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1.
Anticancer Res ; 39(8): 4019-4022, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366483

RESUMO

Historically, analysis of intragastric exfoliative cytology (IEC) of gastric cancer (GC) was used with a diagnostic intent only. With the successful advent of endoscopic biopsy, the rate of detection of GC has improved worldwide and, as a consequence, IEC has been progressively abandoned. Today, however, there is a renewed interest in this field of research, as witnessed by several pertinent publications. As discussed in this review, in fact, currently the importance of analyzing IEC in patients with early and advanced GC seems to reside in its clinicopathological and prognostic significance. In fact, compared to non-sloughing tumors, GC exhibiting intragastric exfoliation was recently associated with an aggressive tumor phenotype (characterized by deeper infiltration of the gastric wall, lymph nodal or distant metastases, angiolymphatic and perineural invasion) and poorer prognosis. Adoption of IEC examination in routine practice might help identify patients at higher risk of developing local recurrence and peritoneal metastasis from early and advanced GC, optimizing their treatment and improving quality of life and life expectancy.


Assuntos
Citodiagnóstico/métodos , Recidiva Local de Neoplasia/diagnóstico por imagem , Neoplasias Gástricas/diagnóstico por imagem , Estômago/diagnóstico por imagem , Endoscopia , Humanos , Recidiva Local de Neoplasia/genética , Recidiva Local de Neoplasia/patologia , Peritônio/diagnóstico por imagem , Peritônio/patologia , Prognóstico , Estômago/patologia , Neoplasias Gástricas/genética , Neoplasias Gástricas/patologia
2.
Presse Med ; 48(7-8 Pt 1): 816-824, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31439443

RESUMO

Diagnosis of mature B cell malignancies is highly multidisciplinary. Biological tools provide diagnostic, prognostic and theranostic information. Biological hematology allows considering mature B cell diseases from two perspectives : cellular and molecular approaches. Cytomorphology and flow cytometry are tools from cell hematology. Conventional cytogenetics, FISH and molecular biology are tools from molecular hematology. NGS is a new technique that could dramatically change diagnostic and therapeutic management of B cell malignancies in the near future. Integration of clinical, pathological and biological data allows for personalized management of these diseases.


Assuntos
Técnicas de Laboratório Clínico/métodos , Leucemia de Células B/diagnóstico , Linfoma de Células B/diagnóstico , Integração de Sistemas , Hibridização Genômica Comparativa/métodos , Citodiagnóstico/métodos , Análise Citogenética/métodos , Análise Mutacional de DNA/métodos , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Humanos , Imunofenotipagem/métodos , Hibridização in Situ Fluorescente/métodos , Leucemia de Células B/genética , Leucemia de Células B/patologia , Linfoma de Células B/genética , Linfoma de Células B/patologia , Técnicas de Diagnóstico Molecular/métodos , Imagem Multimodal/métodos , Imagem Multimodal/tendências
4.
Urologe A ; 58(9): 1093-1106, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31399775

RESUMO

Follow-up care of patients with muscle-invasive bladder cancer is subdivided into oncological and functional surveillance. More than 80% of local relapses and distant metastases occur within the first 2 years. Recurrences in the remnant urothelium also occur several years after radical cystectomy. Urinary cytology and a computed tomography (CT) scan of the abdomen and thorax including a urography phase are the standard diagnostics for tumor follow-up. There is no clear evidence for a survival benefit for the detection of asymptomatic vs. symptomatic recurrences. After partial cystectomy or trimodal treatment, there is no established follow-up schedule; however, the relatively high incidence of intravesical recurrences should be considered as there are curative treatment approaches including salvage cystectomy. Functional surveillance, which should be carried out lifelong, encompasses prevention and diagnostics of metabolic complications, urethral/ureteral strictures, problems with the urinary stoma, urinary incontinence, sexual dysfunction and urinary tract infections.


Assuntos
Carcinoma de Células de Transição/patologia , Citodiagnóstico/métodos , Recidiva Local de Neoplasia/patologia , Neoplasias da Bexiga Urinária/patologia , Cistectomia , Seguimentos , Humanos
5.
Indian J Pathol Microbiol ; 62(3): 379-383, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31361224

RESUMO

Context and Background: Cytological grading of salivary gland lesion, which is a simple, cost-effective, and reproducible method, can be used as a tool for the selection of treatment modality. The proposed Milan classification establishes one guideline for reporting of salivary gland cytology and thus helps in individualized treatment and follow-up. Aims and Objectives: (1) The aims and objectives of this study were to establish the validity and reliability of the Milan classification of cytological grading in salivary gland swelling and (2) to calculate the malignancy risk. Materials and Methods: This prospective study was designed in clinically diagnosed salivary gland swelling at the Department of Pathology of a tertiary care referral hospital. Fine-needle aspiration (FNA) was done, and stained smears were examined under light microscope and cytological findings were noted according to the Milan classification. Tissue for the histopathological study was obtained in 119 cases. The previous cytological findings were compared to subsequent histopathology report. Results: : Among 119 FNAs, 2.5% were nondiagnostic and 55.4% were nonneoplastic. While no samples were placed in the atypia of undetermined significance category, benign tumors accounted for 25.2%. About 1.7% was grouped in the salivary gland neoplasm of uncertain malignant potential, 2.5% of cases were categorized as suspicious of malignancy, and 12.6% of cases comprised as malignant tumors. Overall, malignancy risk was observed to be the highest (93.3%) in Category 6 and lowest (3.0%) in nonneoplastic category. Conclusions: The six-tier diagnostic categories of the Milan classification scheme help in segregating patients with salivary gland lesions into the management categories of follow-up, conservative surgery, and radical surgery with/without chemotherapy.


Assuntos
Citodiagnóstico/métodos , Neoplasias das Glândulas Salivares/classificação , Neoplasias das Glândulas Salivares/diagnóstico , Glândulas Salivares/citologia , Glândulas Salivares/patologia , Biópsia por Agulha Fina , Feminino , Humanos , Masculino , Estudos Prospectivos , Reprodutibilidade dos Testes , Centros de Atenção Terciária , Glândula Tireoide/patologia
6.
Acta Cytol ; 63(4): 340-346, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31163417

RESUMO

Neuroendocrine tumors (NET) and carcinomas (NEC) of the breast are rare diseases, but NEC has attracted attention in both cytopathology and surgical pathology because of its specific management and prognosis. Fine-needle aspiration biopsy (FNAB) cytology can make the diagnosis in many cases particularly with high-grade NEC, with definitive diagnosis based on histopathology and immunohistochemistry. This review describes the characteristics of the disease based on the WHO classification 2012 and recent literature and -includes discussion related to the International Academy of Cytology Yokohama System of Reporting Breast FNAB -cytology.


Assuntos
Adenocarcinoma/patologia , Neoplasias da Mama/patologia , Carcinoma Neuroendócrino/patologia , Citodiagnóstico/métodos , Adenocarcinoma/cirurgia , Biópsia por Agulha Fina , Neoplasias da Mama/cirurgia , Carcinoma Neuroendócrino/cirurgia , Feminino , Humanos , Valor Preditivo dos Testes
7.
J Cancer Res Ther ; 15(3): 686-689, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31169241

RESUMO

Background: Minor salivary gland tumors (MSGTs) are less common than major salivary glands and involve only 15-20% of all salivary gland tumors. Most of the cases originate at intra- and peri-oral region. Minor salivary gland lesion cytology has been studied rarely in India. Aims: This present study was performed to evaluate the role of fine needle aspiration cytology (FNAC) in diagnosis of MSGTs and to explore the cases of cytohistological discrepancies in the study. Materials and Methods: This retrospective study was conducted over a 5-year period on 42 cases of MSGTs. In all the cases, cytology was correlated with histology and cytohistological discrepancies were searched. Sensitivity, specificity, and diagnostic efficacy were calculated using histopathology as gold standard. Results: We diagnosed 27 malignant (64.28%) and 15 benign (35.71%) MSGTs in cytological evaluation. We found two false negative and one false positive case in cytology. Sensitivity, specificity, and diagnostic accuracy of the study were 92.59%, 93.33%, and 92.85%, respectively. Conclusion: FNAC is a minimally invasive and cost-effective procedure with high accuracy (92.85%) in the assessment of MSGTs and helps in the management of benign and malignant tumors.


Assuntos
Biópsia por Agulha Fina , Citodiagnóstico , Neoplasias das Glândulas Salivares/patologia , Glândulas Salivares Menores/patologia , Adolescente , Adulto , Idoso , Criança , Citodiagnóstico/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Estadiamento de Neoplasias , Reprodutibilidade dos Testes , Estudos Retrospectivos , Neoplasias das Glândulas Salivares/diagnóstico , Sensibilidade e Especificidade , Centros de Atenção Terciária , Adulto Jovem
8.
Acta Cytol ; 63(5): 424-430, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31234167

RESUMO

BACKGROUND: Squash cytology is of significant importance in intraoperative consultation of central nervous system (CNS) pathology. There are several studies on squash cytology of CNS lesions, and only a few of them deal with spinal lesions alone. AIMS: (1) To evaluate intraoperative squash cytology of spinal lesions. (2) To correlate cytological diagnosis with histopathological diagnosis and assess the diagnostic accuracy. (3) To study Ki67 expression on squash smears and determine whether it can assist in grading spinal tumours on cytology. MATERIALS AND METHODS: A prospective study was conducted on 68 patients with clinico-radiologically diagnosed lesions of the spine. Intraoperative squash smears were stained with haematoxylin-eosin (H&E) stain, Papanicolaou (Pap) stain, and May-Grünwald-Giemsa (MGG) stain. Subsequently, histological diagnosis was made. Ki67 immunostaining was performed on squash smears and histology sections. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of squash cytology in spinal lesions were 84.6, 100, 100, 23.1, and 80.88%, respectively. On immunocytochemistry, the mean Ki67 labelling indices for grade I, II, and III tumours were 0, 0.33 and 9%, respectively. CONCLUSION: Squash smear cytology is a rapid intraoperative technique for diagnosing spinal lesions, with high specificity and high positive predictive value. It is more effective in diagnosing neoplasms than non-neoplastic lesions. Ki67 immunostaining can be done on cytology smears to effectively differentiate between WHO grade I and grade II spinal tumours.


Assuntos
Citodiagnóstico/métodos , Imuno-Histoquímica , Cuidados Intraoperatórios/métodos , Antígeno Ki-67/análise , Manejo de Espécimes/métodos , Neoplasias da Coluna Vertebral/química , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Reprodutibilidade dos Testes , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Neoplasias da Coluna Vertebral/patologia , Neoplasias da Coluna Vertebral/cirurgia , Adulto Jovem
9.
Acta Cytol ; 63(4): 302-313, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31141801

RESUMO

Utilization of fine-needle aspiration biopsy (FNAB) cytology for the diagnosis of diseases of the breast has been met with both excitement and uncertainty during the last couple of decades. Presently, FNAB for the diagnosis of primary and metastatic breast lesions is on the rise again. This is probably due to its fast turnaround time, cost efficiency, and minimal invasiveness, characteristics of this sampling modality which are particularly crucial for patients requiring frequent repeat biopsy in the setting of metastatic lesions. In this article, we will briefly review the main modern applications of FNAB of the breast when coupled with contemporary ancillary techniques. Such contemporary ancillary techniques range from classic immunocytochemistry (ICC) to the most modern molecular techniques, particularly next-generation sequencing. Coupled with contemporary ICC and molecular methods, FNAB of the breast can be used for several applications. The applications reviewed in this article include the primary diagnosis of a breast lesion, the identification of the breast as a primary source of a metastatic lesion, the evaluation of breast prognostic/predictive markers, and the tracking of tumor evolution. In our opinion, FNAB of the breast is an ideal sampling method, sharing many of the advantages of truly liquid and of tissue biopsies. Ultimately, we aim at demystifying the complexity of many of the challenges traditionally associated with the application of ancillary techniques to FNAB of the breast and provide insights into some of the most cutting-edge and clinically useful application scenarios.


Assuntos
Biomarcadores Tumorais/metabolismo , Neoplasias da Mama/diagnóstico , Citodiagnóstico/métodos , Imuno-Histoquímica/métodos , Guias de Prática Clínica como Assunto/normas , Biópsia por Agulha Fina , Neoplasias da Mama/metabolismo , Neoplasias da Mama/cirurgia , Feminino , Humanos , Valor Preditivo dos Testes
10.
Acta Cytol ; 63(5): 401-410, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31112943

RESUMO

BACKGROUND: Oral exfoliative cytology is a noninvasive and nonpainful technique for early diagnosis of oral potentially malignant disorders and oral cancer, and the use of cytomorphometry ameliorates its diagnostic reliability. The objective of the present study was to analyze methyl green-pyronin Y (MGP)-stained oral exfoliated cells (OECs) of oral leukoplakia (OL) and oral squamous cell carcinoma (OSCC) by cytomorphometry. MATERIALS AND METHOD: An observational study was conducted on 150 individuals equally divided into three groups: normal mucosa, OL, and OSCC. Smears were prepared from OECs and stained with MGP. Cytomorphometry was done for 100 cells per subject, and various cell and nuclear parameters were measured and calculated. RESULTS: The Kruskal-Wallis test with post hoc correlation showed significant differences in nucleus and cell diameter (ND, CD), nucleus and cell area (NA, CA), nucleus and cell perimeter (NP, CP), and nucleus to cytoplasmic (N:C) ratio for diameter, perimeter, and area. Spearman's ρ correlation of various N:C ratio methods showed good correlation between N:C perimeter and diameter ratio, N:C diameter and ellipse ratio, and N:C area and ellipse ratio. Additional morphological factors showed significant relations for both cell and nuclear regularity factor, shape factor, and nuclear contour index. DISCUSSION: MGP-based cytomorphometry showed a significant decrease in CD, CA, and CP and increase in ND, NA, NP, and N:C ratio from normal mucosa to OL and OSCC. MGP proved its worth as an effective stain for OECs, despite its strict standardization.


Assuntos
Corantes/química , Citodiagnóstico/métodos , Detecção Precoce de Câncer/métodos , Leucoplasia Oral/patologia , Verde de Metila/química , Neoplasias Bucais/patologia , Pironina/química , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Coloração e Rotulagem/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , não Fumantes , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Fumantes , Manejo de Espécimes
11.
Acta Cytol ; 63(5): 411-416, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31121588

RESUMO

OBJECTIVES: Touch imprint cytology (TIC) is a rapid and cheap method and can be used as an adjunct to biopsy for the evaluation of suspected malignancy. We evaluated the advantages and limitations of TIC for the preoperative diagnosis of oral squamous cell carcinoma. STUDY DESIGN: We used 280 incisional biopsies of clinically suspected oral squamous cell carcinoma and compared TIC diagnosis to histopathological sections. The sensitivity, specificity, and diagnostic accuracy of TIC were evaluated. RESULTS: A total of 201 (82.5%) cases were diagnosed as malignant, 22 (7.9%) cases were diagnosed as suspicious of malignancy, and 54 (19.3%) cases as benign/negative on TIC. The overall sensitivity of TIC was 98.2%, specificity was 89.3%, the positive-predictive value 97.3%, and the negative-predictive value was 92.6%. The accuracy of the test was 96.4%. CONCLUSIONS: TIC is an accurate, simple, rapid, and cost-effective method that aids the diagnosis of oral squamous cell carcinoma but does not replace incisional biopsy. The cytologic examination of imprints of biopsies also helps determine the adequacy of the specimen for histologic examination.


Assuntos
Citodiagnóstico/métodos , Neoplasias Bucais/patologia , Manejo de Espécimes/métodos , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Análise Custo-Benefício , Citodiagnóstico/economia , Feminino , Custos de Cuidados de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Manejo de Espécimes/economia , Fatores de Tempo , Fluxo de Trabalho , Adulto Jovem
12.
BMC Infect Dis ; 19(1): 390, 2019 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-31068141

RESUMO

BACKGROUND: Persistent infection with high-risk human papillomavirus (HR-HPV) is a major cause of cervical intraepithelial neoplasia and invasive cervical cancer. We investigated the prevalence of HR-HPV infection and distribution of viral genotypes among women in this area. METHODS: Women in Sichuan older than 20 years were screened for cervical cancer between January 2015 and December 2016 using liquid-based cytology testing and a flow cytometry-fluorescence hybridization test for HPV-DNA. Frequency tables were evaluated using the chi-squared test (χ2). RESULTS: Of the 17,319 women aged 20-85 years who participated in the study, Overall prevalence of HR-HPV infection was 12.6% (2178/17,319). The most prevalent viral type was HPV-52, which was present in 2.5% of individuals, followed by HPV-53 (1.6%), HPV-58 (1.5%), HPV-16 (1.1%), HPV-56 (0.9%), HPV-39 (0.8%). In HSIL, the five most common HR-HPV types were HPV52, 16, 58, 33 and 56. HPV16/18 in HSIL only makes up 25.9% of HSIL, whereas HPV31/33/45/52/58 make up 56.8%. Overall HR-HPV prevalence among women older than 65 years was 15.2%, significantly higher than the prevalence in other age groups (P < 0.05). Infection with dual or multiple HR-HPV types was associated with greater risk of abnormal cytology. CONCLUSION: Overall HR-HPV prevalence in Sichuan is as high as in large cities in China. The HR-HPV types 52, 16, 58, 33 and 56 predominated in this sample of HSIL women primarily from the banking and public sector in Sichuan. High prevalence among women older than 65 years needed pay attention to.


Assuntos
Papillomaviridae/genética , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/virologia , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos Transversais , Citodiagnóstico/métodos , Feminino , Genótipo , Humanos , Pessoa de Meia-Idade , Papillomaviridae/patogenicidade , Prevalência
13.
BMC Neurol ; 19(1): 90, 2019 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-31064334

RESUMO

BACKGROUND: Primary central nervous system lymphoma (PCNSL) is the most prevalent brain, spinal cord, eyes, and leptomeningeal lymphoma. It is often misdiagnosed due to an unspecific presentation or unavailable biopsy and results in a poor prognosis. Although the craniocerebral imaging examination of PCNSL has some characteristics, it is limited, and atypical cases are especially difficult to identify with intracranial tumours and other diseases. The biopsy, as the gold standard for PCNSL diagnosis, is not eligible for all patients suspected of having PCNSL. CASE PRESENTATION: This report documents a woman who presented with a three-month history of numbness and weakness in the right leg. She was treated with drugs at a local hospital for one month. She developed demyelination lesions and her symptoms were aggravated. The patient was admitted to the Department of Nerve Infection and Immunology at Tiantan Hospital. Head magnetic resonance imaging (MRI) enhanced scanning indicated significant inflammatory demyelinating disease, and lymphoma was not excluded. CSF revealed a high protein level and CSF cytology detected abnormal cells, PCNSL was eventually presumed according to positive CSF cytology and cytological detection of the cerebrospinal fluid flow. CONCLUSIONS: PCNSL is a highly invasive tumour. With the development of technologies such as cerebrospinal fluid cytology and flow cytology, CSF analysis has become one of the definite diagnosis methods, and the tumour cell finding in CSF is the only reliable basis for diagnosis. Flow cytometric analysis and gene rearrangement testing also provide objective evidence.


Assuntos
Neoplasias do Sistema Nervoso Central/líquido cefalorraquidiano , Linfoma Difuso de Grandes Células B/líquido cefalorraquidiano , Neoplasias do Sistema Nervoso Central/diagnóstico , Neoplasias do Sistema Nervoso Central/patologia , Citodiagnóstico/métodos , Feminino , Humanos , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/patologia , Pessoa de Meia-Idade
14.
Zhonghua Zhong Liu Za Zhi ; 41(5): 326-330, 2019 May 23.
Artigo em Chinês | MEDLINE | ID: mdl-31137164

RESUMO

Objective: To explore the feasibility of bronchoscopic brushing liquid-based slide cytology combined with automatic immunocytochemistry (ICC) for pathological typing of lung cancer. Methods: A liquid-based thin-prep was prepared from 171 bronchoscopic brushing specimens of patients with pulmonary lesions. ICC was detected by automatic immunohistochemistry instrument while cytomorphological diagnosis was made. The results were compared with those of histopathological diagnosis. Results: Among 171 patients, 130 (76.0%) could be classified by cell morphology alone, including 31 squamous cell carcinomas, 44 adenocarcinomas and 55 small cell carcinomas; 162 (94.7%) could be classified by cell morphology combined with ICC, including 38 squamous cell carcinomas, 61 adenocarcinomas and 63 small cell carcinomas (P<0.001). According to the gold standard of histopathological diagnosis, the coincidence rate of cytomorphology combined with ICC was higher than that of cell morphology alone. The coincidence rate of squamous cell carcinoma was increased from 85.2% to 97.1% (P=0.093), adenocarcinoma from 92.5% to 98.0% (P<0.001), and small cell carcinoma from 96.1% to 98.3% (P=0.465). Conclusion: The combination of liquid-based thin-prep cytology and automatic immunohistochemistry can effectively improve the accuracy of pathological typing of brushing specimens under fiberoptic bronchoscopy, and provide more objective diagnostic results for clinical treatment.


Assuntos
Adenocarcinoma/patologia , Carcinoma de Células Escamosas/patologia , Imuno-Histoquímica/métodos , Biópsia Líquida/métodos , Neoplasias Pulmonares/patologia , Carcinoma de Pequenas Células do Pulmão/patologia , Broncoscopia/instrumentação , Broncoscopia/métodos , Citodiagnóstico/instrumentação , Citodiagnóstico/métodos , Estudos de Viabilidade , Humanos , Biópsia Líquida/instrumentação , Neoplasias Pulmonares/classificação
15.
Acta Cytol ; 63(3): 206-214, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30947186

RESUMO

Cervical cancer is a major worldwide health problem. Therefore, regular cervical screening in order to make an early diagnosis can help to prevent cervical cancer, through identifying and treating preinvasive cervical lesions. The aim of this review is to evaluate the correlation between the cytological screening result and the final gold standard histological outcome in the diagnosis of cervical lesions. More specifically, the correlation between high-grade intraepithelial lesion (HSIL) on cytology and histological cervical intraepithelial neoplasia grade 2 or higher (CIN2+) was intended, by calculating the positive predictive value (PPV). PPV is an important value from a clinical point of view. An electronic search was carried out in the electronic databases MEDLINE (through PubMed) and the Cochrane Library (last searched beginning of December 2017), supplemented with the related article feature in PubMed and snowballing. Article selection (predefined inclusion and exclusion criteria) and data extraction were evaluated by two independent reviewers (N.K. and A.V.L.). After identifying 1,146 articles, 27 articles were finally included in this systematic review, representing 28,783 cytological HSIL diagnoses in total. The PPV of HSIL was 77.5% (range: 45.4-95.2%) for the histological diagnosis of CIN2+ and 55.4% (range: 36.4-67.6%) for the diagnosis of CIN3+. In this systematic review, 77.5% of the HSIL-positive women eventually had a CIN2+ diagnosis. The diagnostic value of a cytological HSIL result (conventional or liquid-based cytology) in the diagnosis of CIN2+ lesions is good, but a combination of tests could raise this value.


Assuntos
Citodiagnóstico/métodos , Detecção Precoce de Câncer/métodos , Lesões Intraepiteliais Escamosas Cervicais/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Feminino , Humanos , Programas de Rastreamento/métodos , Gradação de Tumores , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Lesões Intraepiteliais Escamosas Cervicais/patologia , Neoplasias do Colo do Útero/patologia
16.
Acta Cytol ; 63(3): 224-232, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30982032

RESUMO

OBJECTIVE: Intraoperative examination is a highly valuable tool for the evaluation of central nervous system (CNS) lesions, helping the neurosurgeon to determine the best surgical management. This study aimed to evaluate the accuracy and to analyze the diagnostic disagreements and pitfalls of the intraoperative examinations through correlation with the final histopathological diagnosis in CNS lesions. STUDY DESIGN: Retrospective analysis of intraoperative examination of CNS lesions and their final diagnosis obtained during 16 consecutive years. All diagnoses were reviewed and classified according to World Health Organization (WHO) grading for CNS tumors. Squash was performed in 119 cases, while frozen section and both methods were done in 7 cases each. RESULTS: Among the 133 intraoperative examinations considered, 114 (85.7%) presented concordance and 19 (14.3%) diagnostic disagreement when compared with subsequent histopathological examinations. The sensitivity and specificity for the detection of neoplasia in intraoperative examination was 98 and 94%, respectively. The positive and negative predictive values were 99 and 88%, respectively. The accuracy for neoplastic and nonneoplastic disease was 85.7%. Disagreements were more frequent among low-grade (WHO grades I and II) neoplasms and nonmalignant cases. CONCLUSIONS: Our results showed good accuracy of the intraoperative assessments for diagnosis of CNS lesions, particularly in high-grade (grades III and IV) lesions and metastatic neoplasms.


Assuntos
Doenças do Sistema Nervoso Central/diagnóstico , Neoplasias do Sistema Nervoso Central/diagnóstico , Sistema Nervoso Central/patologia , Monitorização Neurofisiológica Intraoperatória/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Sistema Nervoso Central/fisiopatologia , Sistema Nervoso Central/cirurgia , Doenças do Sistema Nervoso Central/fisiopatologia , Doenças do Sistema Nervoso Central/cirurgia , Neoplasias do Sistema Nervoso Central/fisiopatologia , Neoplasias do Sistema Nervoso Central/cirurgia , Criança , Pré-Escolar , Citodiagnóstico/métodos , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sensibilidade e Especificidade , Adulto Jovem
18.
Int J Clin Oncol ; 24(9): 1075-1080, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30976938

RESUMO

BACKGROUND: In general, urine cytology is often problematic because of its low sensitivity, especially for low-grade urothelial carcinoma (UC) in clinical practice. To improve the sensitivity, we focused on 5-aminolevulinic acid (5-ALA), because recent studies suggested that 5-ALA-induced urine cytology can be used for photodynamic diagnosis. In this study, we evaluated the diagnostic efficacy of 5-ALA-induced fluorescent urine cytology for UC. METHODS: We included in this study 318 patients comprising 158 non-cancer patients, 84 bladder tumor patients, and 76 upper urinary tract urothelial carcinoma (UUT-UC) patients treated in our institution from March 2013 to September 2018. Using the same voided urine sample, we compared sensitivity and specificity between conventional urine cytology and 5-ALA-induced fluorescent urine cytology. RESULTS: Overall, the sensitivity of 5-ALA-induced fluorescent urine cytology was significantly higher than that of conventional urine cytology (86.9% vs. 69.4%; p = 0.0002), and the specificity was equivalently high (96.2% vs. 95.6%; p = 1.0). In subgroup analysis, the high sensitivity of 5-ALA-induced fluorescent urine cytology was also detected regardless of age, sex, and tumor type. However, in terms of stage and grade, differences were only detected in patients with less than pTa stage (89.2% vs. 52.1%; p = 0.0001) and low-grade tumor (91.5% vs. 51.1%; p < 0.0001). CONCLUSIONS: 5-ALA-induced fluorescent urine cytology was significantly more effective for UC diagnosis when compared with the conventional cytology, especially in patients with low-stage and low-grade tumors. These findings indicate that 5-ALA-induced fluorescent urine cytology may potentially be a very useful tool for clinical use.


Assuntos
Ácido Aminolevulínico/farmacologia , Neoplasias da Bexiga Urinária/urina , Urina/citologia , Neoplasias Urológicas/urina , Adulto , Idoso , Idoso de 80 Anos ou mais , Citodiagnóstico/métodos , Feminino , Fluorescência , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Neoplasias da Bexiga Urinária/patologia , Neoplasias Urológicas/patologia
19.
Asian Pac J Cancer Prev ; 20(4): 1019-1024, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31030468

RESUMO

Abnormalities in the cervix, when identified early by Pap smear, can be treated in the early stages or in the precursor stages of the neoplasia, which may increase the chances of regression of the lesion. The aim to verify the rate of cervical abnormalities and to evaluate the risk of progression or regression associated with age and cytological diagnosis. Methods: The study was conducted in a referral hospital in Southern Brazil, based on the results of pathology and cytopathology laboratory tests of uterine cervix. The historical cohort included patients with an abnormal cytology diagnosis in the period from January 2010 to December 2014, followed until July 2016. Results: A total of 42,389 cervical smears were analyzed, 4,427 of which were eligible for analysis of the evolution of cervical abnormalities. In progression and regression events analysis, we observed that patients with a cytological diagnosis of atypical glandular cells presented a higher risk of cervical abnormality progression (Hazard Ratio: 2.0 and 95% confidence intervals 1.36­3.48). We also observed that patients younger than 25 years old were more likely to regress the cervical lesions (Hazard Ratio:1.4 and 95% confidence intervals 1.20­1.74). Conclusions: The associations found between the events (progression and regression), age and cytological diagnosis, highlights the importance of cytological screening in populations at risk of precursor of cervical cancer lesions, especially in women older than 25 years.


Assuntos
Citodiagnóstico/métodos , Detecção Precoce de Câncer/métodos , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/patologia , Adenocarcinoma/epidemiologia , Adenocarcinoma/patologia , Adulto , Idoso , Brasil/epidemiologia , Neoplasia Intraepitelial Cervical/epidemiologia , Neoplasia Intraepitelial Cervical/patologia , Progressão da Doença , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Prognóstico , Indução de Remissão , Fatores de Risco , Lesões Intraepiteliais Escamosas Cervicais/epidemiologia , Lesões Intraepiteliais Escamosas Cervicais/patologia , Neoplasias do Colo do Útero/classificação , Esfregaço Vaginal
20.
J BUON ; 24(1): 382-390, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30941995

RESUMO

PURPOSE: The purpose of this study was to assess the performance of strain elastography (SE) in predicting malignancy for the thyroid nodules with undetermined cytology, Bethesda categories III and IV. The cut-off point was 20 mm of a thyroid nodule. METHODS: A retrospective analysis from April 2012 to April 2016 was conducted by examining the records of 547 consecutive eligible patients with 655 thyroid nodules, the undetermined cytology of which surgery had been recommended. RESULTS: A sum of 655 nodules in 547 patients were studied. Eighty-two (12.5%) of 655 thyroid nodules were Bethesda Category III and IV (undetermined cytology). Of the 655 thyroid nodules examined, 401 (61.2%) were less than 20 mm and 254 (38.8%) were more than 20 mm in diameter. No significant difference was detected between nodule sizes more than 20 mm in diameter and Tsukuba Elasticity score (TES) 4 and 5 by McNemar test and 0.677 area under the curve (AUC). No significant difference was detected between nodule sizes over 20 mm in diameter and Bethesda III and IV (undetermined cytology) by McNemar test and 0.632 AUC. In addition, no significant difference was detected between nodule size with the cut-off value of 20 mm and the histopathology of the thyroidectomies by McNemar test and 0.607 AUC. CONCLUSION: Nodules size 20 mm in diameter was not a useful cut-off point for distinguishing malignant from benign thyroid nodules among the nodules with TES 4 and 5, Bethesda III and IV, and malignant histopathology.


Assuntos
Citodiagnóstico/métodos , Técnicas de Imagem por Elasticidade/métodos , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/patologia , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/instrumentação , Feminino , Humanos , Masculino , Agulhas , Gradação de Tumores , Estudos Retrospectivos
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