Prevalence of positive screening test results and agreement between cytology and human papillomavirus testing in primary cervical cancer screening in North-Western Romania.

Using data from a pilot study conducted in North-Western Romania, we aimed to estimate the prevalence of abnormal cytology and positive high-risk human papillomavirus (hr-HPV) test results in an ethnically diverse screening population and to assess the agreement between cytology and hr-HPV testing to evaluate the feasibility of integrating the latter as a primary test in the national cervical cancer screening program. The cross-sectional pilot study included Roma women, other ethnic minorities, and women in rural remote areas. Samples were taken for liquid-based cytology and hr-HPV testing (Hybrid Capture 2 DNA test) by a mobile health unit. The prevalence of positive screening results and the agreement between cytology and hr-HPV testing were estimated by κ coefficient. A total of 1019 women were included in the study. The population prevalence of positive screening results was similar for both tests (12%). The prevalence of abnormal cytology increased with increasing age, whereas the prevalence of positive hr-HPV test showed a bimodal age pattern. Substantial differences in the prevalence of abnormal cytology were found by ethnicity, with highest prevalence in Romanian women (14%), followed by Roma women (6%) and women of other ethnicities (5%) (P = 0.002). Similar ethnic differences in the prevalence of positive hr-HPV test were not observed. The overall agreement of positive screening results between the two methods was fair (κ = 0.25; 95% confidence interval = 0.18-0.30, P < 0.001) and ranged from poor to substantial depending on the age group. The prevalence of abnormal cytology result was high and similar to the prevalence of positive hr-HPV test result, which could allow for the implementation of hr-HPV testing as a primary test in the cervical cancer screening program in Romania.

The value of exfoliative cytology in the diagnostic of oral mucosa changes in diabetes mellitus.

In this study, we performed microscopic qualitative analyses of the oral epithelium cytological smears in potential early phase of diabetes and in type 1 and 2 diabetic patients versus a healthy control group. The cytological assessment of the oral changes was realized on superficial and profound smears, from jugal and ventral tongue mucosa and it was based on the comparison between three staining methods [Papanicolaou, APT (polychrome tannin blue)-Dragan and Hematoxylin-Eosin (HE)]. Cytological changes of oral cells population were correlated with the type, duration and complications of diabetes. Oral flora was also evaluated. Irrespective the staining used, we found a clear dividing line between the control group and the real diabetic patients. In all diabetes cases (independently of the type of smear, harvest site, clinical form of disorder and present complications), cells presented alterations both at the level of cytoplasm and nucleus. Dyschromasia, cytolysis, different degrees of fatty degenerescence, binucleated cells, hyperchromasia, nuclear enlargement with modified nuclear÷cytoplasmic ratio, were the most frequent findings. There were no discrepancies in the cellular aspects of type 1 or 2 diabetic patients' smears or between the control group and the potential prediabetic status patients. Findings were interpreted as oral epithelium reactive changes induced by the disease. We concluded that exfoliative cytology alone is of low value as a diagnostic and prognostic tool in the diagnosis of diabetes mellitus (DM); it detects the reactive changes induced by the disease, but it makes no differences between DM types or degree of severity and does not allow by qualitative analysis alone to detect abnormalities in early diabetes.