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At least 253 records · Page 14Linked to original sources
PubMed1992

Human papillomavirus infection of the female genital tract: correlation of HPV DNA with cytologic, colposcopic, and natural history findings.

Although molecular biology evidence suggests a strong link between HPVs and anogenital neoplasias, evidence from clinical studies is still less convincing. Thus, the recognition of both overt and subclinical HPV infection has become increasingly important. We studied the correlation between HPV DNA and cytologic, colposcopic and natural history findings in a defined group of women. The study population consisted of 150 HPV DNA positive cases (mean age 25.7 years, SD 7.4) and 69 randomly selected HPV DNA negative controls (mean age 27.3 years, SD 7.9) enrolled in an ongoing study of the natural history of genital HPV infections. All cases and controls had normal cervicovaginal cytology at the enrollment. A commercial dot-blot technique hybridization test (Virapap and Viratype, Digene Diagnostics, USA) was used for HPV DNA testing of cervicovaginal scrapes. Five percent of the patients had HPV 16/18, 31% had HPV 31/33/35, 15% had more than one of the three HPV DNA groups ("mixed"), and 15% had untypable HPV DNA. Cases and controls were followed by repeat examinations every 4th month. The mean follow-up time was 12.2 months (SD 8.7) for the cases, and 12.8 months (SD 6.9) for the controls. The study endpoint was defined as the presence of cytologic changes consistent with CIN. The overall prevalence of atypical transformation zone (ATZ) findings was 45% in the controls and 56% in the cases, with no significant differences between the specific HPV DNA groups. Although vulvar or vaginal abnormalities (acetowhite epithelium, squamous papillomatosis, filaments, satellite lesions, fissures, papules or exophytic condylomas) were more commonly seen in the cases than in the controls, the difference was significant only for condylomas and fissures.(ABSTRACT TRUNCATED AT 250 WORDS)

Colposcopy↗
PubMed2005

[Current colposcopic terminology. Successes and limitations].

Colposcopy is nowadays a habitual tool applied to the routine gynecological exploration. The terminology for the normal and abnormal colposcopic findings has changed according with the time and the new knowledge about the low genital tract diseases. Gynecologists must be aware of this terminology for a correct application in diagnosis, therapeutics and papers on findings and results. It is necessary that the whole medical community around the world applies the same terminology in order to have a better communication.

Colposcopy↗
PubMed2006

Negative colposcopic biopsy after positive human papilloma virus (HPV) DNA testing: false-positive HPV results or false-negative histologic findings?

We studied histologic examination-related factors contributing to false-negative colposcopic biopsy results. Patients positive for high-risk human papillomavirus (HPV) DNA with negative cervical histologic findings were identified between January 2002 and December 2003. Three additional H&E-stained levels were obtained when the original diagnosis was confirmed on review. Patients with atypical squamous cells of undetermined significance (ASC) Papanicolaou test results, positive HPV DNA results, and negative cervical histologic findings accounted for 4.5% of all ASC smears submitted for HPV DNA testing. Slides and tissue blocks were available for 95 cases; 4% had focal HPV infection or mild dysplasia. When deeper levels were examined, 31% had clinically significant lesions: HPV infection or cervical intraepithelial neoplasia (CIN) 1, 19%; CIN 2/3, 8%; and dysplasia, not otherwise specified, 3%. Of the remaining patients, follow-up revealed squamous abnormalities in 25%. About 5% of patients with positive HPV DNA results had a negative follow-up biopsy result. "False-negative" biopsies accounted for one third of cases. Additional levels should be obtained for discrepant results. Close follow-up is crucial when the initial biopsy result is negative because a small number of patients will have squamous abnormalities in subsequent studies.

Biopsy↗
PubMed1991

[Possibilities and limitations of the acetic acid test in the identification of vulvar papillomavirus lesions. A colposcopic, histologic and virologic study].

42 subclinical HPV related vulvar lesions have been studied by Southern Blot Hybridization and histological samplings. 15 women had normal Pap smears. Cervical intraepithelial neoplasia was present in 24 other women, 15 of them had HPV on Southern Blots. Macular or papular areas on the vulva were strongly correlated with HPV infection, since 6 out 9 of them harboured HPV 16, 42 or X. Histologically, flat condyloma was present in 6 cases. However, 33 nonspecific acetowhite reactions of the vulva were free of HPV. It is therefore important to recognize such aspects on colposcopical examination of the vulva to avoid unnecessary treatment.

Acetates↗
PubMedDate not supplied

[Colposcopic, cytologic and histologic changes in the uterine cervix caused by human papilloma viruses].

This study is an evaluation of 485 histological findings of directed biopsies, which were performed due to the cytological state of dysplasia (IIIA and IIIB) or an abnormal colposcopy finding. The analysis of cervical smears showed 18.4% of the patients to have koilocytosis, whereas 6.8% of them had colposcopically recognized cervical condyloma. The samples obtained by biopsy underwent histological examination, which confirmed koilocytotic changes in 8.5% of cases, i. e. in significantly lower percentage than indicated by cytology (t = 4.500; p < 0.001). Colposcopy findings of condyloma, on the other hand, were confirmed much more often (60.6% compared to 31.5%; t = 3.163, p < 0.001, i. e. the difference is statistically significant). Pathohistological examination verified 68.3% of cytologically recognized cases of koilocytosis, compared to 48.8% of cytologically recognized cases of koilocytosis, compared to 48.8% of those discovered by colposcopy--the difference is not significant (t = 1.822; p > 0.05). However, the joint implementation of cytology and colposcopy revealed 85.4% of koilocytoses. Compared to the results of colposcopy as the single method, the difference is statistically significant (t = 3.812; p < 0.001), but compared to cytology it is not (t = 1.879; p > 0.05). Koilocytosis is significantly more frequent in women under 35 years of age (82.9%; t = 4.218, p < 0.001) and the patients suffering from it are also much more likely to have dysplasia or CIS than those with no HPV infection (58.5% compared to 42.4%; t = 2.012, p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2006

Correlation between colposcopically directed biopsy and large loop excision of the transformation zone and influence of age on the outcome.

OBJECTIVES: To assess the accuracy and correlation between Colposcopically Directed Biopsy (CDB) and Large Loop Excision of the Transformation Zone (LLETZ) and the influence of age. MATERIAL AND METHOD: A comparative analysis was conducted from the 352 women referred to Rajavithi Hospital from January 1998 to December 2003, to compare between CDB and LLETZ. Correlation was assessed by the percentage of concordance (accuracy), Spearman's rank correlation coefficient (r) and Kappa statistics (K). A subgroup analysis was performed in women aged > or = 50 years to evaluate the influence of age on the correlation. RESULTS: A 66.2% concordance was found between CDB and LLETZ. The correlation and agreement between the two procedures were low (r = 0.32, p < 0.0001; K = 0.24, p < 0.0001). In women aged > or = 50 years, the accuracy was 60.7% and stronger correlation and agreement were noted (r = 0.50, p < 0.0001; K = 0.31, p = 0.001). CONCLUSION: CDB is an inadequate diagnosis tool for Squamous Intraepithelial Lesion (SIL) in woman below 50 years of age. In women aged 50 years or more with satisfactory colposcopy, the accuracy and correlation between two procedures are not compromised.

Adolescent↗
PubMed1991

[Colposcopic-histologic results in 97 patients with mild dysplasia shown by Pap test].

Colposcopy and biopsy were performed in 97 patients whose referral smears showed mild dysplasia (CIN 1). Of 97 women, 40 (41.2%) had a biopsy or a colposcopic examination alone considered normal, 36 (37.1%) had CIN 1 or HPV changes, 12 (12.4%) had CIN 2 and 9 (9.3%) had CIN 3. No invasive cancer was detected. This data suggest that, if colposcopy resources are available, repeat smear alone is inadequate to follow women who have a mild dysplasia smear.

Biopsy↗
PubMed1991

Comparative study of cytologic and colposcopic findings in preclinical cervical cancer.

Seventy-seven patients who had PAP smear cytology and colposcopic examination in a 2-year period between 1988 and 1989 were reviewed. Those with findings indicative or suspicious of malignancy were subjected to biopsy. All 50 patients thus biopsied were confirmed to have preclinical cancer on histological examination. Compared against histology, PAP smear cytology gave an accuracy rate of 90% (5 false negatives) and colposcopy gave an accuracy rate of 94% (3 false negatives). These results demonstrate that the two techniques are useful as screening tests for preclinical cervical cancer. The results are improved if they are used complementarily. However, there was poor specificity in the categorisation of cervical cancer by both methods. This was probably due to the subjectiveness of the two procedures. The study also raised the possibility of a higher incidence of preclinical cervical cancer in the Chinese ethnic group.

Adult↗
PubMed1991

[Cervical endoscopy for rational colposcopic evaluation].

Having analysed the results of a large series of patients, the Authors propose endocervical examination as a vital step to be performed at the same time as colposcopy or, in certain well identified cases, following cytohistological results. Endocervical examination either before or after colposcopy is then described in a protocol taking into account the various parameters. The most important are: the assessment of the squamocolumnar line, the type of colposcopic lesion, and cytohistological findings. Following a brief discussion of traditional diagnostic tests (endocervical curettage, endocervical observation using Kagan forceps), the Authors underline the importance of the endocervicoscope which allows a closer, noninvasive and precise evaluation to be made.

Cervix Uteri↗
PubMed1991

Comparison of topical Xylocaine with placebo as a local anesthetic in colposcopic biopsies.

Colposcopically directed biopsies cause discomfort for the patient. Topical lidocaine (Xylocaine) had routinely been applied to the cervix before biopsies performed at the colposcopy clinic of the Ottawa General Hospital. A prospective, single-blind trial was performed to compare the effect of topical Xylocaine with that of a placebo. Patients in both groups experienced discomfort; the median pain score in both groups was equal, and statistical analysis of the results by the Mann-Whitney test showed no difference between the two treatment groups.

Anesthesia↗
PubMed1990

[A comparison of cytological and histological studies on women with a colposcopically atypical cervix uteri].

The study was made on 62 at random chosen women between 16 and 71 years of age with atypical colposcopic findings, on whom cytological and histological studies were performed. Histological atypical epithelium was found in 36 patients. 3 out of 36 women had invasive carcinoma, 8--carcinoma in situ, but dysplasia of I to III degree was established in 25 women. The comparison of cytological and histological findings show a high degree of correlation.

Adolescent↗
PubMedDate not supplied

Routine colposcopic survey of patients with squamous atypia. A method for identifying cases with false-negative smears.

Routine colposcopy was performed on 376 women with cervical squamous atypia (originally reported as "inflammatory atypia"). Colposcopy showed no abnormalities in 240 cases and a lesion in 136 cases; the latter were sampled by colposcopy-guided biopsy. The biopsy samples showed evidence of human papillomavirus (HPV) infection and/or grade I cervical intraepithelial neoplasia (CIN I) in 42 cases (11.1%), CIN II in 4 cases (1.1%) and CIN III in 5 cases (1.3%); the other 85 biopsied cases were histologically negative. Most cases of HPV/CIN I (35 of 42) and all of the cases of CIN II-III occurred in women under the age of 40. The detection rates were 4.4% for CIN II-III in women under the age of 40, 4.0% for HPV/CIN I in women 40 and older and 17.2% for HPV/CIN I in women under the age of 40 (P less than .001). It thus appears that women under the age of 40 who show cytologic evidence of squamous atypia would benefit from colposcopic examination.

Adult↗
PubMed1990

[The demonstration of human papillomavirus DNA in genital lesions with and without colposcopic atypism].

34 cellular suspensions from the vaginal part of women were examined for presence of HPV DNA of the types: 6, 11, 16 and 18--from a lesion and a healthy area--by filter in situ hybridization. The women were examined by colposcopy because of cervical lesions established macroscopically as well as for other various complaints. Cells were also investigated from women after undergone ablation treatment: diathermy coagulation, conization and hysterectomy on account of CIN. The data were compared with cytological, colposcopic and histological findings. The established presence of HPV DNA of high risk type 16 and 18 in some of the patients after operative treatment required continuous control of these women as well as examination of lower genital tract because of the discovered multicentricity of HPV infection.

Adolescent↗
PubMed1990

[HPV-induced subclinical lesions of the male genitalia. Use of a colposcope].

Thirty-nine HIV-negative men, without apparent genital warts, were evaluated for evidence of subclinical genital condylomata by visual examination of the genitalia with colposcopy after the application of 5% acetic acid. 24 patients (group I) had a history of recurrent genital condylomata; 8 (group II) were sexual partners of women with HPV-related lesions and 7 (group III) presented another sexually transmitted disease. Under colposcopic magnification, acetowhite areas were biopsied for conventional histology and in situ hybridization using 6/11, 16/18 and 31/35/51 HPV-DNA probes. Colposcopy and histologic features were positive for condylomata acuminata in 16 patients of group III (14%). HPV 16/18 - whose oncogenic potentiality is well known - was detected in 3 patients: of these, one patient of group I presented a histologic picture suggestive of bowenoid papulosis.

Adolescent↗
PubMed1986

Colposcopic assessment of the lower genital tract in female renal transplant recipients.

The incidence of epithelial or cutaneous abnormality of the lower genital tract was studied colposcopically in 31 women aged 35 (SD9) years on renal replacement therapy for one to 184 months (mean 73 months). Twenty-four women had a renal transplant and had received immunosuppressive therapy for two to 173 months (mean 61 months). Seven women (two with failed transplants) were on home hemodialysis (one to 48 months, mean 19 months) awaiting transplantation. In 22 women (17 transplant and 5 dialysis patients) no abnormality was found. One hemodialysis patient had an extensive area of vulval intra-epithelial neoplasia. Five transplant recipients had evidence of genital papilloma virus (HPV) infection. No patient had cervical intra-epithelial neoplasia or invasive genital tract malignancy. The high incidence of HPV-associated lesions in this group, and the increasing evidence that HPV changes may predispose to cervical neoplasia suggest that this high risk group require regular gynecological assessment.

Adult↗
PubMed1986

[Papillomavirus and cervix atypia. Retrospective histo-colposcopic study of 175 cases].

One hundred and seventy five CIN cases diagnosed during the years 1958-60 have been reviewed and histologic slides as well as colpographies have been reevaluated for the presence of Papillomavirus-related features. Histo-colposcopic features of HPV infection have been found in 70% of CIN cases, incidence comparable to the one actually observed. Thus, the relationship between HPVs and cervical cancer doesn't seem to be changed.

Adult↗