Negative human papillomavirus testing in normal smears selects a population at low risk for developing high-grade cervical lesions.

High-risk human papillomaviruses (HR-HPV) are the necessary cause of cervical carcinomas and there is an increasing interest in using HR-HPV DNA detection in adjunction to cytological examination for primary cervical screening. To determine whether women with a normal smear negative for HR-HPV DNA detection with the Hybrid Capture II assay might represent a low-risk population for developing a high-grade squamous intraepithelial lesion (HSIL), 4401 women have been followed in a period of 12-72 months (median=34 months). During this follow-up, four HSIL and one microinvasive carcinoma have been detected in this cohort (three in the cohort of 3526 women >29 years). The global negative predictive value (NPV) of double-negative tests is thus of 99.9% (ninety-five percent confidence interval (95% CI): 99.8-100%), whereas cytology alone gives an NPV of 99.2% (95% CI: 98.9-99.5%). If we obtain a second negative HR-HPV test 1-2 years after the initial test, the NPV is 100%. The NPV is also of 100% in the cohort of women >49 years. We conclude that all these women could be safely screened at longer intervals between 3 and 5 years. This policy will offset the increased costs induced by an additional HR-HPV testing in primary screening.

DNA image cytometry and human papillomavirus (HPV) detection help to select smears at high risk of high-grade cervical lesions.

Three samples were submitted from women undergoing routine screening (n=910): two smears (one for routine cytology and one for DNA image cytometry) and a scrape for human papillomavirus (HPV) testing. DNA histograms were classified as suspect in cases of aneuploidy, polyploidy, and/or diploidy with a high proliferation rate. Follow-up was available in 239 cases. The primary end-point was the presence of a high-grade squamous intraepithelial lesion (HGSIL) at biopsy. Seventy women (7.7%) had a high-risk (HR) HPV infection and a suspect DNA profile. In 77 women with cytological abnormalities, 28 HGSILs were detected: four with a prior diagnosis of ASCUS (all HR-HPV infected including three with a suspect DNA profile), three with smears evocative of LGSIL (all with HR-HPV infection and a suspect DNA profile), and 21 with smears evocative of HGSIL (all with HR-HPV infection and 20 with a suspect DNA profile). During the follow-up period, out of 239 women with a cytologically normal smear at first entry, five developed a HGSIL; all were HR-HPV-positive and four had a suspect DNA profile at the first smear. HR-HPV detection alone gives a sensitivity of 100% for the detection of HGSIL, with a specificity of 84.3%, whereas DNA measurement associated with HPV testing significantly enhances the specificity to 95.4%. Thus, the combination of HPV testing and DNA measurement provides a highly sensitive and specific evaluation of the risk of HGSIL on cervical smears.

[Pulmonary hydatidosis. Comparison of cytology and scanning electron microscopy]. / Hydatidose pulmonaire. Confrontation de la cytologie et de la microscopie à balayage.

The puncture of a hydatid cyst with a fine needle is not generally recommended as a procedure and may even be contra-indicated in the first instance. Sometimes, however, the cytologist will be surprised to discover some scolices in the aspirate when the radiology is misleading, or not suggestive, and the serology is negative. We report two cases where the diagnosis was made by the cytological examination of the aspirate. The cytological study of the liquids was compared with electron microscopy scanning, enabling the stages of development of the parasite in the tissue of the pulmonary parenchyma to be assessed.

Trisomy 7 in a lung carcinoid tumor: precocious index of malignant transformation?

A chromosomal study has been performed on a benign carcinoid tumor of the lung after short-term culture. A trisomy of chromosome #7 was found in all the metaphases. The significance of this finding is discussed in relation to the transformation process.

[Cytology of chronic bronchitis: comparative study of sputum, brushing and bronchial biopsy (author's transl)]. / Aspects cytologiques de la bronchite chronique. Etude comparée de l'expectoration, du brossage et de la biopsie bronchique.

Present research in chronic bronchitis is directed towards a technique of cytological detection. The object of the study was to compare the results of biopsy, brushing and sputum in 65 patients with clinical signs of chronic bronchitis. We established a good correlation between the results of biopsy and brushing. Unfortunately no reliable test for chronic bronchitis can be derived from the cytological study, which could indicate the future trend of the patient.