The prevalence of cervical HPV and cytological abnormalities in association with reproductive factors of rural Nigerian women.

OBJECTIVE: To estimate the prevalence of cervical human papillomavirus (HPV) and cytological abnormalities while addressing demographic and reproductive variables in a sample of rural Nigerian patients. METHODS: In March 2004, a medical project was conducted in Okene, Nigeria. The obstetrics/gynecology team collected demographics of 231 patients and 199 ThinPrep Pap smears (Cytyc, Marlborough, MA), which were analyzed cytologically and for the presence of HPV DNA. RESULTS: Of 231 patients (mean age 32.2), 76% had seen a physician four times or less. From 199 Pap smears performed, 21.6% had high-risk (HR) HPV, low-risk (LR) HPV, or both. HR HPV was present in 16.6% of the women. There were 13 (6.5%) abnormal Pap smears, of which 9 (4.5%) had atypical squamous cells of undetermined significance (ASCUS), 1 (0.5%) had atypical glandular cells (AGC), 2 (1%) had low-grade squamous intraepithelial lesions (LSIL), and 1 (0.5%) had a high-grade SIL (HSIL). Other findings were Trichomonas vaginalis in 18 patients (9%) and Candida in 27 patients (13.5%). CONCLUSIONS: The prevalence of cervical HPV and SIL in Okene, Nigeria, is consistent with reports from other African regions. Improved access to healthcare and cervical cancer screening programs may help to decrease transmission of HPV and subsequent cervical cancer in underprivileged areas.

Diagnostic utility of D2-40 and podoplanin in effusion cell blocks.

The distinction between malignant mesothelioma and adenocarcinoma is a diagnostic challenge in cytologic specimens of effusion fluids. As for today, no single antibody has demonstrated absolute sensitivity or specificity for Mesothelioma. D2-40 and podoplanin have recently been recognized to stain mesothelial cells. Our aim for this study was to evaluate the utility of these two markers as indicators of mesothelial cells using cell blocks by comparison with two other established mesothelial markers. A total of 40 cell blocks of effusion fluids including cases of epithelioid mesotheliomas, metastatic carcinomas and benign cases with reactive mesothelial cells were selected. A panel of immunostains including D2-40, podoplanin, CK5, and calretinin was performed. D2-40 and podoplanin were positive in 100% of mesothelioma cases in comparison to metastatic adenocarcinoma cases where the positivity was 0%. It is concluded that D2-40 and podoplanin are very useful markers for mesotheliomas. Since these markers are extremely helpful in differentiating epithelioid mesothelioma from metastatic adenocarcinoma, they shall be a valuable addition to the battery of markers used to differentiate the two entities.

The use of lamellar body counts to predict fetal lung maturity in pregnancies complicated by diabetes mellitus.

OBJECTIVE: The purpose of this study was (1) to correlate amniotic fluid lamellar body counts with the lecithin/sphingomyelin ratio and the presence of phosphatidylglycerol in pregnancies that were complicated by maternal diabetes mellitus and (2) to determine a lamellar body count value that maximizes sensitivity and specificity in the prediction of fetal lung maturity. STUDY DESIGN: We reviewed our prospectively collected perinatal database from November 1992 through October 1999 to identify pregnancies that were complicated by diabetes mellitus for which fetal lung maturity studies had been performed within 72 hours of delivery. Lamellar body counts were correlated with lecithin-sphingomyelin ratio and phosphatidylglycerol values. The sensitivities and specificities of various lamellar body count cutoff values were calculated with the lecithin/sphingomyelin ratio and phosphatidylglycerol values as indicators of fetal lung maturity. Receiver operating curves were used to determine the lamellar body count that indicated fetal lung maturity. Our neonatal database was reviewed for this same time period to obtain all cases of respiratory distress syndrome. The maternal data were compared with the neonatal data to determine whether distress syndrome had developed in an infant who had undergone fetal lung maturity testing respiratory. RESULTS: Lamellar body counts were correlated with lecithin/sphingomyelin ratio (r = 0.51, P <.001) and phosphatidylglycerol values (r = 0.57, P <.001) in 90 diabetic pregnant patients. A lamellar body count of 37,000/microL was found to have a sensitivity of 80% and a specificity of 100% in the prediction of fetal lung maturity by standardized methods of phospholipid analysis. There were no cases of neonatal respiratory distress syndrome in this study population. CONCLUSION: The lamellar body count is a valid, rapid screening test for the determination of biochemical fetal lung maturity in pregnancies that are complicated by diabetes mellitus. A lamellar body count of > or =37,000/microL correlated with the lecithin/sphingomyelin ratio and phosphatidylglycerol values in the pregnancies of diabetic patients. Use of lamellar body counts in pregnancies that are complicated by diabetes mellitus could decrease the need for time-consuming and more costly phospholipid profiles. A full phospholipid profile is recommended for amniotic fluid specimens with lamellar body count values of <37,000/microL.