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Cervical cytology and histology correlation as an analytic quality assurance exercise: Experience from an accredited cytology laboratory 宫颈细胞学和组织学相关性作为分析质量保证练习:来自认可细胞学实验室的经验
4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2023-01-01 DOI: 10.4103/joc.joc_174_22
ShubhangiV Belekar, Meherbano Kamal, AishwaryaS Warke
Context: The performance parameters of cervical cytology in any accredited cytology laboratory requires implementation of quality control exercise, which ensures acceptable performance by a laboratory. This study aims to assess the analytical aspect of quality control measures by evaluating the frequency and accuracy of epithelial abnormalities as detected in cervical Pap smears using histopathologic diagnosis as the gold standard. Methods: A retrospective diagnostic test study from 2018 to 2020 was conducted. Out of the total 6000 Pap smears, histopathologic correlation was available in 150 cases in the form of colposcopic-directed biopsy (CDB) and loop electrosurgical excision procedure (LEEP) tissue in 105 cases. The quality control measures analyzed were Atypical Squamous Cell: Squamous Intraepithelial Lesion (ASC: SIL) ratio, cyto-histo correlation, and study parameters like sensitivity, specificity, positive predictive value, and negative predictive value of Pap smears as against CDB and LEEP. Results: 4.5% smears were reported as inadequate, 92.3% as Negative for intraepithelial lesion or malignancy (NILM), followed by epithelial abnormality found in 3.21%. The ASC: SIL ratio was 1.3:1. Concordance rate against CDB was 100% in Squamous cell carcinoma (SCC), 82.35% in high-grade squamous intraepithelial lesion (HSIL), 82% in atypical squamous cells of undetermined significance (ASCUS), 65.6% in low-grade squamous intraepithelial lesion (LSIL), and 50% in Atypical Squamous Cell ,High grade Squamous Intraepithelial Lesion can not be ruled out (ASC-H). Total concordance rate was 84.15%. Sensitivity of Pap smear was 65% for LSIL and 82% for HSIL. Specificity, positive predictive value, and negative predictive value were 63.63%, 90%, and 75%, respectively. Concordance rate was 96% with LEEP. Conclusion: Quality control measures give an insight of performance of any accredited cytology laboratory. This exercise needs to be conducted on a regular basis, so that relevant steps can be taken in case of major discrepancy.
背景:任何认可的细胞学实验室的宫颈细胞学性能参数要求实施质量控制活动,以确保实验室的可接受性能。本研究旨在评估质量控制措施的分析方面,通过评估宫颈涂片检测上皮异常的频率和准确性,以组织病理学诊断为金标准。方法:2018 ~ 2020年进行回顾性诊断试验研究。在总共6000例巴氏涂片检查中,150例以阴道镜指导活检(CDB)和105例环电手术切除(LEEP)组织的形式存在组织病理学相关性。分析的质量控制措施包括非典型鳞状细胞:鳞状上皮内病变(ASC: SIL)比率、细胞与组织的相关性,以及巴氏涂片对CDB和LEEP的敏感性、特异性、阳性预测值和阴性预测值等研究参数。结果:涂片不充分者占4.5%,上皮内病变或恶性(NILM)阴性者占92.3%,上皮异常者占3.21%。ASC: SIL比值为1.3:1。鳞状细胞癌(SCC)对CDB的符合率为100%,高级别鳞状上皮内病变(HSIL)为82.35%,不确定意义的非典型鳞状细胞(ASCUS)为82%,低级别鳞状上皮内病变(LSIL)为65.6%,非典型鳞状细胞为50%,高级别鳞状上皮内病变不能排除(ASC-H)。总符合率为84.15%。巴氏涂片检测LSIL的敏感性为65%,HSIL的敏感性为82%。特异性为63.63%,阳性预测值为90%,阴性预测值为75%。LEEP的符合率为96%。结论:质量控制措施提供了任何认可细胞学实验室的性能洞察力。这项工作需要定期进行,以便在出现重大差异时采取有关步骤。
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引用次数: 0
Microcystic Meningioma - A Diagnostic Dilemma During Intraoperative Squash Smear Study. 微囊性脑膜瘤——术中挤压涂片研究中的诊断难题。
IF 1.3 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2023-01-01 Epub Date: 2023-02-15 DOI: 10.4103/joc.joc_28_22
Sukhpreet Kaur, Rahul Karode, Hanni V Gulwani

Background: Meningiomas are generally slow-growing, benign, and non-infiltrating in nature. They are usually easy to diagnose cytologically if they are of the meningothelial type; however, they may cause diagnostic challenges when they manifest as unusual morphological variants, like the microcystic type. Because of the rarity of microcystic meningioma (MM), information on its cytological features is rarely available in the literature.

Objectives: The goal of this study is to review the cytological features of MM in crush preparations prepared at the time of intra-op consultation and to identify the more common features which are helpful in rendering a correct diagnosis.

Material and methods: Cytological features of five cases of MM were reviewed and noted from the records.

Results: There were five patients of MM with a male: female ratio of 1.5:1 and a mean age of 52 years. All tumors were supratentorial and dura-based. Magnetic resonance imaging (MRI) showed low signal intensity on T1 and high signal intensity on T2 weighted images in four cases. Cytosmears were moderate-to-highly cellular. There were variable-sized cystic spaces within the meningothelial cell clusters. In four cases, nuclear pleomorphism was frequently observed. Nuclear pseudoinclusions, atypical mitoses, vascular proliferation, and necrosis were absent in all cases. Whorling and psammoma bodies were seen in only one case.

Conclusion: Cytological features identified would be helpful in the diagnosis of microcystic meningiomas, especially in unusual radiological findings. Their unusual cytological features might lead to problems in differential diagnosis from other intracranial tumors, including glioblastoma, metastatic tumor, etc.

背景:脑膜瘤通常是生长缓慢、良性和非浸润性的。如果它们是脑膜型,通常很容易在细胞学上诊断;然而,当它们表现为不寻常的形态变异,如微囊型时,可能会引起诊断挑战。由于微囊型脑膜瘤(MM)的罕见性,文献中很少有关于其细胞学特征的信息。目的:本研究的目的是回顾术中会诊时准备的挤压制剂中MM的细胞学特征,并确定有助于正确诊断的更常见特征。材料和方法:对5例MM的细胞学特征进行回顾性分析。结果:MM患者5例,男女比例为1.5:1,平均年龄52岁。所有肿瘤均以幕上和硬脑膜为基础。4例患者的磁共振成像(MRI)显示T1低信号强度,T2加权图像高信号强度。细胞涂片为中度至高度细胞性。脑膜上皮细胞簇内有大小不等的囊性间隙。在四个病例中,经常观察到核多形性。所有病例均无核假包涵体、非典型有丝分裂、血管增生和坏死。只在一个案例中发现了Whorling和psammma尸体。结论:确定细胞特征有助于诊断微囊性脑膜瘤,尤其是在不寻常的放射学表现中。它们不寻常的细胞学特征可能会导致与其他颅内肿瘤的鉴别诊断问题,包括胶质母细胞瘤、转移瘤等。
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引用次数: 1
Programmed death ligand-1 testing in adenocarcinoma lung: A comparative study of cell block versus biopsy 肺腺癌的程序性死亡配体-1检测:细胞阻滞与活检的比较研究
4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2023-01-01 DOI: 10.4103/joc.joc_33_22
Nuzhat Husain, Saumya Shukla, RahulK Pandey, Vani Gupta, Anurag Gupta, Surya Kant
Background: Immunotherapy currently stands as a novel treatment option, specifically in cases of advanced non-small cell lung carcinoma (NSCLC). Expression of programmed death ligand-1 (PD-L1) in tumor cells forms the mainstay for the use of anti-PD-L1 monoclonal antibodies in the treatment of NSCLC. Aims: The objectives of the study were to assess utility of cell blocks for testing of PD-L1 in adenocarcinoma lung and to compare the expression of PD-L1 in cell blocks and the corresponding biopsy specimens. Materials and Methods: The current study was a prospective case series that included 20 cases of NSCLC–adenocarcinoma lung. Cases included in the study had biopsies performed from lung masses, along with which cell blocks were prepared from fine needle aspiration cytology (FNAC) samples. Testing for PD-L1 was done using the monoclonal PD-L1 antibody, SP-263 clone on the Ventana Benchmark XT system. PD-L1 expression was assessed only in the tumor cells, and cases with >1% expression, cytoplasmic or membranous, in tumor cells were categorized as positive. Results: PD-L1 expression was identified in the biopsy samples of tumor cells of 20% of cases (n = 4/20). In the corresponding cell blocks, PD-L1 expression was identified in the tumor cells of 15% of cases (n = 3/20). Sensitivity and specificity of cell blocks were 75% and 100%, respectively. Positive and negative predictive values were 100% and 94.12%, respectively. Conclusion: PD-L1 testing has both predictive and prognostic implications. PD-L1 testing in cell block samples is a potential alternative, specifically in cases where biopsy tissue is minimal or unavailable.
背景:免疫疗法目前是一种新的治疗选择,特别是在晚期非小细胞肺癌(NSCLC)的病例中。程序性死亡配体-1 (PD-L1)在肿瘤细胞中的表达是使用抗PD-L1单克隆抗体治疗非小细胞肺癌的主要依据。目的:本研究的目的是评估细胞块检测肺腺癌中PD-L1的效用,并比较细胞块和相应活检标本中PD-L1的表达。材料和方法:本研究是一个前瞻性的病例系列,包括20例非小细胞肺癌肺腺癌。研究中包括的病例对肺肿块进行了活组织检查,同时从细针吸细胞学(FNAC)样本中制备了细胞块。在Ventana Benchmark XT系统上使用单克隆PD-L1抗体SP-263进行PD-L1检测。PD-L1仅在肿瘤细胞中表达,在肿瘤细胞中细胞质或膜性表达>1%的病例被归类为阳性。结果:20%的病例(n = 4/20)的肿瘤细胞活检样本中检测到PD-L1表达。在相应的细胞块中,15%的病例的肿瘤细胞中检测到PD-L1表达(n = 3/20)。细胞块的敏感性和特异性分别为75%和100%。阳性预测值为100%,阴性预测值为94.12%。结论:PD-L1检测具有预测和预后意义。在细胞块样本中进行PD-L1检测是一种潜在的替代方法,特别是在活检组织很少或无法获得的情况下。
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引用次数: 0
Role of Guided FNA in Gallbladder Cancer: A Retrospective 3-Year Study. 导向性FNA在胆囊癌症中的作用:一项为期3年的回顾性研究。
IF 1.3 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2023-01-01 Epub Date: 2023-02-15 DOI: 10.4103/joc.joc_224_21
Surbhi Goyal, Garima Prasad, Dimple Chaudhary, Puja Sakhuja, Siddhartha Srivastava, Anil K Aggarwal

Background: A majority of the patients with gall bladder cancer (GBCa) present at an advanced stage and have poor survival. The aim is to retrospectively study the role of guided FNA in the diagnosis of GBCa in a superspecialty institute and to describe the cytomorphologic spectrum of gall bladder (GB) lesions in the North Indian population.

Materials and methods: All suspected cases of GBCa who underwent guided FNA from the primary GB mass or metastatic liver space-occupying lesion from 2017 to 2019 were included. The aspirate smears were retrieved and analyzed for cytomorphological features independently by two cytopathologists. The neoplastic lesions were classified according to the WHO 2019 classification.

Results: Of 489 cases, fine needle aspiration cytology (FNAC) was diagnostic in 463 cases (94.6%), of which 417 (90.1%) were positive for malignancy, 35 (7.5%) were inflammatory, and 11 (2.4%) were inconclusive for malignancy. Adenocarcinoma not otherwise specified (NOS) was the most common type seen in 330 cases (79.1%) and 87 (20.9%) were unusual variants. These included papillary adenocarcinoma (22, 5.2%), mucinous adenocarcinoma (12, 2.8%), signet ring carcinoma (2,0.4%), adenosquamous carcinoma (8, 1.9%), squamous cell carcinoma (10, 2.4%), neuroendocrine neoplasms (7, 1.7%), undifferentiated carcinoma (24, 5.7%) and non-Hodgkin lymphoma (2,0.4%), respectively. Immunohistochemistry on the cell block confirmed the diagnosis wherever possible. Histopathology was discordant in 5 out of 33 cases.

Conclusion: Guided FNAC is a sensitive investigation that plays a crucial role in confirming the diagnosis and deciding the further treatment options in advanced-stage GBCa patients. The uncommon variants of GBCa can be reliably categorized on cytology.

背景:大多数癌症(GBCa)患者处于晚期,生存率低。目的是在一家超专业研究所回顾性研究引导下的FNA在GBCa诊断中的作用,并描述北印度人群胆囊(GB)病变的细胞形态学谱。材料和方法:纳入2017年至2019年接受原发性GB肿块或转移性肝占位病变引导下FNA的所有疑似GBCa病例。两位细胞病理学家独立检索和分析抽吸涂片的细胞形态学特征。肿瘤病变根据世界卫生组织2019年分类进行分类。结果:在489例病例中,细针穿刺细胞学(FNAC)诊断为463例(94.6%),其中417例(90.1%)为恶性阳性,35例(7.5%)为炎症性,11例(2.4%)为非恶性。未另行说明的腺癌(NOS)是330例(79.1%)中最常见的类型,87例(20.9%)是不寻常的变体。其中包括乳头状腺癌(22,5.2%)、粘液腺癌(12,2.8%)、印戒癌(2,0.4%)、腺鳞状癌(8,1.9%)、鳞状细胞癌(10,2.4%)、神经内分泌肿瘤(7,1.7%)、未分化癌(24,5.7%)和非霍奇金淋巴瘤(2,0.4%)。在可能的情况下,细胞块上的免疫组织化学证实了诊断。33例中有5例组织病理学不一致。结论:FNAC是一项敏感的研究,对晚期GBCa患者的诊断和进一步治疗方案的确定起着至关重要的作用。GBCa的不常见变异可以在细胞学上可靠地分类。
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引用次数: 1
Fine Needle Aspiration Cytology of Maxillary Ameloblastoma: A Cytological Eye-Opener. 上颌成釉细胞瘤的细针抽吸细胞学:细胞学大开眼界。
IF 1.3 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2023-01-01 Epub Date: 2023-03-10 DOI: 10.4103/joc.joc_106_22
Akriti Jindal, Gargi Kapatia, Manjit K Rana, Nikhil Rajan, Utkarshni Khera
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引用次数: 0
Clinico-cytomorphological Spectrum of Calcinosis Cutis. 皮肤钙化症的临床细胞形态学谱。
IF 1.3 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2023-01-01 Epub Date: 2023-03-13 DOI: 10.4103/joc.joc_75_22
Malvika Shastri, Pratibha Gautam, Preeti Diwaker, Priyanka Gogoi, Vinod K Arora

Introduction: The deposition of calcium in the skin is known as calcinosis cutis. It can affect any part of the body and can mimic soft tissue or bony lesions clinically.

Aim: To describe the clinical and cytomorphologic features of calcinosis cutis on fine needle aspiration cytology smears.

Materials and methods: A total of 17 cases reported as calcinosis cutis on fine needle aspiration cytology were reviewed for the available clinical and cytological details.

Results: The cohort included both adult and pediatric patients. Clinically, the lesions appeared as painless swellings of variable sizes. The common sites affected were the scrotum, iliac region, scalp, pinna, neck, axilla, elbow, arm, thigh, and gluteal region. Aspirate was chalky white, paste-like in all the cases. The cytologic evaluation revealed amorphous crystalline deposits of calcium along with histiocytes, lymphocytes, and multinucleated giant cells.

Conclusions: Calcinosis cutis has a wide spectrum of clinical presentations. Fine needle aspiration cytology is a minimally invasive approach for diagnosing calcinosis cutis, thus eliminating the need for more extensive biopsy procedures.

引言:钙在皮肤中的沉积被称为钙化性皮肤病。它可以影响身体的任何部位,在临床上可以模拟软组织或骨损伤。目的:在细针吸取细胞学涂片上描述钙化性皮肤的临床和细胞形态学特征。材料和方法:对细针吸取细胞学检查中报告的17例皮肤钙化症进行回顾性分析,以了解可用的临床和细胞学细节。结果:该队列包括成人和儿童患者。临床上,病变表现为大小不等的无痛性肿胀。受影响的常见部位是阴囊、髂区、头皮、耳廓、颈部、腋窝、肘部、手臂、大腿和臀大区。吸气器呈粉白色,在所有情况下都像浆糊一样。细胞学评估显示,钙与组织细胞、淋巴细胞和多核巨细胞一起存在无定形结晶沉积。结论:钙化性皮肤病具有广泛的临床表现。细针抽吸细胞学检查是诊断钙化性皮肤病的一种微创方法,因此无需进行更广泛的活检程序。
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引用次数: 0
Cytomorphological features of complex fibroadenoma breast 乳腺复杂纤维腺瘤的细胞形态学特征
4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2023-01-01 DOI: 10.4103/joc.joc_58_23
RaviH Phulware, Samikshya Thapa, Arvind Kumar, Sanjeev Kishore
Dear Editor, Fibroadenomas are the most common solid benign breast lesions in women having epithelial and stromal components. It may occur at any age, with the peak incidence being in adolescent girls around their 20s and 30s, except for complex fibroadenoma occurring in older women.[1,2] Hormonal stimulations have an etiological role, particularly an increase in estrogen and progesterone activity, pregnancy, and lactation. Being hormone-dependent, tumor dimensions increase during these hormonally active periods and decrease during the perimenopausal period.[2,3] The size of the lump in complex fibroadenoma is relatively smaller (average 1.3 cm in diameter) compared to simple fibroadenoma (average diameter: 3 cm). Fibroadenoma is termed complex fibroadenoma when it possesses either of the histological features, cyst >3 mm in diameter, sclerosing adenosis, epithelial calcification, and papillary apocrine metaplasia.[1,3,4] We report a case of a 48-year-old postmenopausal woman who presented with a history of a painless, mobile lump in the right breast for 1 month. The lump was single, nonprogressive in size, and was not associated with pain or nipple discharge. The patient did not give any history of hormonal therapy or surgery. On examination, a solitary, round to oval hard, nontender mass was felt in the right breast’s upper outer and central quadrant measuring 6 × 5 cm. No significant ipsilateral axillary lymph node was palpable. She had no family history of any breast lumps. At our center, mammography of the right breast revealed an irregular-shaped high-density lesion with a microlobulated margin in the upper outer quadrant extending into the upper-central and lower-outer quadrant measuring 64 × 58 × 40 mm and a focus of macrocalcification within it (Breast Imaging Reporting and Data System: BIRADS 4b). The possibility of benign phyllodes tumor was rendered [Figure 1a]. Similarly, ultrasonography of the right breast exhibited an irregular-shaped heterogeneously hypoechoic lesion with a few cystic areas measuring 63 × 54 mm (BIRADS 4b), the possibility of phyllodes tumor. Subsequently, ultrasound-guided fine-needle aspiration cytology was performed from the lesion. The smear from the representative site was cellular, comprising sheets of benign ductal epithelial cells and a few mildly cellular stromal fragments [Figure 1b]. Few epithelial cell clusters show discohesiveness at the periphery with nuclear pleomorphism in the form of enlarged nuclei, prominent nucleoli, and occasional mitosis. The background showed bare bipolar nuclei and blood [Figure 1c-e]. Based on these findings, the fine-needle aspiration cytology was reported as an atypical breast lesion according to The International Academy of Cytology Yokohama system, and the patient was advised to excision biopsy for a definitive diagnosis.Figure 1: (a) Mammography of the right breast shows an irregularly shaped (microlobulated margin) high density, heterogeneously hypoechoic lesion with
此外,它显示不规则边界,大小不一的导管上皮细胞片,具有明显的不粘连性。少数非典型导管细胞核增大,核仁突出。少量肌上皮细胞可被识别。[3-5]与单纯性纤维腺瘤(中位年龄28.5岁)相比,复合纤维腺瘤主要发生在老年女性(中位年龄47岁)中。[5,6]复杂纤维腺瘤发展为恶性的风险为2.17%,在同侧或对侧发生浸润性乳腺癌的风险为3.1倍,因此有必要对纤维腺瘤的不同变体进行鉴别,因为每种变体在预后和治疗上都存在差异。[2,3]文献显示,复杂型纤维腺瘤患者发生癌的相对危险度是普通人群女性的3.1倍,而非复杂型纤维腺瘤的相对危险度为1.89倍。[3-6]因此,在细胞病理学诊断的日常实践中,需要对复杂纤维腺瘤的特征有准确的认识。总的来说,复杂纤维腺瘤的细胞学可能是可变的,但它们通常被认为是良性肿瘤。在细胞学上,细胞的大小和形状均匀,核质比低。细胞可以排列成多种模式,包括片状、小梁状和簇状。细胞学上,复杂纤维腺瘤可能显示上皮和基质成分的存在,这使得它们比简单纤维腺瘤更复杂。上皮细胞可表现为轻度异型性,即细胞核略微不规则,但这种异型性并不严重到提示为恶性。基质细胞可能显示透明化区域,这意味着组织因胶原蛋白沉积而变硬。患者同意声明作者证明他们已经获得了所有适当的患者同意表格。在表格中,患者已经同意他/她/他们的图像和其他临床信息将在杂志上报道。患者明白他们的姓名和首字母不会被公布,并将尽力隐藏他们的身份,但不能保证匿名。财政支持及赞助无。利益冲突没有利益冲突。
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引用次数: 0
MASC gets UNMASKED: Visiting a rare tumor with emphasis on cytomorphological features MASC被揭露:访问一个罕见的肿瘤,强调细胞形态学特征
4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2023-01-01 DOI: 10.4103/joc.joc_155_22
Ashok Singh, MichaelL Anthony, Neha Kumari, Reshma Jeladharan, VinayN Gowda, PrashantPranesh Joshi, Prashant Durgapal, Arvind Kumar
Background: Secretory carcinoma (SC) is a newly described entity which has been often misdiagnosed earlier as acinic cell carcinoma on cytology. Diagnosing SC was initially based upon identifying the ETV6:NTRK3 fusion gene with the help of fluorescence in situ hybridization (FISH). Lately, with more knowledge of the reliable histomorphology, cytology, and immunohistochemistry features, definitive diagnosis can be confidently made without the help of FISH in almost every case. Materials and Methods: Six histologically confirmed cases of SC were studied. The cytology slides of all the six cases were retrieved and reviewed to identify the characteristic features which could have helped in raising the possibility of SC on fine needle aspiration cytology itself. Cell blocks were also studied, wherever available. Results: Patients were all male with average age of 35.2 years. The six cases in the current study demonstrated at least focal cytoplasmic vacuolization of varying sizes, papillae formations, and bland nuclear features on fine needle aspirate smears. It was also seen that S-100 and mammaglobin immunohistochemistry (IHC) are very helpful in confirming the diagnosis. Conclusions: The results of the current study highlight the cytomorphological features which may help in clinching the diagnosis SC on cytology itself. They also highlight certain cytological features which help to rule out the other differential diagnoses.
背景:分泌性癌(SC)是一种新发现的肿瘤,在细胞学上常被误诊为腺泡细胞癌。SC的诊断最初是基于荧光原位杂交(FISH)鉴定ETV6:NTRK3融合基因。最近,随着对可靠的组织形态学、细胞学和免疫组织化学特征的更多了解,几乎所有病例都可以在没有FISH帮助的情况下自信地做出明确的诊断。材料与方法:对6例组织学证实的SC病例进行了研究。所有6例的细胞学切片都被检索和审查,以确定可能有助于提高细针穿刺细胞学本身SC的可能性的特征。只要有可能,细胞块也会被研究。结果:患者均为男性,平均年龄35.2岁。本研究中的6例患者在细针穿刺涂片上至少表现出不同大小的局灶性细胞质空泡化、乳头状结构和温和的核特征。S-100和乳蛋白免疫组化(IHC)对诊断有很大帮助。结论:本研究的结果突出了细胞形态学特征,这可能有助于细胞学本身诊断SC。他们还强调了某些细胞学特征,这些特征有助于排除其他鉴别诊断。
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引用次数: 0
High-risk Human Papillomavirus (hrHPV) Prevalence and Genotype Distribution among Turkish Women. 土耳其妇女中高危人类乳头瘤病毒(hrHPV)的患病率和基因型分布。
IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2023-01-01 Epub Date: 2023-03-20 DOI: 10.4103/joc.joc_129_22
Melin Gecer

Purpose: This study aimed to determine the rates of distribution of high-risk HPV (hrHPV) genotypes according to cervical smear samples and biopsy results in a large sample of Turkish women.

Methods: The study was conducted with 4,503 healthy volunteer women aged 19-65 years. Samples of cervical smears were collected during the examination and liquid-based cytology was used for the Pap tests. The Bethesda system was used for reporting the cytology. High-risk HPV genotypes including HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68 were investigated in samples. The study cohort was grouped according to age in decades, with comparisons made according to these age groups, Bethesda class, and cervix biopsy results.

Results: Among all cases, 903 (20.1%) participants were positive for 1074 hrHPV-DNA genotypes. HPV-DNA positive cases were most common in the 30-39 age group (28.0%), followed by women under the age of 30 (38.5%). HPV genotypes were determined as, in order of frequency: Other hrHPV (n = 590, 65.3%), HPV16 (n = 127, 14.1%), Other HPV + HPV16 (n = 109, 12.1%), HPV 18 (n = 33, 3.6%), and Other HPV + HPV 18 (n = 32, 3.5%). Cervical smears were reported as ASCUS in 304 (6.8%) samples and high-grade squamous intraepithelial lesion (HSIL) in 12 (0.3%) of the samples. Biopsy demonstrated the presence of HSIL in 110 (12.5%) participants, with 644 (73.3%) negative cases.

Conclusion: This showed an increasing incidence of Other HPVs besides the known importance of HPV 16 and 18 genotypes as risk factors for cervical cancer.

目的:本研究旨在根据土耳其妇女的宫颈涂片样本和活检结果,确定高危HPV(hrHPV)基因型的分布率。方法:对4503名19~65岁的健康女性志愿者进行研究。在检查过程中采集了宫颈涂片样本,并使用液基细胞学进行巴氏检查。Bethesda系统用于报告细胞学。在样本中调查高危HPV基因型,包括HPV16、18、31、33、35、39、45、51、52、56、58、59、66和68。研究队列根据几十年来的年龄进行分组,并根据这些年龄组、贝塞斯达等级和宫颈活检结果进行比较。结果:在所有病例中,903名(20.1%)参与者的1074 hrHPV DNA基因型呈阳性。HPV-DNA阳性病例最常见于30-39岁年龄组(28.0%),其次是30岁以下的女性(38.5%)。HPV基因型按频率顺序确定为:其他hrHPV(n=590,65.3%)、HPV16(n=127,14.1%)、其他HPV+HPV16,和其他HPV+HPV18(n=32,3.5%)。304份(6.8%)样本中的宫颈涂片报告为ASCUS,12份(0.3%)样本中报告为高级鳞状上皮内病变(HSIL)。活检显示110例(12.5%)参与者存在HSIL,644例(73.3%)为阴性。结论:除已知HPV16和18基因型作为癌症危险因素的重要性外,其他HPV的发病率也在增加。
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引用次数: 0
Evaluation of the Cytonucleomorphometric Parameters for Cases Diagnosed as Squamous Cell Abnormality on Conventional Cervico-Vaginal Pap Smears. 常规宫颈阴道巴氏涂片诊断为鳞状细胞异常病例的细胞核形态计量学参数评估。
IF 1.3 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2023-01-01 Epub Date: 2022-12-26 DOI: 10.4103/joc.joc_73_22
Satyam Mishra, Ujjawal Khurana, Neelkamal Kapoor, Ankur Joshi, Deepti Joshi

Background and aim: The natural history of cervical cancer is unique that it is preceded by a precancerous condition for a long time. Morphometry as a tool can be used in early and accurate diagnosis of these precancerous and cancerous lesions. The present study aims at assessing the utility of cellular and nuclear morphometry in differentiating squamous cell abnormality from benign conditions and also differentiating the categories of squamous cell abnormalities.

Materials and methods: Forty-eight diagnosed cases of squamous epithelial cell abnormality, that is, 10 cases each of atypical squamous cell of undetermined significance (ASC-US), low-grade squamous intraepithelial lesion (LSIL), high-grade SIL (HSIL), and squamous cell carcinoma (SCC) and eight cases of ASC-H (ASC cannot exclude HSIL), were made the sample population and compared with a control population of 10 cases of negative for intraepithelial lesion or malignancy (NILM). Parameters like nuclear area (NA), nuclear perimeter (NP), nuclear diameter (ND), nuclear compactness (NC), cellular area (CA), cellular diameter (CD), cellular perimeter (CP), and nucleocytoplasmic (N/C) ratio were used.

Results: There was a significant difference in the six groups of squamous cell abnormality based on NA, NP, ND, CA, CP, and CD (P < 0.05) using one-way analysis of variance. Nuclear morphometry parameters like NA, NP, and ND were found to be the maximum for HSIL, followed by LSIL, ASC-H, ASC-US, SCC, and NILM groups in decreasing order. The mean CA, CP, and CD were found to be the maximum for NILM, followed by LSIL, ASC-US, HSIL, ASC-H, and SCC in decreasing order. On post hoc analysis, the lesions can be divided into three groups: NILM/normal; ASC-US and LSIL; and ASC-H, HSIL, and SCC, based on N/C ratio.

Conclusion: In cervical lesions, holistic parameter of cytonucleomorphometry should be taken rather than taking nuclear morphometry only. N/C ratio is a highly statistically significant parameter that can differentiate between low-grade lesions and high-grade lesions.

背景和目的:癌症的自然病史是独特的,它之前有很长一段时间的癌前病变。形态计量学作为一种工具可以用于这些癌前病变和癌性病变的早期准确诊断。本研究旨在评估细胞和细胞核形态计量学在区分鳞状细胞异常和良性疾病以及区分鳞状细胞畸形类别方面的效用。材料和方法:48例诊断为鳞状上皮细胞异常,即不典型意义鳞状细胞(ASC-US)、低度鳞状上皮内病变(LSIL)、高度SIL(HSIL)和鳞状细胞癌(SCC)各10例,ASC-H(ASC不能排除HSIL)8例,并与10例上皮内病变或恶性肿瘤(NILM)阴性病例的对照人群进行比较。使用了核面积(NA)、核周长(NP)、核直径(ND)、核致密度(NC)、细胞面积(CA)、细胞直径(CD)、细胞周长(CP)和核质(N/C)比等参数。结果:采用单向方差分析,NA、NP、ND、CA、CP和CD在6组鳞状细胞异常中有显著性差异(P<0.05)。发现HSIL的核形态计量学参数如NA、NP和ND最大,其次是LSIL、ASC-H、ASC-US、SCC和NILM组,按降序排列。NILM的平均CA、CP和CD最大,其次是LSIL、ASC-US、HSIL、ASC-H和SCC,按递减顺序排列。根据事后分析,病变可分为三组:NILM/正常;ASC-US和LSIL;以及基于N/C比率的ASC-H、HSIL和SCC。结论:在宫颈病变中,应采用细胞核形态测量的整体参数,而不是仅采用核形态测量。N/C比是一个具有高度统计学意义的参数,可以区分低级别病变和高级别病变。
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Journal of Cytology
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