Thinprep Cytologic Test Research Articles

The detection of hTERC amplification using fluorescence in situ hybridization in the diagnosis and prognosis of cervical intraepithelial neoplasia: a case control study

BackgroundCurrently the routine non-invasive screening methods for cervical intraepithelial neoplasia (CIN) and cervical cancer are Thinprep cytology test (TCT) and human papillomavirus testing. However, both methods are limited by the high false positive and false negative rates and lack of association with patients’ prognosis, especially for the early detection of pro-malignant CIN. The aim of the study was to investigate the role of genomic amplification of human telomerase gene (hTERC) in the diagnosis and prognosis of CIN.MethodsThe study group consisted of specimens of exfoliated cervical cells from 151 patients, including 27 with CIN I, 54 with CIN II/III, 17 with carcinoma in situ, and 28 with invasive squamous carcinoma, as well as 25 patients who were at 2-year follow-up after either Loop Electrosurgical Excision treatment (n = 11) or radical surgery (n = 14). hTERC amplification was detected by dual-color interphase fluorescence in situ hybridization (FISH), and the results were compared with TCT and histologic examination. The final diagnosis was determined by the pathological examination. The control group consisted of specimens of exfoliated cervical cells from 40 normal women.ResultsThe percentage of cervical exfoliated cells with positive hTERC amplification and incidence rates of hTERC amplification were 9.2% ± 4.6% and 44.4% (12/27) respectively in patients with CIN I; 16.0% ± 14.4% and 85.1% (46/54) in patients with CIN II/III; 19.7% ± 13.3% and 88.3% (15 /17) in patients with carcinoma in situ; 47.0% ± 25.2% and 100% (28/28)in patients with invasive squamous carcinoma. There was statistically significant difference between the control and study group (P <0.01), and between the patients with various diseases within the study group (P <0.05).ConclusionThe detection of genomic amplification of hTERC using FISH is a non-invasive and effective approach for CIN.

A new convenient technique for making cell blocks

Cell block sections serve as an important diagnostic annex for cytological smears, liquid-based SurePath cytology and the Liquid-based Thin-prep Cytology Test (TCT). A variety of methods for the preparation of cell blocks are described in the literature and the techniques in cell blocks are in continuous improvement. A new technique for making cell blocks was introduced in the present study. We first used pregelatinized starch as the frame for the cell block, which is a really simple and economic method, because it can be carried out at room temperature without additional special instruments. We have performed hematoxylin and eosin (HE) staining, immunohistochemistry analysis and fluorescence in situ hybridization (FISH) in the cell block sections in 122 cytological specimens. The results demonstrated in this article show that pregelatinized starch is a useful frame for cell blocks. The pregelatinized starch can effectively collect even a few cells with powerful adhesiveness. Therefore, this new technique for making cell blocks is especially useful for cytologic samples with low cellularity, such as cerebrospinal fluid specimens.

Analysis of 9260 cases of cervical cytology liquid-based thin-layer analysis

Objective To explore the role of thinprep cytology test(TCT)and HPV-DNA hybrid capture detection played in the screening of cervical lesions.Methods Do TCT examination on 9260 outpatients and do HPVDNA hybrid capture detection on 840 cases therein,836 positive cases continued to have biopsy by colposcope,conformed to the gold standard of histopathology and contrast with cytology in the meantime.Results 8374 cases were negative in the TCT examination;836 cases were cytological abnormal.Cytology-positive rate was 9.03％,ASC-US 398 were 4.29％,LSIL 239 were 2.58％,HSIL 179 are 1.93％,SGUS 9 are 0.097％,SCC 11 are 0.12％.The group of 30 ～40 ranked the highest in cytological positive,it's 43.66％,the second highest was the group of 40 to 50,it's 27.39％.The results of other groups were as follow:＜ 30 is 2.85％,50 ～ 60 is 5.14％,＞ 61 is 0.96％ The difference of them was significant ( P ＜ 0.01 ).HPV infection rate was 27.98％ (235/840).In ASC-US,the detectable rate of CIN in the HPV-positive group was 81.58％ (31/38),the HPV-negative group was 8.98％ ( 15/167),there was significant differene between the two methods(P ＜ 0.01 ).In LSIL,the detectable rate of CIN in the HPV-positive group was 95.45％ (21/22).In HSIL,the detectable rate of CIN in the HPV-positive group was 100％ (16/16).The infection rate in different age group is different,the difference was significant ( x2 =25.2 P ＜ 0.01 ) ; 836positive cases had biopsy by colposcope,507 cases were diagnosed to be CIN,the detectable rate was 60.65％ (507/836).To organize pathology as control,the diagnose accordance rate of cytology and pathology of LSIL and HSIL and SCC were 50.46％,82.12％,100％ (P ＜0.01 ).Took their accordance rate into comparison,the differene was significant.Conclusion Cervical lesion was collected in sex activity period,the peak was 31-40 years.TCT is propitious to screen cervical cancer and precancerous lesion,combined with HPV-DNA hybrid capture detection,colposcopy and pathology,can improve the diagnostic accuracy and the detective rate of CIN and cervical cancer. Key words: Thinprep cytology test ( TCT ) ; Cervical lesions; Human papillomavirus (HPV)

Investigation on the prevalence of high risk human papillomavirus and cervical cancer among adult women, in Shenzhen

To investigate the prevalence of high risk human papillomavirus (HPV) genital infection and cervical cancer in adult women from Shenzhen. Cluster sampling was used to investigate the prevalence of HPV infection and cervical cancer from women aged 20 - 59 years old living in Luohu, Futian, Nanshan, Longgang and Baoan districts in Shenzhen from April 2006 to April 2010. All women were detected for liquid-based cytology test (LCT) or Thinprep cytologic test (TCT) and high-risk HPV-DNA test with hybrid capture II (HC-II). All women with ≥ ASC-US by cytology and/or a positive HC-II test were asked to return for colposcopy and four-quadrant biopsy. Endocervical curettage was performed. Pathological finding were used as the gold standard of the diagnosis of cervical intraepithelial neoplasia. 10 210 women were involved in the study and 10 017 of them having completed data. The overall positive rate of high-risk HPV-DNA was 16.29%. HPV positive rates in 20-, 30-, 35-, 40-, 45-, 50-59 age groups were 17.37%, 15.59%, 16.33%, 14.74%, 17.16% and 17.98%, respectively. The curve of HPV infection rates in different age groups appeared a 'W' shape. HPV infection rates in the 25-years-olds and 50-59 year-olds groups were significantly higher than the other age groups (χ(2) = 4.50, P = 0.03). The overall prevalence rate of cervical intraepithelial lesions (CIN) was 7.52%, of which the prevalence rates of low-grade cervical intraepithelial lesions (CIN I) was 5.32% high-grade cervical intraepithelial lesions (CIN II/III) was 2.21%, cervical cancer was 0.12%. The prevalence of CIN I was significantly higher than the CIN II/III (χ(2) = 134.15, P < 0.001). The prevalence of cervical cancer in 45-age group was 0.12%, the highest. HPV infection rates increased with the grades of cervical lesions including women without CIN as 44.31%, in CINI as 70.73%, in CINII as 86.73%, and in CIN III as 96.75% and in cancer as 100.00%. The HPV infection rates were different in districts (χ(2) = 17.81, P = 0.03), with Futian and Luohu higher than those of Nanshan, Longgang and Baoan district. The prevalence rate of CIN in Baoan was lower than other districts. The CIN prevalence rates were not significantly different among the other districts of Shenzhen (χ(2) = 4.84, P = 0.18). The prevalence of cervical cancer was low in adult women living in Shenzhen, with cervical lesions still in the early stage. Prevention of HPV infection and treatment of CIN were the key points for the prevention of cervical cancer.

Investigation and analysis of cervical cancer among married women in Taishan City, Guangdong Province from 2010 to 2011

Objective To survey the status quo of cervical cancer and cervical precancerous lesion among married women age 35 to 55 in Taishan City,Province and to investigate precautions against cervical cancer.Methods By the request of the government,free cervical cancer screening was carried out from 2010 to 2011,26 879 women in 2010 and 23 197 women in 2011 completed the questionnaire and were checked by gynecological examination and thinprep cytologic test(TCT) voluntarily,and women screened positive by TCT accepted the colposcopy-guided biopsy.Results In 2010,2491 cases of screening positive by TCT,accoanted for 9.47％ ;665 cases of cervical intraepithelial neoplasia ( CIN ),incidence rate was 2.47％,35 cases of invasive cervical cancer ( ICC ),incidence rate was 0.13 ％.In 2011,2038 cases of screening positive by TCT,accounted for 8.78 ％ ;314 cases of cervical intraepithelial neoplasia( CIN ),incidence rate was 1.35％,16 cases of ICC,incidence rate was 0.07％.Conclusion Carrying out cervical cancer screening,could detect CIN in time,give treatment of precancerous lesions as soon as possible and prevent cervical cancer. Key words: Cervix neoplasms; Data collection

Efficacy of Pap Test in Combination with ThinPrep Cytological Test in Screening for Cervical Cancer

Our aim was to investigate the efficacy of the Pap test in combination with the ThinPrep cytological test (TCT) in screening for cervical cancer in China. From March 2006 to October 2008, 988 women with the mean age 46.4 ± 10.5 years (range, 23-80 years) were recruited to receive cervical cancer screening. Pap test results ≥ grade III and TCT findings ≥ ASCUS/AGUS were considered abnormal. Subjects with a Pap test result ≥ grade IIb received TCT. Colposcopy and biopsies were performed in all participants, and final diagnosis was based on pathological findings. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Youden index for predicting CIN I or above were determined. The sensitivity, specificity, PPV, NPV and Youden index of the Pap test were 43.1%, 97.2%, 70.0%, 91.9%, and 40.3%, respectively. The same values for TCT in predicting CIN were 80.0%, 63.2%, 16.0%, 97.3%, and 43.2%, respectively. The two tests in combination gave values for predicting CIN of 64.8%, 87.6%, 43.6%, 94.4%, and 53.5%, respectively. Combined testing exhibited the highest Youden index (53.4%). The Pap test with a reduced threshold in combination with the TCT has high sensitivity and high specificity in screening for cervical cancer.

Metabonomic signature analysis of cervical carcinoma and precancerous lesions in women by 1H NMR spectroscopy

(1)H nuclear magnetic resonance (NMR)-based metabonomics has been used to characterize the metabolic profiles of cervical intraepithelial neoplasia (CIN) and cervical squamous cell carcinoma (CSCC). Principal component analysis (PCA) and orthogonal partial least-squares discriminant analysis (OPLS-DA) were used to model the systematic variation related to patients with CIN or CSCC with healthy controls. Potential metabolic biomarkers were identified using database comparisons, and the one-way analysis of variance (ANOVA) test was used to examine the significance of the metabolites. Compared with plasma obtained from the healthy controls, plasma from patients with CIN had higher levels of very-low density lipoprotein (VLDL), acetone, unsaturated lipid and carnitine, together with lower levels of creatine, lactate, isoleucine, leucine, valine, alanine, glutamine, histidine, glycine, acetylcysteine, myo-inositol, choline and glycoprotein. Plasma from patients with CSCC had higher levels of acetate and formate, together with lower levels of creatine, lactate, isoleucine, leucine, valine, alanine, glutamine, histidine and tyrosine compared with the plasma of the healthy controls. In addition, compared with the plasma of patients with CIN, the plasma of CSCC patients had higher levels of acetate, formate, lactate, isoleucine, leucine, valine, alanine, glutamine, histidine, tyrosine, acetylcysteine, myo-inositol, glycoprotein, α-glucose and β-glucose, together with lower levels of acetone, unsaturated lipid and carnitine. Moreover, the profiles showed high feasibility and specificity by statistical analysis with OPLS-DA compared to the Thinprep cytology test (TCT) by setting the histopathological outcome as standard. The metabolic profile obtained for cervical cancer is significant, even for the precancerous disease. This suggests a systemic metabolic response to cancer, which may be used to identify potential early diagnostic biomarkers of the cancer and to establish clinical diagnostic methods.

Cervical cancer screening: hTERC gene amplification detection by FISH in comparison with conventional methods

Aim: To assess the clinical significance of hTERC amplification for cervical cancer screening detected by fluorescence in situ hybridization (FISH) and compare it with that of current screening methods within the same group. Methods: A total of one hundred and nine women were recruited in this study. All of them had liquid-based thin-prep cytologic test (TCT), human papillomavirus (HPV) DNA testing and hTERC gene amplification analysis using interphase two-color FISH. In addition, colposcopically directed biopsy and/or cone biopsy were conducted for definite histopathologic diagnosis for each case. The optimal threashold of hTERC gene amplification by fluorescence in situ hybridization (FISH) were assecced by receiver operating characteristic (ROC) curve. The results of hTERC gene amplification analysis were compared with the cytological analysis, HPV DNA testing and those of subsequent biopsies. Results: Among the 109 patients, 18 were benign lesion, 17 were LSIL, 66 were HSIL and 8 were invasive carcinoma of cervix (ICC). Of them, hTERC-positive cases were found in 0.0% (0/18) of normal specimens, 11.8% (2/17) of LSIL, 72.7% (48/66) of HSIL and 100.0% (8/8) of ICC, respectively. The positive rate of hTERC gene amplification was significantly higher in HSIL and ICC compared with normal and LSIL (all P < 0.01).The optimal cut-off point of percentages of cells with hTERC amplification was determined as 5.5%. Using this threshold the hTERC test reached a much higher specificity(94.3%, 33/35) and a relatively lower sensitivity(77.0%, 57/74) to distinguish benign lesion and LSIL from HSIL and ICC in comparison with HR-HPV test (51.4%; 91.9%) and TCT (74.3%; 81.1%). Area Under the Curve revealed that hTERC amplification test performed more accurately (area under the curve = 0.857) compared to HPV test (area under the curve = 0.717) and cytology(area under the curve = 0.777) to discriminate HSIL or higher from LSIL or lower. This study also found a significant positive correlation between positive hTERC gain and HR-HPV infection, abnormal cytological or histopathologic lesions (all P < 0.01) in patients with cervical diseases. Conclusion: hTERC amplification testing may be a promising adjunct to screen women for cervical precancer or cancer with high specificity and accuracy.

Comparison of two different deposition methods of 3-aminopropyltriethoxysilane on glass slides and their application in the ThinPrep cytologic test

In this work, two different deposition methods of 3-aminopropyltriethoxysilane (APTES) on glass slides were compared in order to study the adhesion effect of cervical exfoliated cells on smear slides. Glass slides were modified by vapor-phase deposition (V-D) and liquid-phase deposition (L-D), respectively. The topographic images and amine density of the modified slides were investigated by using atomic force microscopy, UV-vis spectroscopy and X-ray photoelectron spectroscopy. The numbers of cells adhered on the slides functionalized by V-D and L-D were counted and compared under the microscope. The data showed significant differences between the two methods (t-test: P < 0.05). The results presented here have made it theoretically possible to produce amine slides by V-D method for the ThinPrep cytologic test.

Significance of liquid-based thinprep cytology test and human papillomavirns in cervical lesions screening

Objective To evaluate the clinical value of liquid-based thinprep cytology test (TCT) and human papillomavirus (HPV) in cervical lesions diagnosis.Methods 525 patients with TCT was inflammation and abnormalities had HPV testing and colposcopy with biopsy analysis.Results Histopathological diagnosis as CIN Ⅰ or CIN Ⅰ above cases percentage of TCT of ASCUS,LSIL,HSIL,and cancer cases were 55 ％ (160/290),88 ％ (99/113),92 ％ (24/26) and 100 ％ (4/4),Pathological diagnosis as inflammation and glandular phosphate in 441 cases of this TCT-positive patients were 148 patients,false positive 34 ％.TCT-negative patients,pathologically confirmed of CIN in 84 cases patients with moderate to severe cervical erosion or cervical polyps were 22 cases,26 ％ TCT false negative.They had statistically significance (x2 =815.4,P =0.000).74 ％ HPV positive patients diagnosed as CIN Ⅰ or CIN Ⅰ above (x2 =104.94,P =0.000).Diagnosed as CIN Ⅰ cases in less than 30 years old accounted for 62 ％ (61/98),CIN Ⅱ and above for only 38 ％ (37/98) and without cancer.But the CIN Ⅰ in above 30 age group was significantly reduced to only 37 ％ (81/217),CIN Ⅱ and above was significantly increased to 63 ％ (136/217),and cancer rate increased (x2 =63.71,P =0.012).Histopathological diagnosed as CIN Ⅰ case were 26 ％ (83/315) of cervical smooth,74 ％ (232/315) of cervical erosion; 14 cases of cancer occurred in patients with cervical erosion.It was statistically significant (x2 =39.9,P =0.014).Conclusion TCT and HPV for screening of cervical lesions play an important role in cervical lesions screening. Key words: Uterine cervical diseases; Cytological techniques; Papillomaviridae

Application of TruScreen in detecting ASCUS patients

Objective To explore the application of cervical cancer screening system, TruScreen in detecting atypical squamous cell of undetermined significance (ASCUS) patients. Methods A total of 42 cases were selected, who were diagnosed as ASCUS by thinprep cytologic test (TCT). Area from site 15 to 20, site 21 to 32 were detected by TruScreen. And the result was compared with those of cases which had positive pathological result of cervical biopsy. Results There were 16 cases with abnormal pathological result in ASCUS cases, including 6 cases with cervical intraepithelial neoplasia (CIN) I, 6 cases with CIN II, 3 cases with CIN III and 1 case with infiltrating carcinoma. The consistency between TCT and pathological test was 38.10% (16/42). The positive rate of TruScreen at site 15-20 was 61.91% (26/42). There was significant difference in consistency with pathological test between TCT and TruScreen ( x 2=4.762, P=0.029). The positive rate of TruScreen at site 21-32 was 66.67% (28/42)(Kappa=0.181, P=0.016). There was significant difference in consistency with pathological test between TCT and TruScreen ( x 2=9.4919, P=0.002). And no case was missed when site 21-32 of patients with CINII and above were detected by TruScreen. Conclusions TruScreen is effective in detecting ASCUS patients.

Detection of survivin expression in cervical cancer cells using molecular beacon imaging: new strategy for the diagnosis of cervical cancer

ObjectiveDevelopment of novel approaches for quantitative analysis of gene expression in intact tumour cells could provide new methods for the detection of cervical cancer. Molecular beacons (MBs) are single-stranded oligonucleotide probes that form stem-and-loop structures. Survivin, a member of the ‘inhibitor of apoptosis’ family of proteins, is highly expressed in cervical cancer. The aim of this study was to determine the feasibility of MBs targeting wild-type survivin in the diagnosis of cervical cancer. Study designMBs with oligonucleotide sequences complementing survivin mRNA and covalently linked with FITC or Cy3 were designed and synthesized. The specificity and sensitivity of survivin MBs were examined in human cervical cancer cell lines and smears from cervical cancer patients, and confirmed by reverse transcriptase polymerase chain reaction (RT-PCR), immunocytochemistry, Western blotting and the thinprep cytological test (TCT). ResultsBoth survivin MB-FITC and MB-Cy3 produced a strong fluorescent signal in cervical cancer cells, and the intensity was consistent with the results from RT-PCR, Western blotting and immunocytochemical staining. In the initial clinical cohort study, the sensitivity of survivin MBs was 61.37% (27/44) and the specificity was 72.72% (34/44); the sensitivities of Western blotting and TCT were 76.1% (32/42) and 68.19% (30/44), respectively. No significant difference in sensitivity was observed between MBs, Western blotting and TCT for different tumour grades and International Federation of Gynecology and Obstetrics (FIGO) stages. ConclusionsSurvivin MBs are specific and sensitive molecular probes for the detection of cervical cancer cells. They have great potential in the early detection and follow-up of patients with cervical cancer.

Study for association between high risk human papillomavirus and cervical lesions in the samples from opportunistic screening

To investigate the association between HPV genotypes and cervical lesion in Hybrid Capture 2 (HC2) HPV test positive samples. 602 cervical samples randomly obtained detected as HPV positive by the HC2 high-risk probe cocktail were determined by polymerase chain reaction (PCR)-reverse dot blot (RDB), among them 344 participated Thinprep Cytology test. 569 (94.5%) samples were successfully amplified. The most common HPV genotypes were HPV16 (31.6%), 52 (16.7%), 58 (15.1%), 56 (8.1%), 39 (7.9%); HPV16 or HPV16/18 infection was significantly related to ASCUS, LSIL and HSIL; 24 samples suggested single HPV infection with the genotypes not available for HC2. The most common HPV genotypes in random screening were HPV16, 52 and HPV58; Our data demonstrated the pseudo-positivity of HC2 test was 4.0%; HPV16 was a index for progression of HSIL.

Quantitative detection of screening for cervical lesions with ThinPrep Cytology Test

OBJECTIVE To investigate the available parameters in gynecological screening for cervical lesions by liquid-based cytology technology (ThinPrep Cytology Test, TCT) and The Bethesda System (TBS), also with computer image analysis. METHODS With application of the image analysis system, all grades of cervical lesion cells were detected quantitatively and sorted in atypical squamous cells of undetermined significance (ASCUS), atypical squamous cells-cannot exclude HSIL (ASC-H), low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL) and cervical squamous cell carcinoma (SCC) with the mean optical density (MOD), average grey (AG), positive units (PU), and nucleus to cytoplasmic ratio (N:C). Differences between each group of cells were compared and analyzed statistically. RESULTS Apart from four stereologic parameters in LSIL and HSIL groups there were no di? erences among them, in the other groups, there was statistically significant in differences between MOD, AG and PU values. Differences between them in the ratio of nucleus to cytoplasm were highly statistically significant. CONCLUSION Stereological indexes may serve as a screening tool for cervical lesions. The image analysis system is expected to become a new means of cytological assisted diagnosis.

Analysis of diagnosis and follow-up results in 135 CIN patients

Objective To investigate the value of TCT and HPV detect in CIN patients. Method 135 patients diagnosed as CIN by pathologic method were involved. Their clinical and pathological data were reviewed and were given a 3-times follow-up in 2007,2008 and 2009. The follow-up studies include TCT and HPV detect. Results (1) in 73 HR-HPV positive patients, 15 of them were diagnosed as ASCUS, 3 were ASCUS-H ,28 were LSIL and 27 were HSIL by ThinPrep Cytology Test(TCT). In those 73 patients, 17 of them were CIN Ⅰ,24 were CIN Ⅱ,30 were CIN Ⅲ and 2 were possibly-invasive cervical cancer. (2) in the 3-times follow-up, non of the patients recurred. Conclusion TCT and HPV detect are effective in diagnose and follow-up of CIN patient. Key words: Cytology; Papillomavirus,human; Cervical intraepithelial neoplasia

Clinical study on cervix biopsy guided by colposcopy in diagnosis of cervical diseases in pregnant women

To investigate the value and safety of biopsy guided by colposcopy in diagnosis of cervical diseases in pregnant women. From Aug. 2007 to Feb. 2009, 17 828 pregnant women who receive antenatal examination underwent cervical cytological screening thinprep cytology test (TCT) in Beijing Obstetrics and Gynecology Hospital. If abnormal cytological results were found, those pregnant women were administered by colposcopic examination and biopsy after they signed informed consent. (1) TCT: the abnormal TCT results of 1502 pregnant women (8.425%, 1502/17 828) were found in 17 828 cases. (2) Colposcopic examination: two hundred and four pregnant women underwent colposcopic examination. The rate of satisfied colposcopic imaging was 92.6% (189/204), colposcopic examination identified 125 cases with cervical inflammation or cervical intraepithelial neoplasia (CIN)I, 25 cases with CINII and 54 cases with CINIII or microinvasive squamous carcinoma (MIVC) of squamous cervical carcinoma (SCC). (3) The results of biopsy guided by colposcopy: among 204 cases, it was found 33 cases with cervical inflammation or wart, 95 cases with CINI, 28 CINII, 36 cases with CINIII and 12 cases with MIVC. (4) The rate of concordance: compared with biopsy pathologic examination, colposcopy examination found 113 cases with cervical inflammation and CINI, the rate of concordance was 90.4% (113/125). And 54 cases with CINIII or SCC diagnosed by colposcopy examination, however biopsy pathologic examination confirm 23 cases with CINIII and 10 cases with SCC at stage Ia, the concordance rate was 61% (33/54). (5) Complication: eight (3.9%, 8/204) pregnant women underwent cervical wound suturing due to continuous bleeding after colposcopy exam or biopsy. No other complications were recorded. It is necessary that TCT should be performed in pregnant women without cytological screening within one year. Colposcopic examination and biopsy were indicated if pregnant woman with abnormal cytological result were found. Pregnant women with cervicitis or CINI diagnosed by colposcopy should be followed up. If pregnant woman was suspected with CINII or advanced disease, biopsy guided by colposcopy should be performed.

Fluid-based ThinPrep cytology teat in the diagnosis of cervical diseases

Objective To explore the value of ThinPrep cytology test (TCT) in the screening and diagnosis of cervical diseases. Methods 330 patients were detected by Pap smear and fluid-based TCT. Those with positive cytological results (ASCUS or above) received colposcopic biopsies. The findings of biopsy were compared with that of the cytological test. Results The rate of abnormal epithelial cells identified by TCT was significantly higher than that of Pap smear (23.94% vs. 16.06%, P<.0.05). And the rate of severe cellular abnormity detected by TCT increased by 42.92%. With colposcopy-guided biopsies as the gold standard, the positive coincidence rate of TCT was significantly higher than that of Pap smear (67.09% vs. 45. 28%, P< 0.05). Conclusions ThinPrep cytology test is more sensitive than pap smear in screening cervical diseases, and TCT combined with colposcopy-guided biopsies may increase the accuracy of diagnosis. Key words: ThinPrep cytology test; Pap smear, Cervical biopsy; Cervical diseases

Application of ThinPrep cytology test in the diagnosis of lung cancer

To explore the diagnostic value of ThinPrep cytology test (TCT) in lung cancer. 353 cases of bronchoalveolar lavage fluid (BALF) and(or) bronchial brushing cytology (192 cases from lung cancer patients and 161 cases from benign lung disease patients) were detected with TCT and method of direct smear, respectively. The sensitivity and specificity of two methods was compared. The sensitivity and specificity of TCT were 39.6% and 99.4%. And which of direct smear method were 8.3% and 100%, respectively. The sensitivity of TCT was significantly higher than that of method of direct smear in the diagnosis of lung cancer (P < 0.01). There were 71 patients who underwent BALF and bronchial brushing cytology simultaneously, the sensitivity of TCT of BALF was higher than that of bronchial brushing cytology (P < 0.05). Of the 69 cases which had both TCT and histopathological results, TCT and pathology concordance rate was 84.1%. TCT has more diagnostic value in lung cancer; BALF is more preponderant than bronchial brushing cytology by TCT in the diagnosis of lung cancer.

Factors associated with abnormal cervical cytology in pregnant women

To investigate the risk factors associated with abnormal cervical cytology findings in pregnant women. From Sep. 2007 to Sep. 2008, 12,112 pregnant women who underwent their antenatal examinations at 12-36 gestational weeks in Beijing Obstetrics and Gynecology Hospital were enrolled in this study. They were all excluded from the following pathologic obstetrics factors including threatened abortion, premature rupture of membranes or placental previa. Thinprep cytology test (TCT) were given at their first examination, meanwhile, a personal clinic file was established to record her occupation, education, address, family income, nationality, age of first intercourse, number of sex partners, contraception, marriage and pregnancy, current gynecologic diseases, family history of gynecologic tumors, history of gynecologic diseases and smoking and result of pelvic examination. Those risk factors leading to abnormal cervical cytology were analyzed. The complete clinical data were collected from 11 906 cases (98.30%, 11,906/12,112). It was found that 10,354 women were shown with normal TCT result, however, 1134 women (9.52%, 1134/11,906) with atypical squamous cells of undetermined significance (ASCUS), 112 women (0.94%, 112/11,906) with atypical glandular cells of undetermined significance (AGUS), 229 women (1.92%, 229/11,906) with low grade squamous intraepithelial (LSIL), 74 women (0.62%, 74/11,906) with high grade squamous intraepithelial (HSIL). Multiple factorial non-conditioned logistic regression analysis showed that age of first sexual intercourse (OR(ASCUS) = 2.90, OR(AGUS) = 7.32), number of sex partners (OR(ASCUS) = 1.49, OR(AGUS) = 2.02), number of abortion (OR(ASCUS) = 1.68, OR(AGUS) = 3.50) were correlated with ASCUS and AGUS. In LSIL group and HSIL group, age of first sexual intercourse (OR(LSIL) = 6.34, OR(HSIL) = 9.26), number of sex partners (OR(LSIL) = 1.69, OR(HSIL) = 1.65), number of abortion (OR(LSIL) = 1.53, OR(HSIL) = 5.33), smoking (OR(LSIL) = 1.84, OR(HSIL) = 1.77) were remarkable variables. The infection of human papilloma virus (HPV) and trichomonas vaginitis were correlated with abnormal cervical cytology (including ASCUS, AGUS, LSIL and HSIL) significantly (P < 0.01). Columnar epithelium dystopia were also significantly correlated with abnormal cervical cytology (chi(2) = 43.269, P = 0.000). However, abnormal cervical cytology was uncorrelated with degrees of Columnar epithelium dystopia. The risk factors associated with abnormal cervical cytology in pregnant women were the same with those of non-pregnant women.

The clinical analysis on the 956 cases with atypital squamous cells

Objective To analyze the clinical management of women with atypital squamous cells(ASC).Methods During Sep 2003 to Sep 2008,a totle of 956 women in our department were diagnosed with ASC by cytological test,they were further biopsied under the colposcope.The result of TCT,colposcopic test,biopsy and the highrisk factor were recorded and analysed;the based the biopsy were analyzed by the X~2-test;the high-risk factors and the odds Ratio(OR) were counted by SPSS10.0.Results Among the women with ASC,the rate of cervical intraepithelial neoplasia(CIN) diagnosed by the biopsy under the colposcope was 50.7% ,the rate of the high-grade lesion over CINII Was 13.3% ;if the colposcopic test were low-grade lesion,the rate of the cases which biopsys were the highgrade lesion over CINII,was 8.3% ;the high-risk factors which caused the cervical high-grade lesion were the number of sex-partners over 3,the age less than 20 yearold when the sex were made,the cervical erosion,the result of TCT with ASC-H.Conclusion Among the women with ASC,the biopsy shows multiformity;the rate of CIN and the highgrade lesion is also high;if TCT is ASC,the colposcopie test is advised;if the woman who has the high-risk factors,biopsy is advised. Key words: Thinprep cytology test; Colposcopie test; Cervical intraepithelial neoplasia