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PubMed1980

[Vaginal smears of malignant ovarian tumors: comparison with cervical canal, aspirate uterine corpus, ascites, imprint smears and cytomorphology of histological specimens (author's transl)].

Vaginal smears of 21 patients with malignant ovarian tumors were examined. In 5 cases malignant cells were present: 1 mucinous cystadenocarcinoma, 2 poorly differentiated adenocarcinomas, 1 clear cell carcinoma, and 1 adenoid squamous cell carcinoma arising in a dermoid cyst. Cytomorphology of tumor cells in tissue specimens and imprint, ascites, aspirate uterine corpus, cervical canal and vaginal smears were examined. The ovarian malignant cells of the vaginal smears were grouped, round or oval with eccentric round or oval nuclei having a finely granular chromatin pattern regularly distributed, and with vesicular or vacuolated cytoplasm. Tumor diathesis appeared in 1 of 5 cases. Two post-menopausal patients showed an increase of superficial cells in the maturation index. In the comparison of malignant cells taken from different locations, vaginal tumor cells were similar to those in ascites. Since ascites smears were reported to be useful for the diagnosis of some kinds of ovarian tumors, it was expected that vaginal smears might also have this potentiality.

Adult↗
PubMed2003

Review of cytologic criteria of bacterial vaginosis: examination of 2,841 Papanicolaou-stained vaginal smears.

To review the cytologic criteria used in the diagnosis of bacterial vaginosis cases [Bv (+)], 2,841 Papanicolaou-stained vaginal smears were examined cytologically. Clue cells and other cytologic findings were observed in 94 of 2,841 (3.30%) vaginal smears. To detect Bv(+) cases, 94 vaginal smears were screened again. Clue cells, profuse free cocci among cornified type epithelial cells, absence of PMNLs, and vaginal Lactobacilli were detected in 43 of 94 (45.74%). The observation of free cocci which resembled a nebulous appearance was detected first in this study. These four cytologic criteria strongly suggested Bv(+) cases (n = 43). Although clue cells were seen in 51 of 94 (54.25%) vaginal smears, due to the presence of abundant PMNLs, metaplastic cells, vaginal Lactobacilli, and some infectious agents, mainly Trichomonas vaginalis and yeasts, they were considered bacterial vaginosis negative [Bv(-)]. It was postulated that 51 vaginal smears might be aerobic vaginitis. In conclusion, if vaginal smears contain profuse PMNLs, some infectious agents, and metaplastic cells, and even clue cells have been observed they are not accepted as Bv(+) cases.

Adult↗
PubMed2004

The use of cytological examination of vaginal smears (CEVS) in the selection of rabbits for superovulation.

In the present study, we examined two factors associated with the reproduction of rabbit does, cytology of vaginal smears and color of vulva, as potential predictors of the success of superovulation treatment. Vulval color and vaginal smear cytology were assessed in 55 young New Zealand does. Superovulation was then induced by a single administration of eCG (20 IU/kg BW i.m.). Does were artificially inseminated 3 days later, followed by intravenous administration of hCG (120 IU per animal). Does were classified with regard to vulval color (white, rose, red, purple), and the predominant cell type in the vaginal smear (i.e. parabasal, intermediate, superficial, or anuclear). Furthermore, we categorized cells into two groups because we usually observed parabasal and intermediate cells (Group A), and superficial and anuclear cell (Group B) in the same smear. Does were humanely killed 19 h after administration of hCG and the total numbers of corpora lutea (CLs), oocytes, and zygotes (i.e. 1-cell embryos) were determined. The zygotes were assessed by morphological appearance and classified as normal or abnormal. The color of the vulva at the time of eCG treatment did not predict the success of superovulation in terms of the number of CLs, oocytes or zygotes. Does with predominantly superficial cells in vaginal smears yielded significantly fewer CLs and oocytes-zygotes (OZ) compared to does with predominantly parabasal, intermediate, or anuclear cells (P<0.05). Does with predominantly superficial cells in vaginal smears tended to yield fewer normal zygotes (nZ), but this reached significance only when compared to does with predominantly parabasal cells (P<0.05). Does in Group A yielded significantly more (P<0.05) CLs, OZ and nZ compared to does in Group B. Does with predominantly parabasal and intermediate cells in vaginal smears and rose color vulva tended to yield more OZ and nZ (P<0.05). These results suggest that the cytology of vaginal smears may help identify does with a significantly higher likelihood of yielding low numbers of CLs, oocytes, or nZ.

Animals↗
PubMed2002

Validation of a simplified grading of Gram stained vaginal smears for use in genitourinary medicine clinics.

OBJECTIVES: To validate a simplified grading scheme for Gram stained smears of vaginal fluid for the diagnosis of bacterial vaginosis (BV) against the accepted "gold" standard of Amsel's composite criteria. METHODS: Women attending genitourinary medicine (GUM) clinics, as part of a multicentre study, were diagnosed as having BV if three or more of the following criteria were present; homogeneous discharge, elevated vaginal pH, production of amines, and presence of "clue" cells. Women with less than three of the criteria were considered as normal. Simultaneously, smears were made of vaginal fluid and Gram stained and then assessed qualitatively as normal (grade I), intermediate (grade II), or consistent with BV (grade III). Two new grades were used, grade 0, epithelial cells only with no bacteria, and grade IV, Gram positive cocci only. RESULTS: BV was diagnosed in 83/162 patient visits using the composite criteria, the remainder being regarded as normal. The majority of patients with BV had a smear assessed as grade III (80/83, 96%) and the majority of normal women had a smear assessed as grade I (normal, 48/79, 61%), giving a high sensitivity (97.5%), specificity (96%), and predictive value for a positive (94.1%) and negative (96%) test, kappa index = 0.91. Smears assessed as grade II were found predominantly (12/13) among patients diagnosed as normal, with less than three of the composite criteria. Grades 0 and IV were both only found among normal women. CONCLUSION: This simplified assessment of Gram stained smears can be used as an alternative to Amsel's criteria and is more applicable for use in busy GUM clinics.

Body Fluids↗
PubMed1979

[Vaginal smear cycle in 4-day cyclic Chinese hamsters, Cricetulus griseus].

The contents of vaginal smear of 4-day cyclic Chinese hamster (Cricetulus griseus) was investigated every 3 hours for 5 days. A light-dark cycle of 14--10 hr was used with the lights turned on at 6 : 00 a.m. Estrous cycle of the Chinese hamster determined by vaginal smears can be divided into 6 periods. The proestrous phase started at about 0 : 00 of day 1, the day of the proestrous phase was designated as day 1 of the estrous cycle. In the afternoon of the same day 1, nucleated epithelial cells gradually increased in number (proestrus : I), and the vaginal contents became to consist solely of nucleated epithelial cells at about 18 : 00 to 21 : 00 (estrus : II). At about 0 : 00 of day 2, however, nucleated epithelial cells were superseded suddenly by cornified epithelial cells, and this phase lasted for 9 to 12 hr (metestrus I : III). Towards the end of the cornified stage, nucleated cells appeared in short duration (metestrus II : IV). And then, in the evening of day 2, leucocytes gradually increased in number with degeneration of nucleated cells (diestrus I : V-1). On day 3, vaginal smear contained a large amount of mucus as well as degenerated nucleated cells and leucocytes (diestrus II : V-2). At about 21 : 000 of day 4, some cornified epithelial cells were seen and then proestrous stage was returned. The females were mated with 3 to 5 males in the evening of day 1, copulation was confirmed in 83.7% females in the next morning,thus the copulation in the Chinese hamster may be thought to occur during the vaginal smear stage of nucleated epithelial cells (estrous phase), i.e. about 18 : 00 to 24 : 00 of day 1.

Animals↗
PubMed1996

[Introduction of cervico-vaginal smears in France].

Cervico-vaginal smears were quite difficult to accept when they were first introduced in France, during the fifties, probably due to a fear that cytology might replace surgical pathology, whereas both methods may develop close together. At last, bridging the gap was accomplished by the pathologists and, nowadays, a number of cytopathologists have been trained and have become quite clever. Obviously, clinicians cannot do without the method described by George N. Papanicolaou (the so-called Pap test). Although cervical carcinoma is the very one cancer that should have been eradicated, as complete recovery is the rule when the diagnosis is made in time, at the preinvasive stage of the tumor, in France it is still responsible for 2000 annual deaths. Systematical target population screening should be organized, as well as in other countries and should become one of the main priorities of health care control.

Female↗
PubMed1986

Age- and hormone-related changes in vaginal smear patterns in the gray-tailed vole, Microtus canicaudus.

Female voles, Microtus canicaudus, exhibited age-related changes in vaginal smear patterns when isolated from males after weaning. Between 30 and 50 days of age, nearly all females exhibited persistently leucocytic vaginal smears. By 90-120 days, most females showed vaginal cyclicity with alternating predominance of leucocytes, nucleated epithelial cells or cornified epithelial cells. Most females examined between 150 and 200 days of age exhibited persistent vaginal cornification. The vaginal cyclicity seen in females between 90 and 120 days was not a reflection of cyclic ovulatory changes; plasma progesterone concentrations remained constant, regardless of age or vaginal smear pattern, and corpora lutea were never seen in unmated females. Although progesterone concentrations did not differ among vaginal smear patterns of 120-day-old females, plasma oestrogen values were highest in females exhibiting vaginal cornification.

Aging↗
PubMedDate not supplied

Glandular cells in vaginal smears from posthysterectomy patients.

OBJECTIVE: To assess the significance of nonatypical glandular cells in vaginal smears from patients who had undergone total hysterectomy. STUDY DESIGN: Vaginal smears with nonatypical glandular epithelium obtained from post-total hysterectomy patients were identified in our files over a 4.5-year period. The cytologic findings were correlated with the clinical data. RESULTS: Smears with nonatypical glandular epithelium from 15 post-total hysterectomy patients were identified, making this the largest series in the literature. The patients' mean age was 59 years. Most patients (73%) had a history of gynecologic malignancy, and 60% had received radiotherapy. All patients had a normal gynecologic examination when the vaginal smear was obtained. None of the patients developed recurrent or de novo vaginal adenocarcinoma. CONCLUSION: The presence of nonatypical glandular epithelial cells in smears from total hysterectomy patients is not indicative of adenocarcinoma.

Adenocarcinoma↗
PubMed1976

[Impulse cytophotometry in neoplasm prevention. The behavior of normal vaginal smears in the impulse cytophotometric histogram].

Evaluation of histograms of normal cervical and vaginal smears, produced by ""rapid flow through'' cytophotometry. Normal cytological cervical and vaginal smears were examined for their appearance in histograms in order to find criteria for the classification of ""normal non-pathological'' cytological slides. Simultaneously, the reliability of the standardized method for preparation of vaginal and cervical smears was checked. The diagrams and data produced by the histograph were also coded on line and analyzed by a computer; thus obtaining an objective mathematical analysis and avoiding errors due to subjective visual analysis of the histograms. The objective interpretation of histograms of normal vaginal smears is an important step to the realisation of automatic pre-screening.

Computers↗
PubMed1997

DNA typing from stained sperm-positive vaginal smears: four rape cases.

DNA typing from stained sperm-positive vaginal smears was performed in four cases of sexual assault. In Cases 1 and 2, a 6-month-old and a 6-week-old, Papanicolaou-stained vaginal smear with 99% propanol fixation underwent DNA analysis respectively. In Case 1, the HLA-DQalpha type of the sperm fraction of the smear was able to be determined following PCR, and the possibility of the suspect being the rapist could not be excluded. In Case 2, the possibility that the suspect was the rapist in the crime was excluded based on the results of DNA typing by means of two different single-locus probes. In the remaining two cases, H-E-stained smears after air drying for 4 or 5 months were the material for DNA analysis, and DNA typing was attempted by PCR-based STR system. In Case 3, there was no genetic information from sperm fraction of the smear due to the small number of spermatozoa on the glass slide. Therefore, it was impossible to determine whether the suspect was the rapist or not. In Case 4, sperm DNA from the smear was amplified and typed, and the suspect could be excluded. These four cases demonstrate that stained vaginal smears containing many spermatozoa can be used for DNA analysis in sexual assault cases.

Journal Article↗
PubMed1990

How frequently need vaginal smears be taken after hysterectomy for cervical intraepithelial neoplasia?

A retrospective longitudinal review identified 341 women who had had a hysterectomy in association with CIN 3, in Tayside Region, during the years 1967-1977; 219 (64%) had completed 10 years of cytology follow-up and of 140 women eligible for 15-year smears 79 (56%) completed the 15-year follow-up. Eight (4%) of the 219 patients developed abnormal cytology, but in six, smears reverted to normal spontaneously. Two patients had persistently abnormal smears and vaginal intraepithelial neoplasia (VAIN) was diagnosed. Only one patient completing 15-year follow-up had an abnormal smear and VAIN later diagnosed. No patient over this 15-year period developed invasive vaginal carcinoma. Sixty vaginal carcinomas were identified during the period 1957-1987 from the gynaecology cancer register; only one was associated with a previous diagnosis of CIN 3 at hysterectomy. With such data we would propose screening 6-monthly during the first post-operative year and then at 2 years. If these smears were normal, the patient could then revert to the normal screening programme.

Adult↗
PubMed1995

Detection of bacterial vaginosis in wet mount, Papanicolaou stained vaginal smears and in gram stained smears.

In a prospective study of 107 women, bacterial vaginosis was clinically diagnosed in 34 women. Compared with clinical diagnosis of bacterial vaginosis, detection of clue cells in Papanicolaou stained vaginal smears showed a sensitivity of 88.2%, a specificity of 98.6%, a positive predictive value of 96.8% and a negative predictive value of 94.7%. The corresponding values for detection of bacterial vaginosis in Gram stained smears compared with the clinical diagnosis were 100%, 97.3%, 94.4% and 100%, respectively. Compared with clue cells in wet smears, identification of clue cells in Papanicolaou stained vaginal smears showed a Kappa index of 0.87 and compared with Gram stain criteria a Kappa index of 0.94. The correlation between Gram stain and Papanicolaou stained vaginal smears showed a Kappa index of 0.89. In contrast to the results of earlier investigators our studies indicate that the demonstration of clue cells in Papanicolaou stained vaginal smears correlate reasonably well with the conventional clinical criteria. However, the Gram stain method may be more reliable than the Papanicolaou method.

Female↗
PubMed1983

[Change in the vaginal smear cycle following conventionalization and monocontamination of germ-free rats with Enterobacter cloacae].

The relationship between the microbial organism infection and the vaginal smear cycle was investigated using 12 germfree Wistar Imamichi rats at 50 days of age. Germfree rats exhibited continuous vaginal cornification which occasionally interrupted by the appearance of nucleated epithelial cells. However, leukocytes which are characteristic of the metestrus and diestrus stage in conventional rats were not observed in the vaginal smear of these animals. At 70 days of age, 8 animals were taken out from the germfree isolator and conventionalized. In other 4 animals, the vaginal lumen was contaminated with Enterobacter cloacae in the isolator. Within 3 days after the treatments, leukocytes appeared in the vaginal smear of all animals in both groups. Thereafter, these animals continued the regular 4 days vaginal cycle to 90 days of age, at which the observation was terminated. The above results suggested that the appearance of leukocytes in the vaginal smear in the rat is closely related to the bacterial colonization in the lumen, together with the action of the progesterone secreted from the ovary.

Age Factors↗
PubMedDate not supplied

Benign glandular cells in posthysterectomy vaginal smears.

OBJECTIVE: To investigate the occurrence and origin of benign glandular cells in posthysterectomy vaginal smears and to propose a categorization for these cells under the Bethesda system. STUDY DESIGN: Among 4,986 posthysterectomy vaginal smears during a 3.5-year period, 82 patients were identified with smears containing benign glandular cells. The review of the smears, related biopsies and charts form the basis of this report. A control group of 236 posthysterectomy smears without glandular cells from the same period was reviewed. RESULTS: Smears were available for review on 76 of 82 patients. All were within normal limits or showed benign cellular changes. All contained clearly benign glandular cells, most frequently present in groups. In all smears, pale pink-red intracellular mucin was identified either diffusely within the cytoplasm or within vacuoles. The glandular cells appeared as hybrid parabasal-endocervical type, squamous metaplastic or columnar cells. Associated cytologic findings included atrophy, inflammation, blood and repair. Reactive atypia was present in 10 (13%) cases. Biopsies were performed on 40 (48%), all showing benign changes. In four of five cases stained, intracellular mucin was seen within glandular cells. Chart review revealed that the patients' hysterectomies were performed for removal of a malignant tumor in 58 (71%) of the study group and in 100 (42%) in the comparison group and that 48 (58%) of the study group had received radiotherapy and/or chemotherapy, while only 26 (11%) of those in the comparison group had similar therapy. CONCLUSION: The presence of benign glandular cells in posthysterectomy vaginal smears is an infrequent but not rare finding. This study indicated an association with benign processes and showed a frequent association with prior radiation or chemotherapy. A more appropriate designation under the Bethesda System is "benign cellular changes" rather than "glandular cell abnormalities." An aggressive workup does not appear to be warranted in this group of patients. We speculate that this phenomenon represents a metaplastic process, possibly secondary to radiation or chemotherapy.

Adenocarcinoma↗
PubMed2004

Benign glandular cells in posthysterectomy vaginal smears: the incidence is higher than expected.

In this study, we have investigated the frequency and clinical significance of glandular cells in posthysterectomy vaginal smears. The slides of vaginal cuff smears of 290 patients were reviewed. The glandular cells were categorized into three groups: (1) squamous metaplastic-like cells; (2) columnar endocervical-like cells; and (3) small round cuboidal cells. Glandular cells were found in 39 (13%) of the 290 vaginal smears. Group 1 type cells were seen in 76% (n = 30), group 2 type cells in 38% (n = 15) and group 3 type cells in 47% (n = 19) of the smears. In 19 (48%) of the smears combination of two or three groups were seen. The presence of glandular cells showed a strong association with inflammation/repair as a background finding in the smears. No correlation could be found between the presence of atrophy and history of chemotherapy or radiotherapy. Apart from these there was a prominent increase in reporting benign glandular cells after the application of the current Bethesda 2001 reporting criteria in our laboratory. As a result our study showed that the finding of glandular cells in posthysterectomy vaginal smears is more frequent than expected and most of them could be related to inflammatory and regenerative processes in the absence of a clearly identified underlying cause.

Epithelial Cells↗