Abstract:
OBJECTIVE:We evaluated the performance of the Papanicolaou smear in screening and diagnostic settings. STUDY DESIGN:We analyzed Papanicolaou smear results of 1,850 women recruited into a clinical trial to evaluate an emerging technology for the detection of cervical cancer. Screening and diagnosis groups were based on the history of previous Papanicolaou smear results. We calculated sensitivities, specificities, positive and negative likelihood ratios (LR+ and LR-), receiver operating characteristic curves, and areas under the receiver operating characteristic curve (AUC). RESULTS:In the screening group, by defining disease as cervical intraepithelial neoplasia (CIN) 2,3/cancer or worse and using high-grade squamous intraepithelial lesion (HSIL) as the test cutpoint, the AUC was 0.689, and the LR+ and LR- were 39.25 and 0.67, respectively. In the diagnosis group, the AUC was 0.764, and the LR+ and LR- were 3.79 and 0.56, respectively. By defining disease as human papillomavirus/CIN 1 or worse and HSIL as the test cutpoint, the AUC was 0.586, and the LR+ and LR- were 17.01 and 0.92 in the screening group; in the diagnosis group, the AUC was 0.686, and the LR+ and LR- were 2.77 and 0.75, respectively. CONCLUSIONS:In a screening setting, a Papanicolaou smear result of HSIL or worse is 39 times more likely in a patient with CIN 2,3/cancer than in a patient without it. This compares to 4 times more likely in the diagnostic setting. The magnitude of the positive likelihood ratio observed in the screening group indicated that abnormal Papanicolaou smear results obtained in the screening setting should have more impact on clinical decision making than those from results obtained in the diagnostic setting.
journal_name
J Low Genit Tract Disjournal_title
Journal of lower genital tract diseaseauthors
Cárdenas-Turanzas M,Follen M,Nogueras-Gonzalez GM,Benedet JL,Beck JR,Cantor SBdoi
10.1097/LGT.0b013e31816b44bcsubject
Has Abstractpub_date
2008-10-01 00:00:00pages
269-75issue
4eissn
1089-2591issn
1526-0976pii
00128360-200810000-00003journal_volume
12pub_type
临床试验,杂志文章,多中心研究abstract::We describe a rare case of clitoromegaly due to a large clitoral cyst that occurred spontaneously without any declared previous female genital mutilation. The cyst was excised successfully with good cosmetic results. ...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e318259a410
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Massive localized lymphedema (MLL) is a recently described entity associated with obesity, most often on the thighs. It rarely occurs on the vulva, and it may pose diagnostic difficulty for both clinician and pathologist in this setting. CASE:An obese 55-year-old woman underwent excision of bilateral polypo...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章,评审
doi:10.1097/LGT.0b013e31829cf432
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:Chronic vulvar pruritus and vulvodynia are common vulvar diseases. The aim of this study was to compare gynecologic and sexual and physical abuse histories from patients with these diagnoses and from healthy controls. MATERIALS AND METHODS:Questionnaires were self-completed by patients diagnosed with vulvar ...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000075
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVE:To determine the utility of random biopsy and endocervical curettage (ECC) during colposcopy among women who ultimately underwent cervical excisional biopsy. MATERIALS AND METHODS:In a retrospective observational study, the charts were reviewed of every patient who underwent cervical excisional procedure per...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e3182a5296e
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:This study aimed to report 2 cases of squamous cell carcinoma (SCC) of the vulva, arising from unusual subepithelial locations. MATERIALS AND METHODS:The first case was of an 85-year-old woman with a 65-year history of a mass in the left labium majus. The second case was of a 54-year-old woman who presented ...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e31827a8c95
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVES:Fabric-based endocervical and exocervical biopsy tools were compared with exocervical punch biopsy and sharp endocervical curettage. We compared the level of pain reported by the patient and the amount of bleeding rated by the physician relative to the type of biopsy used. MATERIALS AND METHODS:This was a 2...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章,随机对照试验
doi:10.1097/LGT.0b013e318234262d
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:This study aimed to assess the risk of progression/persistence of squamous intraepithelial lesions (SILs) during pregnancy according to the age of the woman, the grade of the lesion, the type of human papillomavirus (HPV) infection, and the mode of delivery. MATERIALS AND METHODS:Eighty pregnant women with a...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e31822e83cf
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:This study aimed to compare cervical cytologic and histologic findings between women using depot-medroxyprogesterone acetate (DMPA) and oral contraceptives (OCs) referred for colposcopy and to determine whether there were differences in the occurrence of false-positive cytologic finding between the 2 contrace...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e31820eb140
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:The Home Study Course is intended for the practicing colposcopist or practitioner who is seeking to develop or enhance his or her colposcopic skills. The goal of the course is to present colposcopic cases that are unusual or instructive in terms of appearance, presentation, or management, or that demonstrate ...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/01.lgt.0000171660.77437.f2
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:Metronidazole vaginal gel (MVG) 0.75% is a US Food and Drug Administration-approved, 5-day treatment for bacterial vaginosis (BV). This study tested the hypothesis that a shorter treatment course at a higher dose (MVG 1.3%) would yield similar efficacy to 5 days of MVG 0.75%. MATERIALS AND METHODS:This phase...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/LGT.0000000000000062
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:The molecular events surrounding the pathogenesis of human cervical cancer remain to be defined to a significant extent. The current study investigates the expression of two putative tumor suppressor genes p16 and Rb in cervical neoplasm. MATERIALS AND METHODS:Tissue was collected from 16 cervical intraepit...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/00128360-199710000-00008
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVE:This study aimed to determine whether electronic medical record (EMR)-based tools influence providers' compliance with guidelines for cervical cancer screening in adolescent (<21 y) patients. MATERIALS AND METHODS:Three EMR-based tools to educate providers on cervical cancer screening guidelines were impleme...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e3182607137
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:To study the clinicopathologic features of a rare disease of pagetoid urothelial intraepithelial neoplasia (PUIN) in the vulva. MATERIALS AND METHODS:We reviewed a case of PUIN in a Chinese woman with a long history of bladder urothelial carcinoma. RESULTS:The patient presented with vulvar pruritus for more...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000020
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Basal cell carcinoma (BCC) is a rare tumor of the vulva; it accounts for approximately 2% to 4% of vulvar cancer. CASE:A 73-year-old woman was referred because of a 2-cm ulcerative lesion on her perineum, near the anus. Punch biopsy showed BCC. She underwent wide local excision of tumor without any damage t...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/01.lgt.0000225898.37090.04
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVE:To determine if human papillomavirus (HPV) DNA in pelvic lymph nodes or plasma of women with early-stage cervical cancer is a marker for recurrence. MATERIALS AND METHODS:Twenty-eight women undergoing radical hysterectomy for cervical cancer stage IB had HPV DNA testing in cervical tissue, plasma, and the la...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e31818c66e6
更新日期:2009-04-01 00:00:00
abstract::This review highlights recent advances in our understanding of preneoplastic squamous lesions of the vulva, from a pathologist's perspective. Vulvar intraepithelial neoplasia (VIN) is the preferred nomenclature for these lesions. VIN lesions may or may not be symptomatic and have a variable clinical appearance. Three ...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/00128360-199801000-00007
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:This study aimed to conduct a representative survey of human papillomavirus (HPV) prevalence and its genotype distribution in invasive anal cancer specimens in the United States. MATERIALS AND METHODS:Population-based archival anal cancer specimens were identified from Florida, Kentucky, Louisiana, and Michi...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e31827ed372
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVES:To report the outcome of patients diagnosed with cervical intraepithelial neoplasia 2, 3 (CIN 2, 3) during pregnancy, who were treated by large loop excision of the transformation zone (LLETZ) in the first trimester or were followed up conservatively and treated after delivery. METHODS:Patients diagnosed wi...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e318299c0af
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:: This study aimed to explore the role of hormone replacement therapy (HRT) in susceptibility to vulvovaginal candidiasis (VVC) in a private vulval disease referral practice. METHODS:: Between January 2009 and December 2010, 149 healthy, nondiabetic patients with vulvar conditions were compared for significa...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e3182241f1a
更新日期:2011-10-01 00:00:00
abstract::Mesenchymal lesions of the vulva may be either regionally specific to the vulva or soft tissue neoplasms that can occur in multiple locations on the body. They may have overlapping histological and immunohistochemical features and, in routine practice, are not likely to be encountered, adding to the diagnostic difficu...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章,评审
doi:10.1097/LGT.0b013e3181f6f2d0
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to evaluate the validity of anal cytology against high-resolution anoscopy in the detection of anal high-grade squamous intraepithelial lesions (HSILs) among women in a clinical setting in Puerto Rico, alone and in combination with high-risk human papillomavirus (HR-HPV) typing. MATE...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000497
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:Our aim was to determine the clinical significance of the two subgroups of atypical squamous cells of undetermined significance (ASCUS), designated "favor reactive" and "favor preneoplastic." MATERIALS AND METHODS:Cervical Papanicolaou smears with a diagnosis of ASCUS favor reactive or ASCUS favor preneoplas...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/00128360-199707000-00006
更新日期:1997-07-01 00:00:00
abstract::Giant condyloma acuminatum is a large, slow-growing, exophytic, cauliflower-like tumor of the external genitalia. It is a histologically benign lesion, largely associated with human papillomavirus infection but with a high recurrence rate. The main differential diagnosis includes verrucous carcinoma. Differentiation b...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e3181c945ed
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to assess whether lower proportions of cervical intraepithelial neoplasia 2+ diagnosed by random biopsy are from lower cut points defining an abnormal colposcopic impression or obtaining only one random biopsy when colposcopic impression is normal. METHODS:We compared colposcopy expe...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000485
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:To compare the treatment and follow-up of patients with lichen sclerosus (LS) at the departments of Gynaecology and Dermatology at the Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands, to evaluate the need for a multidisciplinary vulvar clinic. MATERIALS AND METHODS:Treatment and follow-...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e3181c4bfe6
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:The study aims to assess the frequency of cytological abnormalities in adolescents and young women, to establish the optimum age to start screening. METHODS:A retrospective study of cervical cytology results were obtained from the data center at the Santa Casa Hospital of São Paulo between January 2006 and D...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000273
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:To measure the recurrence rate of disease in women treated for cervical adenocarcinoma in situ (ACIS) by either hysterectomy or conservative surgical management. PATIENTS AND METHODS:One hundred patients with a histopathologic diagnosis of ACIS or glandular dysplasia were identified in a retrospective clinic...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/00128360-200404000-00008
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVES:Vulvar vestibule is a common term in the medical nomenclature. In our view, this term is inaccurate. MATERIALS AND METHODS:Herein, we provide evidence from embryologic, anatomic, and architectonic textbooks that shows the links between the vestibule and vagina. RESULTS:Our research proves that the term vul...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/00128360-200401000-00014
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:This study explores the prevalence and provider- and practice-related correlates of physician recommendation and administration of the quadrivalent human papillomavirus (HPV) vaccine, Gardasil, to 11- to 12-year-old girls and the intention to recommend the HPV vaccine to 11- to 12-year-old boys in Georgia. Th...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000011
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVES:The objectives of this study were to quantify personal stories about cervical cancer and to determine the proportion and sentiment (positive vs negative) of messages ("tweets") that discussed cervical cancer prevention strategies on Twitter. METHODS:This study was a cross-sectional Twitter review of English...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000363
更新日期:2018-01-01 00:00:00