RESUMEN
When an unsatisfactory smear (thick inflammatory infiltrate or blood influencing the staining characteristics of the epithelial cells) is restained for MiB-1, the diagnostic proliferating cells are visualized, and the MiB-1-positive smears can be thus upgraded as borderline, grade I, II, and III, corresponding with the cytologic diagnoses of, respectively, ASCUS, CIN I, II, and > or = III. In a period of 18 months, 2,068 unsatisfactory smears out of a material of 84,817 smears were restained for MiB-1. In the unsatisfactory group, significantly more abnormal smears were detected than in the satisfactory group. Seventy-five of the unsatisfactory group were biopsied because of the MiB-1 findings: Three women proved to have severe dysplasia, four had carcinoma in situ, and three had invasive carcinoma. The per mileage for invasive cervical carcinoma was ten times larger in the unsatisfactory group than in the satisfactory group; thus the MiB-1 method has further enhanced our diagnostic acumen in this difficult type of smears.
Asunto(s)
Proteínas Nucleares/análisis , Frotis Vaginal/métodos , Antígenos Nucleares , Biomarcadores/análisis , Calibración , Carcinoma/diagnóstico , Carcinoma in Situ/diagnóstico , Reacciones Falso Negativas , Reacciones Falso Positivas , Femenino , Humanos , Antígeno Ki-67 , Coloración y Etiquetado/métodos , Displasia del Cuello del Útero/diagnóstico , Neoplasias del Cuello Uterino/diagnósticoRESUMEN
In diagnostic tumor pathology, immunohistochemical detection of proliferating cell populations is increasingly used. With the event of microwave-antigen retrieval it has become possible to detect proliferating cells in cervical smears staining positive for MiB-1. We report that with the PAPNET system, using neural network computing, it is possible to collect from the smears the images with epithelial fragments containing positive nuclei. We used this system for quantification of staining results. Cases with carcinoma in situ contained many epithelial fragments having a large number of positive-staining nuclei and with labelling indices of 60 +/- 16. Dysplasias were often completely devoid of cells with positive nuclei. In addition, we could not detect differences between progressive and regressive dysplasias. Automatic prescreening of immunostained smears using PAPNET is useful when it is desired to quantify staining results.