Managing atypical squamous cells of undetermined significance in Papanicolaou smears.

Objective: To assess strategies using repeated conventional Pap smear and human papillomavirus (HPV) DNA testing, alone or in combination, for identifying women with concomitant cervical intraepithelial neoplasia 2 and 3 (CIN 2/3) in women with atypical squamous cells of undetermined significance (ASCUS) in their Pap smears.

Study Design: A total of 360 women cytologically diagnosed with ASCUS were referred for colposcopy and underwent a repeat Pap smear, a biopsy when necessary and HPV testing using three different modes of detection of high-oncogenic-risk HPV types: 1, first-generation Hybrid Capture test (HC-1) (Digene Diagnostics, Gaithersburg, Maryland); 2, second-generation Hybrid Capture test (HC-2); and 3, polymerase chain reaction (PCR).

Results: Nineteen patients (5.

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.

Human papillomaviruses and vulvar vestibulitis.

Objective: To assess the relationship between human papillomavirus (HPV) infection and vulvar vestibulitis syndrome.

Methods: From November 1995 to December 1997, 135 women with vulvar vestibulitis were compared with 322 controls who had no evidence of vulvar vestibulitis. Human papillomavirus DNA was amplified by polymerase chain reaction and detected with liquid-capture molecular assay.

Predictors of concomitant cervical intraepithelial neoplasia in women with newly diagnosed atypical squamous cells of undetermined significance.

Objective: The percentage of women with atypical squamous cells of undetermined significance (ASCUS) with concomitant cervical intraepithelial neoplasia (CIN) is relatively high, varying between 18% and 30%, depending on the series. The objective of this study was to identify factors other than cervical human papillomavirus (HPV) infection that would help to identify women with newly diagnosed ASCUS and in need of referral to colposcopy.

Materials And Methods: A total of 360 eligible women in whom ASCUS was diagnosed and who were referred to the colposcopy clinic of Saint-Sacrement Hospital in Quebec City were included in this study (participation rate, 92%).

Comparison of the hybrid capture test and polymerase chain reaction in identifying women who have an atypical squamous cell of undetermined significance papanicolaou smear and need colposcopy.

Objectives: The objective of this study was to detect human papillomavirus (HPV) in women with a newly diagnosed atypical squamous cells of undetermined significance (ASCUS) using the hybrid capture (HC) test and the polymerase chain reaction (PCR). We sought to evaluate the accuracy of both tests in identifying women with a concomitant cervical intraepithelial neoplasia (CIN).

Materials And Methods: We studied 360 women who had a diagnosis of ASCUS and were referred to the colposcopy clinic.

100% rapid (partial) rescreening for quality assurance.

Objective: To compare the efficiency of two methods for routine quality assurance in gynecologic cytology: random rescreening of 10% of negative gynecologic smears and rapid rescreening of all negative gynecologic smears.

Study Design: All gynecologic smears considered to be negative or benign and diagnosed between November 1, 1996, and December 31, 1997, were rescreened using the rapid, partial rescreening technique. Results were compared to those of the 10% random rescreening method.

Human papillomavirus. International Academy of Cytology Task Force summary. Diagnostic Cytology Towards the 21st Century: An International Expert Conference and Tutorial.

Issues: Cervical squamous cell carcinomas, adenocarcinomas and their precursors are caused by the human papillomavirus (HPV). Although HPV appears to be essential to the transformation of these epithelial cells, it is not sufficient, and a variety of cofactors and molecular events must take place between when an HPV infection occurs and a cervical cancer or its precursor develops. This review examines the data supporting these contentions, briefly outlines the molecular events that occur, considers the epidemiology and natural history of the disease, and details the implications of using HPV detection and typing in both clinical management and population-based screening programs.

ASCUS and AGUS criteria. International Academy of Cytology Task Force summary. Diagnostic Cytology Towards the 21st Century: An International Expert Conference and Tutorial.

Issues: The conference participants addressed the following issues: (1) reporting of equivocal diagnoses, (2) strategies to minimize the use of such diagnoses, (3) morphologic criteria, and (4) management of women with equivocal diagnoses.

Consensus Position: Equivocal diagnoses should be minimized, to the extent possible, by emphasizing cytologist education and training, improved specimen collection and quality assurance monitoring of individual and laboratory diagnosis rates. Cases fulfilling criteria for other diagnostic entities should not be included in the equivocal category.

Determinants of persistent detection of human papillomavirus DNA in the uterine cervix.

To identify factors associated with persistence of human papillomavirus (HPV) DNA in the uterine cervix, 179 women who were 18-49 years old and who had normal cytologies and positive cervical HPV DNA test at a routine periodic examination were analyzed. Among them, 91 (50.8%) remained HPV-positive a few months (mean, 11 weeks) later.

Risk factors for cervical intraepithelial neoplasia: differences between low- and high-grade lesions.

This case-control study assesses relations of human papillomavirus (HPV) type 16 infection, sexual history, cigarette smoking, and oral contraceptive use to low- and high-grade cervical intraepithelial neoplasia (CIN). A total of 548 high-grade and 338 low-grade CIN cases and 612 controls were identified among women seen at a colposcopy clinic in Quebec, Quebec, Canada, in 1988-1989. Interviews, colposcopy, cervical scrapings, and colposcopically directed biopsies were performed.

Vulvar vestibulitis syndrome: an exploratory case-control study.

Objective: To assess the prevalence of genital bacterial infection among women with vulvar vestibulitis syndrome and to evaluate the association of several potential risk factors with the occurrence of the syndrome.

Methods: Fifty-seven women referred for dyspareunia who satisfied Friedrich's criteria and had symptoms for at least 6 months were recruited as cases. Controls included 173 patients without dyspareunia seen at a private clinic.

Cytologic diagnosis of human papillomavirus. Influence of age and pregnancy stage.

In a review of cytologic findings in 446,038 premenopausal women whose smears were examined during a five-year period ending in 1990, it was established that cytomorphologic evidence of human papillomavirus infection was significantly more common in the younger groups: those under 30 years of age had about twice the rate of the older groups. Similarly, in a group of 29,153 pregnant women it was found that cytologic signs of human papillomavirus were reported twice as often during the second half of pregnancy as in the first.

Condyloma and intraepithelial neoplasia of the uterine cervix: a case-control study.

Cervical condyloma and cervical intraepithelial neoplasia are related to human papillomavirus infections, some of which may be involved in the etiology of cancer of the uterine cervix. This case-control study was designed to assess the relation of age at first sexual intercourse, number of sexual partners, and cigarette smoking to the risk of cervical condyloma and cervical intraepithelial neoplasia. Cases and controls were premenopausal women under age 50 years who had been referred for examination at the Colposcopy Clinic of Saint-Sacrement Hospital in Quebec from 1982 to 1985.

A colposcopical lesion of the uterine cervix frequently associated with papillomavirus type 16 as detected by in situ and Southern blot hybridization: a cytohistological correlation study.

A convoluted aceto-white lesion was observed by colposcopy on the uterine cervix of 19 patients. A search for specific types of papillomavirus was undertaken in these lesions which proved histologically to be a vertical association of CIN in the lower strata of the squamous epithelium and typical condyloma in the uppermost layers. Previous cell samples correlated with histology in only 11 out of the 19 cases, and were not therefore an accurate predictor of histologic findings.

Criteria for the cytologic assessment of hyperplasias in endometrial samples obtained by the Endopap Endometrial Sampler.

The Endopap Endometrial Sampler was used in 1,465 women, either just before endometrial biopsy or curettage (in 760 symptomatic patients) or as an office procedure (in 705 women). The samples were inadequate for interpretation in only 8.7% of the cases.