis with climatic data. Retrospective studies of anatomopathological data help to identify suspected cases of cryptococcosis and demonstrate the importance of monitoring and surveillance of cryptococcosis.

The impact of covid-19 on cervical cancer screening

The pandemic caused by the SARS-Cov-19 virus was declared in March 2020, creating several effects on the provision of health services and society. In Primary Health Care, there was an interruption in the provision of preventive programs, including cervical cancer screening. Studies conducted in 2019 and 2020 show a reduction of close to 67% in certain regions of Brazil. Objectives: To analyze the impact of the COVID-19 pandemic on the collection of cytopathological examinations at the Jackson Roberto Carl Family Health Strategy in Blumenau-SC in 2020 and 2021. Methodology: To verify the impact of the COVID-19 pandemic, an accounting and descriptive analysis of the cytopathological exams performed between 01/30/2018 and 12/07/2021 was carried out regarding the number of exams per year of collection, based on the physical records of the ESF. Results: In the period from 2018 to 2021, 587 cytopathological exams were collected. In 2019, in the pre-pandemic, we had the highest number of screenings performed, totaling 210. Comparing 2019 and 2020 (first year of the COVID-19 pandemic), a significant drop in collections was observed from 210 to 20, respectively, representing a drop of approximately 90%. In 2021 there were 168 collections of this test, which represents the return of this preventive action. Conclusion: The significant drop in the performance of cytopathological tests imposed by the restrictive health measures of social distancing in 2020 refers to the need for active search of women in the screening group in order to recover this loss of coverage.

Notification of cytopathological exams in the Unaí, Minas Gerais, Brazil

The onset of sexual activity in adolescence suggests an important cause for the increased prevalence of HPV and lesions caused by its infection, such as cervical cancer. Cervicovaginal cytopathological exam is considered the main prevention and early detection strategy for this type of cancer and precursor lesions. The aim of this study was to present the clinical and epidemiological profile of cytopathological tests carried out by adolescents aged 15-19 years in the city of Unaí, Minas Gerais, Brazil. The methodological processes were established in an epidemiological, descriptive, cross-sectional study with a quantitative approach. The study population consisted of 195 cytopathological tests from teenagers, aged 15-19 years, corresponding to an adolescent public with active sexual activity, registered in SISCAN according to the tests reported in SISCOLO between 2014-2020. Analyzing the data, it was possible to verify a low adherence of adolescents to preventive exam, that performance of cytopathological exams was conducted mainly for screening (89.8%, n = 175), and that 71.3% (n = 139) were not considered within normal limits, so it can be concluded that there should be a reduction in the minimum age for the preventive exam, in addition to greater emphasis on health education actions for young women.

The detrimental consequences of two consecutive disasters impacting cytopathology in Ukraine: COVID followed by thewar.

The Covid-19 pandemic and ongoing war in Ukraine caused unprecedented disruption in healthcare, including cytopathology activities. This paper elucidates the effect of two consecutive disasters-the COVID-19 pandemic followed by the war-on cytopathology practice in Ukraine through a single-centre retrospective study. Total testing volumes, geographic distribution, and indicators of laboratory operations were assessed during three periods of 3 months each: the first 3 months of the acute phase of the war (March-May 2022, period 1); summer (June-August 2022, period 2); and the fall (September-November 2022, period 3, associated with massive attacks on the energy infrastructure in Ukraine). These data were compared with the corresponding periods in 2020, during the COVID-19 pandemic, and in 2021, the post-lockdown period. The ongoing war in Ukraine has caused a dramatic disruption in routine health maintenance and cytological practice. A net decline in both PAP testing and non-gynaecological pathology was associated with a geographic redistribution of cytopathological testing, and an increase in the rate of abnormal sample reporting. Despite these challenges, cytopathology practice in Ukraine demonstrates resilience, allowing for maintaining the healthcare system and addressing the needs of the civil population during the war. The ongoing war in Ukraine heavily affected cytological practice. The decline in PAP testing during the early period of the war was associated with an increase in the abnormal sample rate. Further study of the war's impact on the cervical pathology rate and the health of the population in the next decades is needed.

Diagnostic accuracy of swine echinococcosis cytopathological tests and challenges for a differential diagnosis: slaughterhouse data.

Echinococcosis disease shows clinical signs similar to many diseases. Hence we report cases that need to be confirmed using appropriate tests. A confirmatory study has been conducted to assess the accuracy of two cytopathological tests, with the histopathology test as the reference standard. The first cytopathological test evaluates the Ziehl Neelsen staining with an epifluorescence microscope (cytopath 1). The second cytopathological test uses the same staining followed by a transmitted light microscope examination (cytopath 2). Of a total of 2524 inspected pigs, 101 suspected cases of echinococcosis were detected, of which 67 were found positive with the two cytopathological tests and the histopathological one. The specificity of cytopath 1 (100 % [95 % CI 100 - 100]) and cytopath 2 (100 % [95 % CI 100;100]) were similar, as well as their respective positive predictive values: 100 % [95 % CI 100 - 100] vs. 100 % [95 % CI 100 - 100]. The sensitivity of cytopath 1 is 79.66 % [95 % CI 69.39 - 89.93], while cytopath 2 equals 66.10 % [95 % CI 54.02 - 78.18]. The difference in sensitivity of both tests was not significant. Negative predictive values found for cytopath 1, and cytopath 2 were 40 [95 % CI 18.53 - 61.47] and 28.57 [95 % CI 11.84 - 45.3], leading to the Generalized Estimating Equations (GEE) Model estimate for an odds ratio of 1.4 [95 % CI 0.41 - 5.2], p = 0.06. Cytopath 1 and cytopath 2 are equivalent in terms of specificity (100 % [95 % CI 100 - 100] vs. 100 % [95 % CI 100;100]) and positive predictive value (100 % [95 % CI 100 - 100]. Cytopath 1 is more sensitive than cytopath 2 but not significant (79.66 % [ 95 % CI 69.39 - 89.93] vs. 66.10 % [95 % CI 54.02 - 78.18]). However, the negative predictive value of cytopath 1 is better than that of cytopath 2: 40 % [95 % CI 18.53 - 61.47] vs. 28.57 % [95 % CI 11.84 - 45.3].

Clinical Correlation between Cervical Cancer Screening Using Pap Smear Test

Objective: The study's objective is to evaluate the effectiveness of the Pap smear screening procedure for identifying precancerous lesions. Study Design: Prospective study Place and Duration: Department of Pathology, Nishtar Medical University Multan, From 1st October, 2021 to 31 March, 2022. Methods: There were 162 females had age 18-50 years were presented in this study. All of the women were given a complete physical examination, including a speculum exam and a vaginal exam, and their medical histories were recorded. Women's cervical cancer screenings often involved a Pap smear. Using an Ayre spatula, a smear was collected and spread over a labelled glass slide before being stored in 95% ethyl alcohol and delivered to the Pathology Department for cytopathological testing. SPSS 24.0 was used to analyze all data. Results: Among 162 females, 45 (27.8%) had age 18-30 years, 73 (45.1%) were aged between 31-40 years and 44 (27.2%) patients had 41-50 years. Mean BMI of the females was 22.4 ±6.52 kg/m2. Frequency of smokers was 4 (2.5%). Most common complaint was vaginal discharge, followed by irregular menstrual cycle and abdominal pain. We found that 63 (32.7%) cases had no pathology, frequency of inflammatory was 49 (30.2%) cases, atypical squamous cells of undetermined significance (ASUS) was 28 (17.3%), low-grade squamous intraepithelial lesions (LSILs) was 8 (4.9%) and high-grade squamous intraepithelial lesions (HSILs) was 5 (3.1%). As per HPV, low risk and high risk virus was found in 11 (6.8%) cases. Conclusion: The Pap smear is an easy, quick, and inexpensive way to check for cervical epithelial precancerous abnormalities. It has the potential to be employed as a routine screening tool, leading to better treatment outcomes and lower death rates. Increased detection of these lesions is facilitated by the Pap test and the HPV-PCR test. Keywords: Cervical Cancer, Pap smear Test, HPV, Pathology

Completeness of cervical cancer staging information in Brazil: A national hospital-based study

BackgroundCancer staging information in Hospital Cancer Registries (HCR) is essential for cancer care quality evaluations. This study aimed to analyze the completeness of cervical cancer staging in Brazilian HCR and identify individual and contextual factors associated with unknown staging. MethodsThe outcome analyzed was missing or unknown staging (Malignant Tumor Classification System and/or International Federation of Gynecology and Obstetrics) in 2006–2015. Individual data on cancer cases were collected from the HCR Integrator. Contextual variables were collected from the Atlas of Human Development in Brazil, the National Registry of Health Facilities, and the Outpatient Information System. The random intercept multilevel Poisson regression model was performed to identify the factors associated with the outcome. ResultsThe prevalence of unknown staging data was 32.4% (95% confidence interval [CI], 32.1–32.7). Women aged 18–29 years (prevalence ratio [PR], 1.48; 95% CI, 1.42–1.54), referred by the public health system (PR, 1.16; 95% CI, 1.11–1.21), living in states with a low density of oncologists (PR, 1.70; 95% CI, 1.62–1.79), and with a low cytopathological testing rate (PR, 1.69; 95% CI, 1.57–1.82) showed a higher prevalence of unknown tumor staging data. A lower level of education (PR, 0.91; 95% CI, 0.84–0.98) was associated with complete staging data. ConclusionsIndividual and contextual factors were associated with missing staging data. It is necessary to improve information on cancer in the HCRs by improving the awareness and training of Brazilian cancer care professionals.

Evaluation of cervical cancer control actions within Brazil and its regions based on data recorded in the Brazilian Unified National Health System

This study analyzes the performance of screening and diagnosis tests for cervical cancer among women aged 25 to 64 years, as well as the delay for the initiation of treatment within Brazil and in its geographic regions, from 2013 to 2020. Information on populational procedures and estimates was obtained from the information systems of the Brazilian Unified National Health System and the Brazilian National Supplementary Health Agency. We calculated the coverage indicators of the Pap smear, the percentages of altered cytopathological and histopathological tests, and the percentage of women diagnosed with cervical cancer with over 60 days of treatment. There was great variation in the coverage of the Pap smear test among the Brazilian regions with a downward trend from 2013, which was aggravated from 2019 to 2020. The number of altered cytopathological tests was 40% lower than estimated, and the difference between the recorded number of cancer diagnoses and the estimated number of patients was below 50%. The percentage of women diagnosed with invasive cervical cancer, who started treatment after 60 days, ranged from 50% in the South to 70% in the North Region with a decrease from 2018. In 2020, there was a decrease in the number of screening and follow-up tests, reducing the proportion of women delayed in starting treatment in the North, Southeast, and South regions. The decline in screening coverage and inadequate follow-up of women with altered results indicate the need to improve early detection strategies for the disease and establish mechanisms for constant evaluation and monitoring of actions.

Short-term effects of the COVID-19 pandemic on cancer screening, diagnosis and treatment procedures in Brazil: a descriptive study, 2019-2020.

To analyze the short-term effects of the COVID-19 pandemic on cancer screening, diagnosis and treatment in Brazil. This was a descriptive study using data from the Outpatient and Hospital Information Systems, and the Cancer Information System. Monthly percentage variation of cancer screening, diagnosis and treatment procedures in 2019 and 2020 was calculated, as well as waiting time for cervical and breast cancer tests. In 2020 cytopathology tests fell by 3,767,686 (-44.6%), screening mammograms fell by 1,624,056 (-42.6%), biopsies fell by 257,697 (-35.3%), cancer surgery fell by 25,172 (-15.7%), and radiotherapy procedures fell by 552 (-0.7%), compared to 2019. Time intervals for performing cervical and breast cancer screening exams were little affected. Cancer control actions were impacted by the pandemic, making it necessary to devise strategies to mitigate the effects of possible delays in diagnosis and treatment.

Pleural Biopsy in Evaluation of Malignant Pleural Effusion- A Review

Malignant pleural effusion (MPE) is one of the common presentation of many carcinoma including lung, breast and lymphomas. It is very important to make an etiological diagnosis of the MPE cases without any delay as treatment depends on its cause. Cytopathological examination of fluid for malignant cells is the easiest and most sensitive method for detecting malignant pleural effusion (MPE). Despite cytology being a sensitive test, many patients remain undiagnosed, then there is a need of histopathological examination of pleura. Invasive procedures like Closed pleura biopsy (CPB) or thoracoscopy was recommended. CPB was earlier considered an investigation of choice in cases of undiagnosed pleural effusion with good efficacy Since the emergence of medical thoracoscopy (MT), use of CPB in the diagnosis of cytology negative MPE is gradually declining. However, due to the high cost and challenges associated with the surgery, thoracoscopy is only used in a restricted number of cases. CPB is less reliable than cytopathological testing of fluid or MT in determining MPE. Yet, it is a simple procedure with little procedure -related complication. The purpose of this article is to assess the clinical presentation and approach to MPE, as well as the role of CPB in diagnosing MPE and to investigate the benefits and drawbacks of CPB.”

Follow-up of squamous atypia’s and the evaluation of the conducts according to the recommendations of the Ministry of Health

ABSTRACT Introduction: Cervical cancer is considered a public health problem, ranking fourth among the most common types of cancer worldwide. Objective: The present study aimed to gather information on the follow-up, and to verify adherence to the management recommended by the Brazilian Ministry of Health (MH) of women with cervical cytopathological results of atypical squamous cells of undetermined significance (ASC-US) and atypical squamous cells, cannot exclude a high-grade squamous intraepithelial lesion (ASC-H), as well as to evaluate the quality of cytopathology tests of the laboratory that provides services to the Brazilian Unified Health System (SUS). Methods: Cervical cytopathology results of squamous atypia were researched between the years 2016 and 2017 in standardized requirements from the MH. The performance of the laboratory that carried out the cytopathology tests were analyzed using indexes recommended in the Internal Quality Monitoring (IQM) of the MH [Quality Management Manual (QMM)]. Results: 42,478 cytopathology tests were evaluated, 893 of these presented ASC-US results, and 199 ASC-H results. In women with ASC-US results, 73.2% repeated the cytopathology test, of which 18.7% remained the altered result, and 81.3% were negative for malignancy. Following the recommendation of the MH, 81.9% of women repeated the test outside the recommended period. In women with ASC-H, 51.8% underwent histopathological examination as recommended by the MH, of which 73.8% were altered. Conclusion: According to the MH Guidelines, most (81.9%) women with ASC-US repeated the cytopathology test

Prevalence and factors associated to cervical changes in units from the Single Health System.

To estimate the prevalence and risk factors associated with cytopathological changes in the uterine cervix of women treated by the Unified Health System. This is a cross-sectional study carried out with 350 women, between 14 and 79 years old who underwent pap smear tests in heath units in Francisco Beltrão, Paraná. Cervical cytopathological analyses and a questionnaire were applied to obtain socioeconomic information, as well as data on sexual behavior, gynecological aspects, and life habits. Chi-square test and logistic regression with p <0.05 were applied for statistical analysis. The prevalence of cervical changes was 3.4% and the main categories found were low-grade cervical intraepithelial lesion, high-grade cervical intraepithelial lesion, and atypical cells of undetermined significance. From these, the first were present in 16.6% of women under 25 years old. The multivariate analysis pointed at associations between previous results of the cytopathology test (OR = 25.693), smoking (OR = 7.576), and oral contraceptives (OR = 5.265) and the outcome. Women with a history of previous cervical cytopathological abnormality, use of oral contraceptives, and smokers were more likely to have an abnormal result in the pap smear test.

Conversas invisíveis: assuntos falados, mas não ouvidos em consultas ginecológicas

This is a qualitative study based on the theoretical-methodological assumptions of the Conversation Analysis (CA) that describes and analyzes face-to-face interactions between three nurses and seven users of primary health care services during the cytopathological test collection visits. The descriptions and analyses were based on excerpts from the audio-recorded interactions during the nursing visits and transcribed based on the CA conventions. Data microanalysis from an emic perspective allowed identifying interactional situations of (mis)alignment, (dis)affiliation, repairs, and sensitive issues, and lack of listening to specific topics by nurses while conducting visits. Thus, signs of suffering, malaise, or violence were not explored, and care was not enhanced. The study shows that the cytopathological test collection visit can be a space to listen to issues related to sexuality and investigate the presence of violence against women. The dissemination of these findings and this methodology among public health and nursing professionals may stimulate a reflection on their communicative abilities, contributing to improved quality of care in health services.

EXAME CITOPATOLÓGICO DO COLO UTERINO: DESCRIÇÃO DOS PRINCIPAIS INDICADORES EM UM MUNICÍPIO NORDESTINO

Introdução: O câncer do colo do útero é um importante problema de saúde pública na população feminina brasileira e seu diagnóstico precoce aumenta consideravelmente a probabilidade de cura. A taxa de cura é próxima aos 100%, demonstrando que medidas preventivas, como o exame Papanicolau, são fundamentais para prevenção desse problema. Objetivo: O objetivo desse estudo foi descrever os resultados dos exames citopatológicos em mulheres de 25 a 64 anos no Município de Mossoró/RN. Metodologia: Levantamento retrospectivo analítico dos exames citopatológicos cadastrados no banco de dados do Sistema de Informação do Câncer de Colo de Útero (SICOLO) entre o período de 2014 e 2019 para o seu perfil epidemiológico. Resultados: Um total de 46606 casos foram incluídos e analisados. Houve uma tendência de aumento na realização dos testes ao longo dos anos. 83,8% dos casos representam células escamosas atípicas de significado indeterminado (ASC-US). 70% das lesões intraepiteliais escamosas (LIS) foram diagnosticadas como sendo de baixo grau (LISL). Não houve diagnóstico citopatológico de carcinoma de células escamosas e apenas 2 casos de adenocarcinoma in situ. Conclusões: Mossoró segue um padrão nacional de maiores resultados celulares atípicos representados por ASC-US e LSIL. Resultados sugestivos de alto grau de malignidade existem em menor frequência nos exames preventivos e necessitam ser avaliados por exames mais invasivos. &#x0D; Palavras-Chave: Neoplasias do colo do útero; Teste de Papanicolaou; Saúde da Mulher.

Special Staining of the Liquid-Based Cytopathology Test in Bronchoalveolar Lavage Fluid for Diagnosis of Invasive Pulmonary Aspergillosis with Nonneutropenic Patients.

In recent years, various biomarkers have been gradually applied on bronchoalveolar lavage (BAL) fluid for the diagnosis of invasive pulmonary aspergillosis (IPA). The objective of this study is to assess the value of the liquid-based cytopathology test (LCT) for improving the identification of IPA in BAL fluid from possible IPA patients, following special staining with periodic acid-Schiff staining (PAS) or Grocott's methenamine silver (GMS). A total of 47 consecutive possible IPA patients who underwent bronchoscopy with BAL fluid from January 2017 to December 2018 were included. 45 people had a pair of BAL fluid specimens and 2 patients had two BAL fluid specimens. The 49 pairs of BAL fluid specimens were processed for culture, tuberculosis acid fast staining smear, direct microbial smear, and LCT with special staining (PAS and GMS), respectively. Then, we compared the sensitivity and specificity of PAS and GMS in BAL fluid in high-risk patients. Among 47 possible IPA patients, 25 patients had proven/probable IPA, and 11 patients had other invasive fungal diseases. The sensitivity of GMS was higher than that of PAS (92.11% versus 81.58%; P = 0.175). The specificity of GMS was 81.82%, which was higher than that of PAS (81.82% versus 72.73%; P = 0.611). The negative predictive value (NPV) for PAS and GMS were 53.33% and 75.00%, respectively. The positive predictive value (PPV) for PAS and GMS were 91.18% and 94.59%, respectively. This study showed that special staining of LCT in BAL fluid may be a novel method for the diagnosis of IPA, and the GMS of LCT had higher sensitivity and specificity, which was superior to PAS.