cytology

细胞学
  • 文章类型: Journal Article
    目的:通过检查口腔黏膜上皮细胞中的微核形成来确定全景射线照相术对这些细胞的遗传影响。
    方法:在这项横断面研究中,在全景X线摄影之前和之后10天,从36例患者的颊粘膜中制备了脱落细胞学样本。使用基于液体的细胞学和Papanicolaou染色制备样品。由两名专家病理学家同时评估载玻片,并以百分比报告具有微核的细胞数量与载玻片上细胞总数的比率。数据分析采用配对样本T检验,皮尔逊相关系数,和协方差分析(α=0.05)。
    结果:研究样本包括24名男性(66.67%)和12名女性(33.33%),平均(SD)年龄为27.36(8.19)岁。全景X线摄影前后微核细胞的频率无统计学差异(p=0.468)。此外,微核细胞的频率与年龄(p=0.737)和性别(p=0.211)无关。
    结论:全景暴露会稍微增加颊粘膜上皮细胞中微核细胞的频率。然而,这一增加没有统计学意义.
    OBJECTIVE: To determine the genetic effects of panoramic radiography on the epithelial cells of the buccal mucosa by examining the micronucleus formation in these cells.
    METHODS: In this cross-sectional study, exfoliative cytology samples were prepared from the buccal mucosa of 36 patients immediately before and 10 days after panoramic radiography. The samples were prepared using liquid-based cytology with Papanicolaou staining. The slides were simultaneously evaluated by two expert pathologists and the ratio of the number of cells with micronuclei to the total number of cells on the slide was reported as a percentage. Data analysis was done using paired-samples T test, Pearson\'s correlation coefficient, and covariance analysis (α = 0.05).
    RESULTS: The study sample consisted of 24 (66.67%) males and 12 females (33.33%) with a mean (SD) age of 27.36 (8.19) years. The frequency of cells with micronucleus before and after panoramic radiography was not statistically different (p = 0.468). Additionally, the frequency of micronucleated cells was not correlated with age (p = 0.737) and sex (p = 0.211).
    CONCLUSIONS: Panoramic exposure slightly increased the frequency of cells with micronucleus in epithelial cells of the buccal mucosa. However, this increase was not statistically significant.
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  • 文章类型: Journal Article
    背景:细胞学检查阴性但高危型人乳头瘤病毒(HR-HPV)阳性的宫颈癌筛查结果并不少见。根据最新的美国阴道镜和宫颈病理学学会(ASCCP)指南(2019),建议无HPV阳性病史的患者进行一年的随访。这项研究的目的是评估HR-HPV阳性的细胞学阴性患者中宫颈上皮内瘤变(CIN)的直接风险。研究了这些患者阴道镜检查的诊断准确性。
    方法:从2022年1月至2023年8月,对细胞学阴性但HR-HPV阳性并转诊为阴道镜的患者进行了回顾性研究。在HPV16阳性组中,比较了患者的CIN病变即刻发生率,HPV18阳性组和非16/18HR-HPV阳性组。根据年龄评估CIN2病变的分布。使用单变量和多变量逻辑回归评估与阴道镜检查准确性相关的因素。
    结果:在372名患者中,195人患有慢性宫颈炎,131例hadCIN1,37例hadCIN2/3,9例患有癌症。非HR-HPV16/18阳性的患者的CIN2病变和CIN3病变的即时发生率与HPV16/18阳性的患者相当(P=0.699)。此外,在诊断为CIN2+病变的患者中,8例(17.39%)患者为年龄<30岁的女性。当病理结果作为参考时,阴道镜检查的一致性率为61.0%(227/372)。多因素分析显示,年龄和宫颈转化区类型是影响阴道镜检查准确性的独立因素(P<0.001)。
    结论:在资源有限的国家,对于细胞学阴性但HR-HPV阳性(包括非16/18HR-HPV阳性)的患者,应建议立即进行阴道镜转诊,对于年龄<30岁的女性,应建议通过共同测试进行宫颈癌筛查。阴道镜检查具有中等诊断价值,并且可以受年龄和宫颈转化区类型的影响。
    BACKGROUND: Cervical cancer screening results that are negative for cytology but positive for high-risk human papillomavirus (HR-HPV) are not uncommon. One-year follow-up is suggested for patients with no history of HPV positivity under the most recent American Society of Colposcopy and Cervical Pathology (ASCCP) guidelines (2019). The aim of this study was to evaluate the immediate risk of cervical intraepithelial neoplasia (CIN) among cytology-negative patients positive for HR-HPV. The diagnostic accuracy of colposcopy in these patients was investigated.
    METHODS: A retrospective study was conducted in patients who were cytology negative but HR-HPV positive and referred for colposcopy from January 2022 to August 2023. Patients were compared in terms of the immediate rate of CIN lesions among the HPV16-positive group, the HPV18-positive group and the non-16/18 HR-HPV-positive group. The distribution of CIN2 + lesions according to age was evaluated. The factors associated with the accuracy of colposcopy were evaluated using univariate and multivariate logistic regression.
    RESULTS: Among the 372 patients, 195 had chronic cervicitis, 131 had CIN1, 37 had CIN2/3, and nine had carcinoma. The immediate rates of CIN2 + lesions and CIN3 + lesions in patients who were not HR-HPV16/18-positive were comparable to those in patients who were HPV16/18-positive (P = 0.699). In addition, among patients diagnosed with CIN2 + lesions, 8 (17.39%) patients were women aged < 30 years. When pathological results were used as a reference, the consistency rate of colposcopy was 61.0% (227/372). Multivariate analyses revealed that age and the type of cervical transformation zone were independent factors affecting the accuracy of colposcopy (P < 0.001).
    CONCLUSIONS: In countries with limited resources, immediate colposcopy referral should be recommended for patients who are cytology negative but HR-HPV-positive (including non-16/18 HR-HPV-positive), and cervical cancer screening via cotesting should be suggested for women aged < 30 years. Colposcopy has moderate diagnostic value and can be affected by age and the type of cervical transformation zone.
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  • 文章类型: English Abstract
    Objectives: To evaluate the clinical value of the Paris system for reporting urinary cytology (TPS) in the diagnosis of urothelial carcinoma (UC). Methods: A total of 1 744 cytological diagnostic records (from 751 cases) were collected retrospectively. All specimens were voided urines and histopathology as the gold standard. The sensitivity and specificity of urinary cytological diagnosis of UC and risk of high grade malignant (ROHM) in each diagnostic category were compared. Results: There were 360 cases with histopathology. The percentage of negative for high-grade urothelial carcinoma (NHGUC) was 30.1% (226/751), atypical urothelial cells (AUC) was 29.8% (224/751), suspicious for high-grade urothelial carcinoma (SHGUC) was 16.8% (126/751), high grade urothelial carcinoma (HGUC) was 21.2% (159/751), and non-urothelial malignancy (NUM) was 2.1% (16/751). The histpathologic ROHM corresponding to each cytological diagnosis category were 27.3% for NHGUC, 32.7% for AUC, 74.7% for SHGUC, 96.6% for HGUC and 100.0% for NUM, respectively. ROHM of SHGUC was significantly higher than that of AUC group, and the difference between the two groups was statistically significant (P<0.001). ROHM of HGUC group was significantly higher than that of SHGUC group, and the difference was statistically significant (P<0.001). With SHGUC as the cut-off value, the sensitivity and specificity of cytological diagnosis of HGUC were 76.7% (165/215) and 85.7% (18/21), and with HGUC as the cut-off value, the sensitivity and specificity of cytological diagnosis of HGUC were 53.0% (114/215) and 100.0% (21/21), respectively. Conclusions: Urine cytology has high sensitivity and specificity in the diagnosis of HGUC. The malignant risk of TPS varies with different diagnosis category. The high malignant risk population in cancer hospital leads to the relatively high malignant proportion and ROHM in each diagnosis category. Urinary cytology TPS reporting system is helpful to clinical management and has good clinical application value.
    目的: 探讨尿液细胞学巴黎报告系统(TPS)在临床应用中的实际意义。 方法: 回顾性连续收集2020年1月至2022年6月中国医学科学院肿瘤医院1 744份自然排空尿标本(751个尿液标本)细胞学诊断资料,以组织病理诊断为金标准,对比尿液细胞学诊断尿路上皮癌的灵敏度、特异度及每个诊断分类的高级别恶性风险。 结果: 360例患者有组织病理诊断结果,细胞学诊断分类占比分别为未见高级别尿路上皮癌 30.1%(226/751)、非典型尿路上皮细胞 29.8%(224/751)、可疑高级别尿路上皮癌 16.8%(126/751)、高级别尿路上皮癌 21.2%(159/751)、非尿路上皮恶性肿瘤 2.1%(16/751)。细胞学各个诊断级别所对应的组织病理相关高级别恶性风险分别为27.3%(未见高级别尿路上皮癌)、32.7%(非典型尿路上皮细胞)、74.7%(可疑高级别尿路上皮癌)、96.6%(高级别尿路上皮癌)、100.0%(非尿路上皮恶性肿瘤)。可疑高级别尿路上皮癌高级别恶性风险高于非典型尿路上皮细胞(P<0.001),高级别尿路上皮癌高级别恶性风险高于可疑高级别尿路上皮癌(P<0.001)。以可疑高级别尿路上皮癌为界值,细胞学诊断高级别尿路上皮癌的灵敏度和特异度分别为76.7%(165/215)和85.7%(18/21);以高级别尿路上皮癌为界值,细胞学诊断高级别尿路上皮癌的灵敏度和特异度分别为53.0%(114/215)和100.0%(21/21)。 结论: 尿液细胞学诊断高级别尿路上皮癌有较高的灵敏度和特异度;TPS不同诊断级别的恶性风险不同,肿瘤专科医院的高恶性风险人群导致了各个诊断级别均有相对高的恶性占比及高级别恶性风险;TPS有助于临床管理,有较好的临床应用价值。.
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  • 文章类型: Journal Article
    背景:细胞学筛查仍然是一种高影响力的实践,特别是在低资源环境中,预防宫颈癌。在中东和非洲最大的国家之一的纵向研究中,尚未对随时间推移的筛查实践和上皮异常的患病率进行调查。
    方法:常规医疗保健数据,在1981年3月至2022年12月之间,是从大开罗地区三级转诊大学医院的早期癌症检测部门的数据库中提取的,埃及。使用标准化技术获得宫颈涂片,并由专家病理学家送至细胞病理学实验室进行常规细胞学检查。对匿名数据进行分析,以确定每年筛查的女性人数的时间趋势以及上皮异常的患病率。
    结果:数据包括95120名妇女满意的涂片结果。筛查时妇女的平均年龄(SD)为38.5(10.5)。纳入的女性均未接受HPV疫苗。5174名妇女(5.44%)报告了上皮细胞异常。在这些上皮异常中,4144名女性(4.36%)中大多数为低度鳞状上皮内病变.其他异常包括378名妇女的非典型鳞状细胞(0.40%),226名妇女(0.24%)的高级别鳞状上皮内病变,184名女性(0.19%)未另外指定的非典型腺细胞,165名女性的腺癌(0.17%),70名女性鳞状细胞癌(0.07%),和非典型腺细胞有利于7名女性(0.01%)的肿瘤。第一次性交时年龄很小的女性,那些选择常规宫颈细胞学筛查的人,筛查时年龄较大的患者更有可能出现上皮异常.每年筛查的女性人数与低级别鳞状上皮内病变的检测呈正相关(相关系数[95%CI]=0.84[0.72,0.91]),与鳞状细胞癌的检测呈负相关(相关系数[95%CI]=-0.55[-0.73,-0.29])。
    结论:每年接受筛查的埃及妇女人数较少,上皮异常的时间趋势严重表明,有必要建立和扩大基于人群的结构化计划,以实现消除宫颈癌的目标。
    BACKGROUND: Cytological screening remains a high-impact practice, particularly in low-resource settings, for preventing cervical cancer. The examination of screening practices over time and the prevalence of epithelial abnormalities have not been investigated in longitudinal studies in one of the largest countries in the Middle East and Africa.
    METHODS: Routine healthcare data, between March 1981 and December 2022, were extracted from the database of the Early Cancer Detection Unit in a tertiary referral university hospital in the Greater Cairo Region, Egypt. Cervical smears were obtained using a standardized technique and sent to the cytopathology laboratory for conventional cytology examination by expert pathologists. The anonymous data were analyzed to determine the temporal trend of the number of women screened each year and the prevalence of epithelial abnormalities.
    RESULTS: Data included the results of satisfactory smears from 95120 women. The mean age (SD) of the women at the time of screening was 38.5 (10.5). None of the included women received an HPV vaccine. Abnormal epithelial cells were reported in 5174 women (5.44%). Of these epithelial abnormalities, the majority were low-grade squamous intraepithelial lesions in 4144 women (4.36%). Other abnormalities included atypical squamous cells in 378 women (0.40%), high-grade squamous intraepithelial lesions in 226 women (0.24%), atypical glandular cells not otherwise specified in 184 women (0.19%), adenocarcinoma in 165 women (0.17%), squamous cell carcinoma in 70 women (0.07%), and atypical glandular cells favoring neoplasms in 7 women (0.01%). Women who were at an early age at first intercourse, those who opted for routine cervical cytology screening, and those who were older at screening were more likely to have epithelial abnormalities. The yearly number of screened women was positively associated with the detection of low-grade squamous intraepithelial lesions (correlation coefficient [95% CI] = 0.84 [0.72, 0.91]) and negatively associated with the detection of squamous cell carcinoma (correlation coefficient [95% CI] = -0.55 [-0.73, -0.29]).
    CONCLUSIONS: The small number of annually screened Egyptian women and the temporal trend in epithelial abnormalities critically demonstrate the need for establishing and scaling up a structured population-based program to achieve the goal of eliminating cervical cancer.
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  • 文章类型: Journal Article
    肝内胆管癌(iCCA)是第二常见的恶性原发性肝癌。iCCA可能在潜在的慢性肝病上发展,其发病率与肥胖和代谢性疾病的流行有关。相比之下,肝门部胆管癌(pCCA)可能伴随着胆道慢性炎症性疾病的病史。CCA的初始管理通常很复杂,需要多学科的专业知识。法国肝脏研究协会希望组织指南,以便总结关于iCCA和pCCA几个关键点的最佳证据。这些指南是根据文献中现有的证据水平制定的,并对每项建议进行了分析,由专家小组讨论和投票。他们描述了CCA的流行病学以及从诊断到治疗如何管理iCCA或pCCA患者。还强调了个性化医学和靶向疗法的使用的最新发展。
    Intrahepatic cholangiocarcinoma (iCCA) is the second most common malignant primary liver cancer. iCCA may develop on an underlying chronic liver disease and its incidence is growing in relation with the epidemics of obesity and metabolic diseases. In contrast, perihilar cholangiocarcinoma (pCCA) may follow a history of chronic inflammatory diseases of the biliary tract. The initial management of CCAs is often complex and requires multidisciplinary expertise. The French Association for the Study of the Liver wished to organize guidelines in order to summarize the best evidence available about several key points in iCCA and pCCA. These guidelines have been elaborated based on the level of evidence available in the literature and each recommendation has been analysed, discussed and voted by the panel of experts. They describe the epidemiology of CCA as well as how patients with iCCA or pCCA should be managed from diagnosis to treatment. The most recent developments of personalized medicine and use of targeted therapies are also highlighted.
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  • 文章类型: Journal Article
    目的:研究p16/Ki-67双重染色细胞学检查(DST)结果之间的关系,在LLETZ手术治疗CIN之前和之后6个月获得,以及治疗后3年的随访方案。
    方法:前瞻性队列研究的次要分析。在LLETZ之前和之后6个月获得宫颈细胞学样本,并进行常规液基细胞学(LBC)和p16/Ki-67双重染色,以及高危HPV基因分型。LLETZ后的临床管理是根据比利时国家指南,临床医生在两个时间点都不知道DST结果。在2023年1月1日审查了病例记录,以记录平均三年后的随访方案:建议女性恢复常规筛查(即,根据当时的比利时指南进行三年一次的LBC测试),或仍受到更频繁的治疗后监测(即,由于持续的hrHPV感染或不存在细胞学消退,因此就诊频率更高)。
    结果:在最初招募的79/110名女性中记录了随访方案(72%)。需要持续的强化治疗后监测与治疗后6个月的hrHPV感染相关(79.3%vs.18.0%,p<0.001),基线和随访时DST结果呈阳性(41.4%vs.84.0%,p<0.001-55.2%vs.16.0%,p<0.001),和6个月时持续的细胞学异常(在ASCUS或更差的阈值,37.9%与16.0%,p=0.028)。在多变量逻辑回归分析中,基线时的DST阳性(aOR20.1,95CI2.03-199.1)与治疗多年后需要强化治疗后监测独立相关.
    结论:这项探索性研究表明,双染色细胞学在预测LLETZ手术后多年的治疗结果方面可能发挥着作用。
    OBJECTIVE: Investigate the association between p16/Ki-67 dual stain cytology test (DST) results, obtained prior to- and 6 months after LLETZ surgery for treatment of CIN, and the follow-up regimen three years after treatment.
    METHODS: Secondary analysis of a prospective cohort study. Cervical cytology samples were obtained just prior to- and 6 months after LLETZ and underwent conventional liquid-based cytology (LBC) and p16/Ki-67 dual staining, as well as high-risk HPV genotyping. Clinical management after the LLETZ was according to Belgian national guidelines, with clinicians being blinded to DST results at both time points. Case records were reviewed in 01/2023 to document the follow-up regimen on average three years afterwards: women had either been advised to return to routine screening (i.e., three-annual LBC testing according to the Belgian guideline at that time), or were still subject to more frequent posttreatment surveillance (i.e., more frequent visits because of persistent hrHPV infection or absence of cytological regression).
    RESULTS: The follow-up regimen was recorded in 79/110 women originally recruited (72%). The need for continued intense posttreatment surveillance was associated with hrHPV infection 6 months after treatment (79.3% vs. 18.0%, p < 0.001), a positive DST result at baseline and follow-up (41.4% vs. 84.0%, p < 0.001-55.2% vs. 16.0%, p < 0.001), and persistent cytological anomalies at 6 months (at an ASCUS or worse threshold, 37.9% vs. 16.0%, p = 0.028). In multivariable logistic regression analysis, a positive DST at baseline (aOR 20.1, 95%CI 2.03-199.1) was independently associated with the need for intense post-treatment surveillance multiple years after treatment.
    CONCLUSIONS: This exploratory study suggests a possible role of dual-stain cytology in predicting treatment outcome multiple years after LLETZ surgery.
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  • 文章类型: Journal Article
    简介淋巴结肿大,以淋巴结肿大为特征,是门诊医生常见的问题。由于潜在原因的不同,它被认为是重要的,值得评估,从可治疗的感染到无法治愈的转移性恶性肿瘤。细针穿刺细胞学(FNAC)是解决这些问题的重要工具,承认其快速诊断能力,简单,准确度,和最小的侵入性。目的这项回顾性研究旨在描述特定时期在三级护理中心观察到的淋巴结病病例的频谱。揭示患病率,病因学,以及与这种情况相关的临床结果。方法对2021年5月至2023年6月到三级护理中心就诊的淋巴结病患者的电子病历进行回顾。患者人口统计数据,临床表现,影像学发现,分析了细胞病理学和组织病理学诊断。结果在研究期间共发现300例淋巴结肿大。研究人群表现出不同的年龄组,对11-20岁的年龄范围略有偏爱。淋巴结肿大最常见的部位是宫颈组,主要临床表现包括淋巴结肿大和发热。病因学上,传染性原因,例如占大多数情况,其次是炎症和肿瘤病因。值得注意的是,2.6%的病例表现为非特异性淋巴结病,保证进一步调查。诊断模式,包括影像学检查和组织病理学检查,在建立准确的诊断中起着至关重要的作用。该研究还强调了区分良性和恶性淋巴结病的挑战,强调需要全面的诊断方法。结论本研究全面概述了三级护理中心的淋巴结病谱,强调多学科方法对准确诊断和管理的重要性。这些发现有助于我们了解淋巴结病的流行病学和病因学模式,指导临床医生在三级医疗保健环境中优化患者护理和结果。
    Introduction Lymphadenopathy, characterized by the enlargement of lymph nodes, is a common concern encountered by physicians in outpatient settings. It is deemed significant and warrants evaluation due to the diverse range of potential causes, ranging from treatable infections to incurable metastatic malignancies. Fine needle aspiration cytology (FNAC) emerges as a crucial tool in addressing these concerns, acknowledged for its rapid diagnostic capabilities, simplicity, accuracy, and minimal invasiveness. Objectives This retrospective study aims to characterize the spectrum of lymphadenopathy cases observed in a tertiary care center over a specified period, shedding light on the prevalence, etiology, and clinical outcomes associated with this condition. Methods Electronic medical records of patients presenting with lymphadenopathy to the tertiary care center between May 2021 and June 2023 were reviewed. Data on patient demographics, clinical presentation, imaging findings, and cytopathological and histopathological diagnoses were analyzed. Results A total of 300 cases of lymphadenopathy were identified during the study period. The study population exhibited a diverse range of age groups, with a slight predilection for the age range of 11-20 years. The most common sites of lymphadenopathy were in the cervical group, and the predominant clinical presentations included tender lymph nodes and fever. Etiologically, infectious causes, such as accounted for the majority of cases, followed by inflammatory and neoplastic etiologies. Notably, 2.6 % of cases presented with non-specific lymphadenopathy, warranting further investigation. Diagnostic modalities, including imaging studies and histopathological examinations, played a crucial role in establishing accurate diagnoses. The study also highlights the challenges in differentiating benign from malignant lymphadenopathy, emphasizing the need for a comprehensive diagnostic approach. Conclusion This study provides a comprehensive overview of the lymphadenopathy spectrum in a tertiary care center, emphasizing the importance of a multidisciplinary approach for accurate diagnosis and management. The findings contribute to our understanding of the epidemiology and etiological patterns of lymphadenopathy, guiding clinicians in optimizing patient care and outcomes in a tertiary healthcare setting.
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  • 文章类型: Journal Article
    背景:1型三鼻咽喉癌综合征(TRPS1)已成为一种可靠的免疫组织化学(IHC)标志物,用于识别转移癌的乳腺起源。这项研究调查了TRPS1IHC在非乳腺细胞学标本中的实用性。
    方法:对我们2021年的病理学数据库进行回顾性搜索,确定了液体(胸膜和腹膜)和肝脏,肺和骨细针穿刺(FNA),并进行手术随访,确认非乳腺转移性癌。使用抗人TRPS1的兔多克隆抗体对具有足够肿瘤细胞的病例的细胞块进行免疫染色。在原始检查后缺乏更深层次肿瘤的病例被排除在研究之外。两名病理学家独立解释TRPS1染色。
    结果:在评估的136例中,31例(22.79%)TRPS1染色呈阳性,105(77.21%)无反应性。在穆勒细胞起源的肿瘤中观察到阳性率,胃肠道(GIT),和肺起源为28.85%,25%,和21.57%,分别。在苗勒细胞起源的肿瘤中,有10例(66.67%)是浆液性癌,4例(26.67%)为子宫内膜样癌,1例(6.67%)为透明细胞癌。肺肿瘤包括7例(63.64%)鳞状细胞癌和4例(36.36%)腺癌,而胃肠道肿瘤包括14例(80%)腺癌和1例(20%)鳞状细胞癌。
    结论:尽管被认为是乳腺癌的敏感标志物,TRPS1免疫染色也在Mullerian中检测到,肺,和GIT癌。这凸显了当仅依靠TRPS1免疫染色来区分转移性乳腺肿瘤时要谨慎的重要性。
    BACKGROUND: Trichorhinophalangeal syndrome type 1 (TRPS1) has emerged as a reliable immunohistochemistry (IHC) marker for identifying breast origin in metastatic carcinomas. This study investigates the utility of TRPS1 IHC in non-breast cytology specimens.
    METHODS: A retrospective search of our pathology database for the year 2021 identified fluids (pleural and peritoneal) and liver, lung and bone fine needle aspirations (FNAs) with surgical follow-up confirming non-breast metastatic carcinomas. Cell blocks from cases with sufficient neoplastic cells underwent immunostaining using a rabbit polyclonal antibody against human TRPS1. Cases lacking tumor on deeper levels after the original work-up were excluded from the study. Two pathologists independently interpreted the TRPS1 staining.
    RESULTS: Of 136 cases assessed, 31 (22.79%) exhibited positive TRPS1 staining, while 105 (77.21%) were nonreactive. Positivity rates were observed in tumors of Mullerian cell origin, gastrointestinal tract (GIT), and lung origin at 28.85%, 25%, and 21.57%, respectively. Of the tumors of Mullerian cell origin 10 (66.67%) were serous carcinomas, 4 (26.67%) were endometrioid carcinomas, and one (6.67%) was a clear cell carcinoma. Lung tumors comprised seven (63.64%) squamous cell carcinomas and four (36.36%) adenocarcinomas, while the gastrointestinal tumors consisted of 14 (80%) adenocarcinomas and one (20%) squamous cell carcinoma.
    CONCLUSIONS: Although recognized as a sensitive marker for mammary carcinomas, TRPS1 immunostaining was also detected in Mullerian, lung, and GIT carcinomas. This highlights the significance of being cautious when depending solely on TRPS1 immunostaining to distinguish metastatic breast tumors.
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  • 文章类型: Journal Article
    背景:越来越多地使用原发性HPV宫颈癌筛查需要确定适当的筛查间隔,以避免对短暂疾病的过度治疗。这项研究检查了HPV筛查后宫颈癌前病变的长期风险,以告知筛查间隔建议。
    方法:这项纵向队列研究(不列颠哥伦比亚省,加拿大,2008-2022年)招募了接受1-2阴性HPV筛查的宫颈(WIC)妇女和个人(HPV1队列,N=5,546,HPV2队列,N=6,624)在一项随机试验和WIC中有1-2个正常细胞学结果(BCS1队列,N=782,297,BCS2队列,N=673,778)从省筛查登记处提取。所有参与者都被跟踪了14年的注册。在HPV和细胞学队列之间比较了宫颈癌前病变或病变(CIN2+)的长期风险。
    结果:八年后,HPV1和HPV2的CIN2+累积风险分别为3.2/1000(95%CI:1.6至4.7)和2.7/1000(CI:1.2至4.2)。这与3年后的细胞学队列中的风险相当(BCS1:3.3/1000,[CI:3.1至3.4];BCS2:2.5,[CI:2.4至2.6])。HPV队列中10年后CIN2+的累积风险较低(HPV1:4.7/1000,[CI:2.6至6.7];HPV2:3.9,[CI:1.1至6.6])。
    结论:HPV队列阴性筛查8年后CIN2+的风险与细胞学队列3年后的风险相当(可接受风险的基准)。
    结论:这些研究结果表明,初次HPV筛查间隔可以延长到目前的5年建议之外,可能会减少筛查的障碍。
    UNASSIGNED: The growing use of primary human papillomavirus (HPV) cervical cancer screening requires determining appropriate screening intervals to avoid overtreatment of transient disease. This study examined the long-term risk of cervical precancer after HPV screening to inform screening interval recommendations.
    UNASSIGNED: This longitudinal cohort study (British Columbia, Canada, 2008 to 2022) recruited women and individuals with a cervix who received 1 to 2 negative HPV screens (HPV1 cohort, N = 5,546; HPV2 cohort, N = 6,624) during a randomized trial and women and individuals with a cervix with 1 to 2 normal cytology results (BCS1 cohort, N = 782,297; BCS2 cohort, N = 673,778) extracted from the provincial screening registry. All participants were followed through the registry for 14 years. Long-term risk of cervical precancer or worse [cervical intraepithelial neoplasia grade 2 or worse (CIN2+)] was compared between HPV and cytology cohorts.
    UNASSIGNED: Cumulative risks of CIN2+ were 3.2/1,000 [95% confidence interval (CI), 1.6-4.7] in HPV1 and 2.7/1,000 (95% CI, 1.2-4.2) in HPV2 after 8 years. This was comparable with the risk in the cytology cohorts after 3 years [BCS1: 3.3/1,000 (95% CI, 3.1-3.4); BCS2: 2.5/1,000 (95% CI, 2.4-2.6)]. The cumulative risk of CIN2+ after 10 years was low in the HPV cohorts [HPV1: 4.7/1,000 (95% CI, 2.6-6.7); HPV2: 3.9 (95% CI, 1.1-6.6)].
    UNASSIGNED: Risk of CIN2+ 8 years after a negative screen in the HPV cohorts was comparable with risk after 3 years in the cytology cohorts (the benchmark for acceptable risk).
    UNASSIGNED: These findings suggest that primary HPV screening intervals could be extended beyond the current 5-year recommendation, potentially reducing barriers to screening.
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  • 文章类型: Journal Article
    背景:每种高危HPV基因型具有不同的致癌潜力,CIN3+的风险因基因型而异。我们评估了HPV阳性分诊结合细胞学的不同策略的性能,p16/ki67双重染色(DS),和扩展的基因分型。
    方法:来自NTCC2研究(NCT01837693)初筛HPVDNA阳性的3180名连续女性的样本,通过BD通明度HPV检测进行回顾性分析,这允许扩展的基因分型。根据CIN3+的风险将基因型分为三组。HPVDNA阳性的女性随访24个月或清除。
    结果:将三组基因型与细胞学或DS结果结合起来,我们确定了一组需要立即进行阴道镜检查的女性(对于CIN3的PPV从7.8%到20.1%),可以进行1年HPV再检测的组(HPV阳性的PPV在2.2至3.8的再检测中),和一个24个月CIN3+风险非常低的群体,即0.4%,由女性细胞学或DS阴性和HPV56/59/66或35/39/68阳性或Oncaricity测试阴性组成,可以参考3年的重新测试。
    结论:在基线HPVDNA阳性/细胞学或DS阴性的女性中,扩展的基因分型允许对CIN3+的风险进行分层,并确定一组在未来24个月内CIN3+风险如此之低的女性,以至于她们可以在3年后被转诊到新一轮筛查。
    背景:意大利卫生部(批准号RF-2009-1536040)。Hologic-Genprobe,罗氏诊断,Becton&Dickinson提供了财务和非财务支持。
    BACKGROUND: Each high-risk HPV genotype has different oncogenic potential, and the risk of CIN3+ varies according to genotype. We evaluated the performance of different strategies of HPV-positivity triage combining cytology, p16/ki67 dual staining (DS), and extended genotyping.
    METHODS: Samples from 3180 consecutive women from the NTCC2 study (NCT01837693) positive for HPV DNA at primary screening, were retrospectively analyzed by the BD Onclarity HPV Assay, which allows extended genotyping. Genotypes were divided into three groups based on the risk of CIN3+. HPV DNA-positive women were followed up for 24 months or to clearance.
    RESULTS: Combining the three groups of genotypes with cytology or DS results we identify a group of women who need immediate colposcopy (PPV for CIN3+ from 7.8 to 20.1%), a group that can be referred to 1-year HPV retesting (PPV in those HPV-positive at retesting from 2.2 to 3.8), and a group with a very low 24-month CIN3+ risk, i.e. 0.4%, composed by women cytology or DS negative and positive for HPV 56/59/66 or 35/39/68 or negative with the Onclarity test, who can be referred to 3-year retesting.
    CONCLUSIONS: Among the baseline HPV DNA positive/cytology or DS negative women, the extended genotyping allows to stratify for risk of CIN3+, and to identify a group of women with a risk of CIN3+ so low in the next 24 months that they could be referred to a new screening round after 3 years.
    BACKGROUND: Italian Ministry of Health (grant number RF-2009-1536040). Hologic-Genprobe, Roche Diagnostics, and Becton & Dickinson provided financial and non-financial support.
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