glycogen and Uterine-Cervical-Dysplasia

The authors noted a significant increase in the diagnosis of atypical squamous cells of undetermined significance (ASCUS) in premenopausal women using oral contraceptive pills (OCP) (9%) versus women not on OCP (4%) using ThinPrep Pap smears (P = 0.02). The purpose of this study was to correlate these morphologic changes with human papillomavirus (HPV) DNA detection by in situ hybridization and clinical follow-up.. Eighty-four ThinPrep Pap smears diagnosed as ASCUS or ASCUS favor low-grade squamous intraepithelial lesions (LGSIL) in young women receiving OCP were studied by HPV in situ hybridization. This information was correlated with colposcopic follow-up and AutoCyte Pap smear results. The authors also studied 80 ThinPreps from young women with a Pap smear diagnosis of unequivocal LGSIL where there was a corresponding biopsy (positive controls) and 40 ThinPreps diagnosed as within normal limits and that rescreened as such (negative controls).. The detection rate of HPV DNA by in situ hybridization was 33% (28 of 84) in ASCUS cases versus 90% (72 of 80) for cases of unequivocal LGSIL. A blinded review of the 29 ASCUS Pap smears performed by AutoCyte showed that 66% (19 of 29) were diagnosed as within normal limits. The majority of the cervical biopsies in the women with ASCUS by ThinPrep Pap smears were negative for dysplasia (29 of 39 [74%]) whereas 71 of 80 biopsies (88%) showed dysplasia in women with Pap smears diagnosed as unequivocal LGSIL. The periodic acid-Schiff (PAS) stain demonstrated that many of the cells with halos in the ThinPrep Pap smears that mimicked LGSIL contained glycogen.. The ThinPrep induces changes that mimic LGSIL in young women on OCP. These artifacts may reflect pressure-induced alteration of glycogen. PAS analysis and, more directly, HPV testing by in situ hybridization can help differentiate this mimicking from actual LGSILs.

Topics: Adolescent; Adult; Artifacts; Contraceptives, Oral; DNA, Viral; False Positive Reactions; Female; Glycogen; Humans; In Situ Hybridization; Papanicolaou Test; Papillomaviridae; Papillomavirus Infections; Precancerous Conditions; Premenopause; Retrospective Studies; Tumor Virus Infections; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms; Vaginal Smears

The purpose of the present study was to assess the findings in cervical smears associated with intramuscular depot medroxyprogesterone acetate (Depo-Provera) contraception. Seventy-four cervical smears of reproductive-age patients on Depo-Provera were reviewed for cytologic abnormalities, predominant cell type, and intermediate cell glycogenation (extensive (EGly) = navicular cells / glycogenation in 10 or more high-powered fields (hpf); moderate (MGly) = 5-10 hpf; and focal (FGly) = less than 5 hpf). A control group of 38 nonpregnant patients without hormonal therapy was reviewed. Study group patients' (SGP) age ranged from 16-44 years (average 28.1); control group patients (CGP) from 17-42 years (average 29.4). Time since last menstrual period (LMP) for the SGP was 16.9 months (range 1-96); LMP for CGP was 18.2 days (range 5-33). Four (5.4%) SGP had squamous intraepithelial lesions (SIL), four (5.4%) atypical squamous cells of undetermined significance (ASCUS), and one (1.4%) atypical repair. No CGP had SIL or ASCUS. Seventy-three (98.6%) SGP had intermediate cell (IC) predominance; one had parabasal cell predominance. Of the CGP, 28 (73.7%) had IC predominance, nine (23.7%) superficial cell (SC) predominance and one (2.6%) had near equal IC and SC. EGly was seen in 22 (29.7%) SGP; two (5.3%) in CGP (chi-square 7.53; 0.95 = 3.84). MGly was seen in 29 (39.2%) SGP; 10 (26.3%) in CG. FGly was seen in 17 (22.9%) SGP; 14 (36.8%) in CGP. No glycogenation was seen in six (8.1%) SGP; 12 (31.6%) in CGP. Time since LMP was inversely proportional to glycogenation in SGP: EGly-LMP 11.6 months; MGly-LMP 14.9 months; FGly-LMP 15.0 months; and no glycogenation-LMP 22.5 months. Glycogenation of IC appears inversely proportional to Depo-Provera effect. EGly due to recent Depo-Provera administration mimics changes associated with pregnancy.

Topics: Adolescent; Adult; Cervix Uteri; Contraceptive Agents, Female; Female; Glycogen; Humans; Injections, Intramuscular; Medroxyprogesterone Acetate; Precancerous Conditions; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms; Vaginal Smears

To determine whether diagnostic information may be recovered from the infrared spectra of exfoliated cell specimens by using a novel spectral feature extraction method, in conjunction with linear and quadratic discriminant analysis, for spectral classification.. Over 800 infrared spectra were included in the study, with corresponding clinical diagnoses based upon cytology and, when available, histology reports. Three sets of classification trials were carried out with the aim of distinguishing the spectra corresponding to normal specimens from CIN 1, 2 and 3. For each of these three cases, the procedure was to: (1) develop a set of provisional classification models using only a "training" subset of the spectra, and (2) test each provisional model by its ability to correctly predict the diagnoses on the basis of the remaining spectra.. For optimal classification trials, training set classification accuracies were 68% for normal/CIN 1, 73% for normal/CIN 2 and 81% for normal/CIN 3; for the corresponding test sets the classification accuracies were 60%, 60% and 67%, respectively.. The infrared spectra of exfoliated cervical cells carry information regarding the presence or absence of dysplasia, and that information is recoverable--albeit imperfectly at this stage--from the spectra of "real life" cell preparations.

Topics: Algorithms; Cervix Uteri; Collagen; Databases, Factual; Discriminant Analysis; DNA, Neoplasm; Epithelial Cells; Female; Glycogen; Humans; Image Processing, Computer-Assisted; Lipids; Mass Screening; Neural Networks, Computer; Reproducibility of Results; Spectroscopy, Fourier Transform Infrared; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms; Vaginal Smears

1. One of the main obstacles to the reliable detection of human papillomavirus in cervical intraepithelial neoplasia is that a minute quantity of infected tissue is often all that is available. 2. In this work, proteinase K-phenol-chloroform-treated sections of frozen cervical biopsies were split in two. Half of the material was precipitated by ethanol in the presence of glycogen, and in the remaining half glycogen was absent. 3. On average a 15-fold increase in total DNA yield was obtained with glycogen. As a result, in 63 cases analysed by PCR for human papillomavirus type 16, we were able to detect nearly 20% more positive samples when glycogen was used. 4. The implications of the improved accuracy of diagnosis are that women requiring a closer follow-up can be identified, and conversely rescreening intervals can be extended for those testing negative for oncogenic human papillomavirus types with more confidence than in the past.

Topics: Adult; DNA, Viral; Female; Frozen Sections; Glycogen; Humans; Middle Aged; Papillomaviridae; Polymerase Chain Reaction; Sensitivity and Specificity; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms

Infrared spectra were obtained from exfoliated cervical cells from 156 females, of whom 136 were normal, 12 had cervical cancer, and 8 had dysplasia. The spectra of the normal women, essentially identical, differed from those obtained from patients with either cancer or dysplasia. In malignant samples we noted (i) significant changes in the intensity of the glycogen bands at 1025 cm-1 and 1047 cm-1, the bands at 1082 cm-1 and 1244 cm-1, the C--O stretching band at 1155 cm-1, and the band at 1303 cm-1, (ii) significant shifts of the peaks normally appearing at 1082 cm-1, 1155 cm-1, and 1244 cm-1, and (iii) an additional band at 970 cm-1. Further study of several of these bands, including the pressure dependence of their frequencies, revealed that in the malignant cervical tissue there were extensive changes in the degree of hydrogen bonding of phosphodiester groups of nucleic acids and C--OH groups of proteins, as well as changes in the degree of disorder of methylene chains of lipids. The IR spectra of samples with dysplasia demonstrated the same changes with cancer samples, except that the changes were of lesser magnitude and the phosphodiester peak normally appearing at 1082 cm-1 did not shift. These spectroscopic changes appear to progress in tandem with the morphological changes that lead normal cervical epithelium to cancer through the premalignant stage of dysplasia. The diagnostic potential of IR spectroscopy is discussed.

Topics: Cervix Uteri; Female; Glycogen; Humans; Hydrogen Bonding; Phosphates; Reference Values; Spectrophotometry, Infrared; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms

Topics: Adult; Cervix Uteri; Female; Glycogen; Histocytochemistry; Humans; Hyperplasia; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms