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1. What does the Data of 354,725 Patients from Turkey Tell Us About Cervical Smear Epithelial Cell Abnormalities? - the Epithelial Cell Abnormality Rate is Increasing - Quality Control Studies and Corrective Activity are Musts

Author

Eken Kg, Binnur Onal, Hatice Özer, Sema Arici, Kamali Gh, Selma Sengiz Erhan, Meral Koyuncuoglu, Akbulut M, Kahraman Ds, Hulya Dogan, Çelik B, Kimiloğlu E, Alp Usubutun, Kivilcim Eren Erdogan, Şahin N, Safak Ersoz, Demir H, Emine Kilic Bagir, Erdoğan G, Mehmet Kefeli, Yılmaz Baş, Abdullah Aydin, Asli Cakir, Astarci M, Tulin Yalta, Serdar Altınay, Iclal Gurses, Çetiner H, Nuray Başsüllü, Funda Eren, Bolat Fa, Yasemin Yuyucu Karabulut, Sevinç Şahin, Bengü Çobanoğlu, Aslan F, Bahar Muezzinoglu, Nihan Haberal, Sevgen Onder, Resit Dogan Koseoglu, Omer Murat Aydin, Özcan Z, Pinar Firat, İlknur Türkmen, Sönmez Fc, OMÜ, BAİBÜ, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Astarcı, Müzeyyen, Çukurova Üniversitesi, Acibadem University Dspace, Hitit Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, ARICI, DILEK SEMA, ŞAHİN, NURHAN, and Çetinaslan Türkmen, İ., Department of Pathology, Istanbul Medipol University Faculty of Medicine, İstanbul, Turkey -- Usubütün, A., Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey -- Çakir, A., Department of Pathology, Istanbul Medipol University Faculty of Medicine, İstanbul, Turkey -- Aydin, Ö., Department of Pathology, Acibadem University Faculty of Medicine, İstanbul, Turkey -- Aka Bolat, F., Department of Pathology, Başkent University ERH, Adana, Turkey -- Akbulut, M., Department of Pathology, Pamukkale University Faculty of Medicine, Denİzlİ, Turkey -- Altinay, S., Department of Pathology, Bagcilar ERH, Istanbul, Turkey -- Arici, S., Department of Pathology, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey -- Aslan, F., Department of Pathology, Dumlupinar University Evliya Celebi ERH, KÜtahya, Turkey -- Astarci, M., Department of Pathology, Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkey -- Kılıç Bağir, E., Department of Pathology, Cukurova University Faculty of Medicine, Adana, Turkey -- Baş, Y., Department of Pathology, Hitit University Çorum ERH, Çorum, Turkey -- Başsüllü, N., Department of Pathology, Bilim University Faculty of Medicine, Istanbul, Turkey -- Çelik, B., Department of Pathology, Antalya ERH, Antalya, Turkey -- Çetiner, H., Department of Pathology, Zeynep Kamil ERH, İstanbul, Turkey -- Çobanoğlu, B., Department of Pathology, Medeniyet University Goztepe ERH, İstanbul, Turkey -- Aydin, A., Department of Pathology, Medeniyet University Goztepe ERH, İstanbul, Turkey -- Demir, H., Department of Pathology, Istanbul University Cerrahpaşa Medical Faculty, İstanbul, Turkey -- Tatlı Doğan, H., Department of Pathology, Yildirim Beyazit University Ankara Ataturk ERH, Ankara, Turkey -- Gülçin Eken, K., Department of Pathology, Sisli Hamidiye Etfal ERH, İstanbul, Turkey -- Şengiz Erhan, S., Department of Pathology, Okmeydani ERH, İstanbul, Turkey -- Erdoğan, G., Department of Pathology, Akdeniz University Faculty of Medicine, Antalya, Turkey -- Eren Erdoğan, K., Department of Pathology, Mersin State Hospital, Mersİn, Turkey -- Eren, F., Department of Pathology, Marmara University Faculty of Medicine, İstanbul, Turkey -- Ersöz, Ş., Department of Pathology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey -- Firat, P., Department of Pathology, Istanbul University Faculty of Medicine, İstanbul, Turkey -- Gürses, İ., Department of Pathology, Mersin University Faculty of Medicine, Mersİn, Turkey -- Haberal, N., Department of Pathology, Baskent University Faculty of Medicine, Ankara, Turkey -- Solakoğlu Kahraman, D., Department of Pathology, Tepecik ERH, İZMİR, Turkey -- Kamali, G.H., Department of Pathology, Okmeydani ERH, İstanbul, Turkey -- Karabulut, Y.Y., Department of Pathology, Cankiri State Hospital, Çankiri, Turkey -- Kefeli, M., Department of Pathology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey -- Koyuncuoğlu, M., Department of Pathology, Dokuz Eylul University Faculty of Medicine, İzmİr, Turkey -- Köseoğlu, R.D., Department of Pathology, Gaziosmanpasa University Faculty of Medicine, Tokat, Turkey -- Müezzinoğlu, B., Department of Pathology, Kocaeli University Faculty of Medicine, Kocaelİ, Turkey -- Onal, B., Department of Pathology, Diskapi ERH, Ankara, Turkey -- Önder, S., Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey -- Özcan, Z., Department of Pathology, Taksim ERH, İstanb, UL, Turkey -- Kimiloğlu, E., Department of Pathology, Taksim ERH, İstanb, UL, Turkey -- Özer, H., Department of Pathology, Cumhuriyet University Faculty of Medicine, Sİvas, Turkey -- Sönmez, F.C., Department of Pathology, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey -- Şahin, S., Department of Pathology, Bozok University Faculty of Medicine, Yozgat, Turkey -- Şahin, N., Department of Pathology, Inonu University Faculty of Medicine, Malatya, Turkey -- Yalta, T., Department of Pathology, Trakya University Faculty of Medicine, Edİrne, Turkey

Subjects
0301 basic medicine, Turkey, hematologic disease, Uterine Cervical Neoplasms, cytotechnologist, Medical Oncology, Turkey (republic), uterine cervix tumor, Control parameters, Early Detection of Cancer, early cancer diagnosis, media_common, medicine.diagnostic_test, uterine cervix dysplasia, Obstetrics, Papanicolaou test, Squamous intraepithelial lesion, female, uterine cervix cytology, oncology, standards, lcsh:RB1-214, Quality Control, medicine.medical_specialty, uterine cervix biopsy, media_common.quotation_subject, 030106 microbiology, uterine cervix carcinoma, Atypical Squamous Cells, Epithelial cell abnormality, Article, Pathology and Forensic Medicine, 03 medical and health sciences, lcsh:Pathology, medicine, Humans, Quality (business), human, Pap test, Vaginal Smears, business.industry, questionnaire, squamous intraepithelial lesion of the cervix, Cervical cytology, medicine.disease, Cervical Smear, Surgery, Cervical smear, business, Quality assurance, vagina smear
Abstract

Erdogan, Kivilcim Eren/0000-0002-4951-8703; kilic bagir, Emine/0000-0002-1447-1060; Celik, Betul/0000-0001-9731-9939; Tatli Dogan, Hayriye/0000-0003-4318-2775; Cakir, Asli/0000-0003-0128-6947 WOS: 000414649400006 PubMed: 28272675 Objective: There is no other screening program close to the success rate of PAP test. Cervical cytology constitutes a large workload so that quality control in cervical cytology is important for the quality assurance of pathology laboratories. Material and Method: In this study, we collected the cervical cytology results from all over Turkey and discussed the parameters influencing the quality of the PAP test. The study was conducted with Turkish gynaecopathology working group and 38 centers (totally 45 hospitals) agreed to contribute from 24 different cities. The study was designed to cover the cervical cytology results during 2013. The results were evaluated from the data based on an online questionnaire. Results: The total number of Epithelial Cell Abnormality was 18,020 and the global Epithelial Cell Abnormality rate was 5.08% in the total 354,725 smears and ranging between 0.3% to 16.64% among centers. The Atypical squamous cells/Squamous intraepithelial lesion ratios changed within the range of 0.21-13.94 with an average of 2.61. When the centers were asked whether they performed quality assurance studies, only 14 out of 28 centers, which shared the information, had such a control study and some quality parameters were better in these centers. Conclusion: There is an increase in the global Epithelial Cell Abnormality rate and there are great differences among centers. Quality control studies including the Atypical squamous cells/Squamous intraepithelial lesion ratio are important. Corrective and preventive action according to quality control parameters is a must. A cervical cytology subspecialist in every center can be utopic but a dedicated pathologist in the center is certainly needed.

Published
2017

2. A Case of Lafora Disease Diagnosed by Axillary Skin Biopsy.

Author

Kimiloğlu E, Akbaş P, Öre ÖE, and Turan Ç

Subjects
Adult, Biopsy, Epilepsies, Myoclonic pathology, Female, Humans, Lafora Disease genetics, Microscopy, Electron, Epilepsies, Myoclonic diagnosis, Lafora Disease diagnosis, Skin pathology
Abstract

Lafora disease is a severe form of progressive myoclonic epilepsy with autosomal recessive inheritance diagnosed by inclusion body in biopsy. A 26-year-old woman was admitted due to complaints of frequent twitches and fainting. The 0.5x0.3x0.3 cm axillary skin punch biopsy was subjected to routine histopathological evaluation. Cytoplasmic PAS-positive inclusion bodies were observed at the basal side of the eccrine and apocrine glands. The diagnosis of Lafora disease can also be made by the observation of the polyglycosan cytoplasmic inclusion bodies in the brain, liver and skeletal muscle biopsies. Although we need more work to understand the etiopathogenesis of Lafora disease, we would like to draw attention to the importance of skin biopsy in the differential diagnosis of young patients with clinically refractory epilepsy, myoclonus, and cognitive decline.

Published
2021
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3. Comparison of the Diagnostic Utility of Manual Screening and the ThinPrep Imaging System in Liquid-Based Cervical Cytology.

Author

Özcan Z, Kimiloğlu E, Iğdem AA, and Erdoğan N

Subjects
Automation, Laboratory methods, Female, Humans, Cytodiagnosis methods, Uterine Cervical Neoplasms diagnosis, Vaginal Smears
Abstract

Objective: To compare the diagnostic results of the ThinPrep manual method (TPMM) and ThinPrep automated method (TPAM) in liquid-based cytology and present the advantages and disadvantages of both methods., Material and Method: A total of 1.500 randomized ThinPrep Pap tests that were screened manually and archived in 2015 were reviewed by a blinded researcher manually and by the ThinPrep automatic method., Results: There was a 83.3% increase in the detection of ASCUS (Atypical squamous cells of undetermined significance) with the TPAM compared to the TPMM, and with respect to the reference results, the accuracy was higher for the TPAM than for the TPMM. We also noted a 33.3% increase in the rate of LSIL (Low grade squamous intraepithelial lesion) and 20% increase in the rate of HSIL (High grade squamous intraepithelial lesion) by the TPAM. Concordance was best between the TPAM and reference cytologic diagnoses. The sensitivity was higher for the TPAM and the specificity was similar for both methods. The false positive rate was higher for the TPAM than the TPMM but the false negative rate was higher for the TPMM. We determined a 30% gain in screening time per smear by the TPAM. However, rejection of many samples by the system, especially because of air bubbles, was a limitation of the TPAM., Conclusion: The TPAM has advantages over the TPMM as well as disadvantages such as limiting features and a high false positive rate. The TPAM should be supported by the manual method to decrease the false positive rate.

Published
2020
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4. What does the Data of 354,725 Patients from Turkey Tell Us About Cervical Smear Epithelial Cell Abnormalities? - The Epithelial Cell Abnormality Rate is Increasing - Quality Control Studies and Corrective Activity are Musts.

Author

Türkmen İÇ, Usubütün A, Çakir A, Aydin Ö, Bolat FA, Akbulut M, Altinay S, Arici S, Aslan F, Astarci M, Bağir EK, Baş Y, Başsüllü N, Çelik B, Çetiner H, Çobanoğlu B, Aydin A, Demir H, Doğan HT, Eken KG, Erhan SŞ, Erdoğan G, Erdoğan KE, Eren F, Ersöz Ş, Firat P, Gürses İ, Haberal N, Kahraman DS, Kamali GH, Karabulut YY, Kefeli M, Koyuncuoğlu M, Köseoğlu RD, Müezzinoğlu B, Onal B, Önder S, Özcan Z, Kimiloğlu E, Özer H, Sönmez FC, Şahin S, Şahin N, and Yalta T

Subjects
Female, Humans, Turkey epidemiology, Uterine Cervical Neoplasms diagnosis, Early Detection of Cancer standards, Medical Oncology standards, Quality Control, Uterine Cervical Neoplasms epidemiology, Vaginal Smears standards
Abstract

Objective: There is no other screening program close to the success rate of PAP test. Cervical cytology constitutes a large workload so that quality control in cervical cytology is important for the quality assurance of pathology laboratories., Material and Method: In this study, we collected the cervical cytology results from all over Turkey and discussed the parameters influencing the quality of the PAP test. The study was conducted with Turkish gynaecopathology working group and 38 centers (totally 45 hospitals) agreed to contribute from 24 different cities. The study was designed to cover the cervical cytology results during 2013. The results were evaluated from the data based on an online questionnaire., Results: The total number of Epithelial Cell Abnormality was 18,020 and the global Epithelial Cell Abnormality rate was 5.08% in the total 354,725 smears and ranging between 0.3% to 16.64% among centers. The Atypical squamous cells /Squamous intraepithelial lesion ratios changed within the range of 0.21-13.94 with an average of 2.61. When the centers were asked whether they performed quality assurance studies, only 14 out of 28 centers, which shared the information, had such a control study and some quality parameters were better in these centers., Conclusion: There is an increase in the global Epithelial Cell Abnormality rate and there are great differences among centers. Quality control studies including the Atypical squamous cells/Squamous intraepithelial lesion ratio are important. Corrective and preventive action according to quality control parameters is a must. A cervical cytology subspecialist in every center can be utopic but a dedicated pathologist in the center is certainly needed.

Published
2017
Full Text
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