OBJECTIVE: The sensitivity of the AutoPap Primary Screening System with Location-Guided Screening (AutoPap LGS) for identifying atypical cells in cervicovaginal smears was evaluated. METHODS: Two hundred forty one slides with atypical cervical cytology randomly sampled were rescreened both manually and by the AutoPap LGS. The AutoPap LGS localized the atypical cells as 15 fields of view(FOVs), which were reexamined by manual review. The sensitivity was also evaluated in accordance with the cellularity of the smears. RESULTS: The AutoPap LGS successfully processed 232 out of 241 slides. The sensitivity of the AutoPap LGS identifying the atypical cells in successfully processed slides was 97.4%(226/232). The false negative rate was 2.6%(6/232). There was no false negative case in high grade squamous intraepithelial lesion (HSIL) or squamous cell carcinoma(SCC) smears in the AutoPap LGS. The FOVs localized the diagnostic-atypical cells in 97.8%(221/226). The number of diagnostic-atypical FOVs was increased in higher-degree of atypical cytology. The AutoPap LGS localized the atypical cells in 100% of adequately cellular smears and in 92.5% even in low cellular smears. CONCLUSION: The AutoPap LGS showed relatively good sensitivity to detect atypical cells. It can be a valuable system to localize atypical cells, especially in HSIL or cancer slides, even in smears with low cellularity.
Mass Screening* ; Vaginal Smears

Objective: Cervical cancer screening can reduce both the incidence and mortality rates of the disease. This study aimed to assess the diagnostic accuracy of conventional cytology, liquid based cytology and visual inspection with acetic acid in detecting pre-malignant and malignant cervical lesions. Methods: There were 249 patients who participated in the study. Of these, 6/249 (2.4%) turned out positive in papsmear, 7/249 (2.8%) turned out positive in liquid based cytology while 23/249 (9.2%) turned out positive in visual inspection with acetic acid. Colposcopic guided cervical biopsy was done on all 249 patients to confirm the results. Results: Fourteen turned out positive for cervical intraepthelial neoplasia, 1 patient had carcinoma in situ and 1 was positive for squamous cell carcinoma. Conclusion Among the three screening tests, VIA appears to be the most accurate, followed by liquid based cytology as compared to the conventional papsmear.
Vaginal Smears ; Cytology ; Cytodiagnosis

OBJECTIVE: This study assessed the usefulness of the AutoPap 300 QC System in identifying of detection false negative(DFN) smears in a slide population previously screened as "within normal limits" and compared the rate of identification of DFN to that using 10% random selection. MATERIALS AND METHODS: From December 1996 to August 1998, we utilized the AutoPap 300 QC System at 30% selection rate to select cases for manual review. During the study period, 1,040(83.4%) among 1,247 smears and 7,848(84.0%) among 9,343 smears were screened as "within normal limits" and were included for the AutoPap 300 QC System and 10% random selection studies, respectively. RESULTS: 357(34.3%) among 1,040 were selected by the AutoPap 300 QC System at 30% QC selection rate and reviewed manually. Overall, 63 among 357 were determined to be abnormal including 47 ASCUS, 2 AGUS, and 14 LSIL. 785(10%) among 7,848 were selected by 10% random selection and reviewed manually. 96 among 785 were determined to be abnormal including 69 ASCUS, 3 AGUS, and 24 LSIL. These results represented an increase in pick up rate of DFN(detection false negative) of 5.1 and 4.4 fold for ASCUS/AGUS and LSIL, respectively and of 1.5 and 1.3 fold when accounting for the volume differences measured. CONCLUSIONS: The study demonstrated that the AutoPap 300 QC System is superior to 10% human random screening for the identification of DFN smears. Further studies are required using variable selection rates and a larger number of smears to fully assess the value of the device in quality control mode.
Humans ; Mass Screening ; Quality Control ; Vaginal Smears

Screening by Test Pap smear is a preventative method and the best way for early detection for cancer, currently. After the Conference organized in May 2001, the gynaecologic cancers agreed with Bethesda system and give out the guidelines to clinical treatments: sample quality, common classification, results, automatic and depended tests, training and suggestion. Cervical cancer is an important healthy issuse which need to be screening because of its regular characteristics and have an effective treatment methods in the first early period, in the long-term preclinical period and can be able to detect. Using test Pap smear has quickly screen result, less invasive procedures, low cost and can be accepted widely
Uterine Cervical Neoplasms ; diagnosis ; Vaginal Smears

Neoplasms/*radiotherapy ; *Uterine Cervical Neoplasms ; *Vaginal Smears

Vaginal Smears ; Uterine Cervical Neoplasms ; Risk

An aim of this study was to evaluate an effect of misinterpretation of pregnancy related cellular changes on the postpartum regression rate of abnormal cervical smears in pregnancy. A series of 265 cases with abnormal cervical smears in pregnancy were selected from a database of cervical smear results. The selected cases were classified as regression, persistence, and progression based on the results of postpartum cervical smears and histology. Of the selected cases, 162 cases were classified as regression and the postpartum regression rate was 61.1% (162/265). We reviewed abnormal cervical smears in pregnancy these cases. The primary cytologic diagnoses of these cases were ASCUS (118 cases), AGUS (2 cases), ASCUS/AGUS (1 case), LSIL (25 cases), LSIL R/O HSIL (2 cases), and HSIL (14 cases). With information of the pregnacy, we identified decidual cells in 24 cases, but cells identified by the Arias-Stella reaction and trophoblasts were not found. Sixteen cases out of 162 cases were reclassified as a pregnancy related change rather than an abnormal. Desidual cells were considered as ASCUS in 15 cases and as LSIL in one case. The revised postpartum regression rate was 55.5%(147/265) and was lower than the original. Consequently, misinterpretation of the pregnancy related cellular changes has an effect on a rise of the postpartum regression rate of the abnormal cervical smear in pregnancy. Pathologists may diagnose pregnancy related cellular changes as abnormal findings if they do not have information regarding the pregnancy. Therefore, clinical information of pregnancy and knowledge about the pregnancy related cellular changes are essential to prevent misinterpretation.
Diagnosis ; Postpartum Period* ; Pregnancy* ; Trophoblasts ; Vaginal Smears*

OBJECTIVE: False negatives of cervical smears due to screening errors pose a significant and persistent problem. AutoPap 300 QC System, an automated screening device, is designed to rescreen conventionally prepared Pap smears initially screened by cytotechnologists as normal. Clinical experience and sensitivity of the AutoPap 300 QC System were assessed and compared with current 10% random quality control technique. MATERIALS AND METHODS: In clinical practice, a total of 18,592 "within normal limits" or "benign cellular changes" cases classified by The Bethesda System were rescreened by the AutoPap System. In study for sensitivity of The AutoPap System to detect false negatives, a total of 1,680 "within normal limits" or "benign cellular changes" cases were rescreened both manually and by the AutoPap System. The sensitivity of the AutoPap System to these false negatives was assessed at 10% review rate to compare 10% random manual rescreen. RESULTS: In clinical practice, 38 false negatives were identified by the AutoPap System and we had achieved 0.2% reduction in the false negative rate of screening error. In study for sensitivity, 37 false negatives were identified by manual rescreening, and 23 cases(62.2%) of the abnormal squamous cytology were detected by the AutoPap System at 10% review rate. CONCLUSONS: The AutoPap 300 QC System is a sensitive automated rescreening device that can detect potential false negatives prior to reporting and can reduce false negative rates in the laboratory. The device is confirmed to be about eight times superior to the 10% random rescreen in detecting false negatives.
Mass Screening ; Quality Control ; Vaginal Smears

Cytologic and histopathologic features and human papillomavirus (HPV) DNA detection associated with 101 cervicovaginal smears which are classified as 'atypical squamous cells of undetermined significance, rule out high grade squamous intraepithelial lesion(ASCUS, R/O HSIL)' were reviewed and compared to 89 smears of 'ASCUS, not otherwise specified(NOS)' . Cytologic fieatures of ASCUS, R/O HSIL included atypical single small cells(36.6%), hyperchromatic tissue fragments(35.6%), atypical metaplastic cells(18.8%), endometrial cell-like clusters(5.9%), and atypical parakeratotic cells(3.0%). A final diagnosis of HSIL on biopsy was assigned to 47(54.0%) of 87 women with ASCUS, R/O HSIL and to 13(14.6%) of 89 women with ASCUS, NOS ( p=0.000). There was no difference in HPV DNA detection rate between ASCUS, R/O HSIL and ASCUS, NOS smears. These data suggest that subclassification of ASCUS is helpful to manage patients because ASCUS, R/O HSIL is more often associated with an underlying HSIL on biopsy. Therefore, women with ASCUS, rule out HSIL should be actively managed with colposcopic examination.
Biopsy ; Diagnosis ; DNA ; Female ; Humans ; Vaginal Smears

Conventional cervical smears have been a great tool to reduce the incidence of cervical cancer; however, many studies have revealed significant false negative rates. To resolve this problem, the liquid based cytology (LBC) method was developed. The LBC method reduces the number of false positive and false negative smear results because LBC achieves an even distribution of monolayered cells, eliminated the obscuring effects of inflammation and blood. Although the LBC method has many advantages, there are several drawbacks. The LBC method requires an adaptation period for cytopathologists and cytotechnicians. Another drawback is the expense of the method. Thus, the LBC method has been questioned, and criticism has been raised regarding the design of the studies that assert its superiority. With a focus on the cytomorphologic and technical differences of LBC compared with conventional cervical smears, a review of the clinical and cost effectiveness of LBC, a brief comparison of two popular LBC methods, and the basic concepts of study design with respect to LBC are presented in this review.
Cervix Uteri ; Cost-Benefit Analysis ; Female ; Incidence ; Inflammation ; Vaginal Smears