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G Medley

Publications and source records attributed to G Medley.

62 records · Page 4Linked to original sources
PubMedDate not supplied

Detection of unsuspected abnormalities by PAPNET-assisted review.

OBJECTIVE: To determine the positive predictive value of abnormalities detected by PAPNET-assisted review of slides considered to show no abnormality on two manual screenings and to evaluate the repeatability of technical codes assigned by the PAPNET scanner. STUDY DESIGN: PAPNET-assisted review was performed on 19,805 slides that had been assessed as showing no abnormality on two occasions by manual screening plus 195 slides with abnormal cells seeded at random. Abnormalities detected by cytotechnologists were graded by cytopathologists and compared with the findings of later histology/cytology. RESULTS: On PAPNET-assisted review, the cytotechnologists identified 212 slides as containing unsuspected abnormalities; cytopathologists agreed with 76% (162/212) of these predictions. Later histology/cytology confirmed 54% (14/26) and 32% (33/102) of the predictions of high and low grade abnormality, respectively. The PAPNET scanner gave concordant technical codes for 94.8% of 2,690 slides that were submitted twice for scanning. CONCLUSION: Some additional abnormalities will be detected by a PAPNET-assisted review, even among slides considered negative on two manual screenings. However, many of these abnormalities will not be confirmed on later investigation and will thus appear to represent false positive cytology. The assigning of technical codes by the PAPNET machine is subject to a degree of variation on repeat evaluation of the same slides.

Artifacts↗
PubMedDate not supplied

Detection of laboratory false negative smears by the PAPNET cytologic screening system.

OBJECTIVE: To evaluate the ability of PAPNET-assisted screening to identify abnormal slides that had originally been reported as negative on manual screening. STUDY DESIGN: One hundred ninety-five abnormal slides were seeded into 20,000 slides that had been assessed as showing no abnormality on two occasions by manual screening. All slides were submitted for PAPNET review and the tiles assessed by trained cytotechnologists. RESULTS: With a single assessment of the PAPNET tiles and when the prevalence of seeded abnormality was around 1%, only 44% of the seeded abnormal slides were recognized as abnormal. With multiple independent assessments and by increasing the prevalence of abnormality to 81%, 83% of the seeded abnormalities were recognized by at least one of three reviewing cytotechnologists. This increase in sensitivity appeared to be associated with a state of relative hyperalertness in the reviewing cytotechnologists. CONCLUSION: The sensitivity of a PAPNET-assisted review was < 100% for the detection of seeded abnormal slides. Altering the format of presentation of information to the cytotechnologist may result in improved sensitivity.

Algorithms↗
PubMedDate not supplied

Prevalence of HPV in a Melbourne female STD population: comparison of RNA and DNA probes in detecting HPV by dot blot hybridization.

A total of 377 women, consecutively selected as first attenders to a sexually transmitted diseases clinic in Melbourne, Australia, were examined for overt Condylomata acuminata and were screened for genital HPV DNA types 6, 11, 16, 18, 31, 33 and (35) using 2 dot blot hybridization methods. Overall, there was a 90% positivity correlation between the 2 methods with HPV DNA being detected in 12% of ectocervical samples. Overt warts were found in 15% of the women and HPV DNA was detected at the cervix in 35% with cytology predicting HPV with or without dysplasia in 27%. Thirteen percent had a past history of warts but none on examination and HPV DNA was evident in 16% while 18% had cytological features of HPV. Those with no warts evident and no past history of warts had both HPV DNA and cytological features of HPV in 7%.

Condylomata Acuminata↗
PubMedDate not supplied

Papanicolaou smears in Victoria: are the wrong women being screened?

While a mismatch is evident in the age distribution of women who are smear-tested by the Victorian Cytology (Gynaecological) Service (VC(G)S) and the women who are developing and dying of invasive cancer of the cervix, evidence is presented that the screened population have significant morbidity from precursor lesions. Women whose cervical cytological examination is undertaken by the VC(G)S have higher detection rates for carcinoma-in-situ than does the general population; a more than three-fold excess over the SA Cancer Registry rates is evident. During 1984 one in 148 of the women who were screened by the VC(G)S had histologically-proved dysplasia or carcinoma-in-situ in contrast with one in 5606 Australian women who were diagnosed as having invasive cancer of the cervix. These results indicate that the women who are currently screened should not be considered an intrinsically low-risk group for cervical malignancy.

Adult↗
PubMedDate not supplied

Influence of endocervical status on the cytologic prediction of cervical intraepithelial neoplasia.

A case-control analysis of the endocervical status of smears that preceded a histologic diagnosis of cervical intraepithelial neoplasia (CIN) showed that smears which correctly predicted CIN were significantly more likely to include metaplastic cells than were smears reported to be negative. There was no significant difference between the smears with respect to the presence of columnar cells. A high level of agreement was apparent between scientists in determining both columnar and metaplastic cell status. A discussion of the definition, role and potential impact of endocervical status in the prevention of cervical cancer is presented.

Adult↗
PubMedDate not supplied

Quality control measures for cervical cytology laboratories.

The results of three quality control measures for evaluating a cytopathology laboratory's performance in the diagnosis of cervical abnormalities are presented. The sensitivities of cervical cytology were estimated to be 95.5% or 93.1% (using two different methods of analysis) for the detection of histologically diagnosed invasive squamous cell carcinoma of the cervix and 60% for the detection of adenocarcinoma and adenosquamous carcinoma of the cervix in 1983. The positive predictive values for a histologic diagnosis of neoplasia after cytologic reports of CIN III and invasive carcinoma were 92.5% and 99%, respectively. Repeatability of a negative cytologic result exceeded 98%. These results indicate that accurate cervical cytologic reporting can be achieved. Regular monitoring of the type described, which is both practical and reasonably comprehensive, is recommended for all laboratories.

Adenocarcinoma↗
PubMedDate not supplied

Polymerase chain reaction. A sensitive indicator of the prevalence of human papillomavirus DNA in a population with sexually transmitted disease.

A total of 311 cervical samples from first attenders at a sexually transmitted disease clinic assayed for human papillomavirus (HPV) DNA with ViraType (VT) were analyzed with the polymerase chain reaction (PCR) for HPV using HPV L1 consensus primers and typed using L1 type-specific probes for 6/11, 16, 18 and 33. The prevalence of HPV by PCR was almost double that by VT (23.5% as compared to 12.6%, respectively). The increase was due largely to HPV types other than 6/11, 16, 18 and 33 (61.8%), while HPV types 6/11, 16 and 18 were responsible for 5.9%, 2.9% and 11.8%, respectively. Equal numbers of mixed infections of HPV 6/11/18 and HPV 16/18 each contributed to 8.8%. Mixed infection, as determined by VT, was 11% and increased to 40% with PCR. While the increase in the HPV detection rate by PCR was evident in all clinical categories examined (patients with no warts evident and no past history of warts, with no warts but a past history of warts and with clinical condylomata), a statistically significant increase occurred only in the first group, reflecting the increased sensitivity of PCR in detecting latent infection.

Cervix Uteri↗