• Asian Pacific Journal of Cancer Prevention
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• 제16권16호
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• pp.7381-7384
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• 2015

This study was conducted to 1206 women who had cervical cancer screening at Chonburi Cancer Hospital. The spilt-sample study aimed to compare the efficacy of abnormal cervical cells detection between liquid-based cytology (LBC) and conventional cytology (CC). The collection of cervical cells was performed by broom and directly smeared on a glass slide for CC then the rest of specimen was prepared for LBC. All slides were evaluated and classified by The Bethesda System. The results of the two cytological tests were compared to the gold standard. The LBC smear significantly decreased inflammatory cell and thick smear on slides. These two techniques were not difference in detection rate of abnormal cytology and had high cytological diagnostic agreement of 95.7%. The histologic diagnosis of cervical tissue was used as the gold standard in 103 cases. Sensitivity, specificity, positive predictive value, negative predictive value, false positive, false negative and accuracy of LBC at ASC-US cut off were 81.4, 75.0, 70.0, 84.9, 25.0, 18.6 and 77.7%, respectively. CC had higher false positive and false negative than LBC. LBC had shown higher sensitivity, specificity, PPV, NPV and accuracy than CC but no statistical significance. In conclusion, LBC method can improve specimen quality, more sensitive, specific and accurate at ASC-US cut off and as effective as CC in detecting cervical epithelial cell abnormalities.

• 대한의용생체공학회:의공학회지
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• 제36권1호
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• pp.1-6
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• 2015

This study aims to design a monolayer cell adsorption apparatus that would help to produce high-quality slides for Liquid-Based Cytology (LBC) of an early cancer diagnosis for human bodies. The LBC collects exfoliated cells of human bodies and spreads the cells on the slides. Through processes of dyeing and cytological examination, the LBC screens for cancers in early stage. In this study, both of a cell suction module and a cell adsorption module, which are the key elements of the monolayer cell adsorption apparatus, were developed, and using those modules, the study set, first, conditions to help both GYN and NON-GYN apply principal cells without de-endothelialization before conducting its own analysis on the utility. As a results, for GYN, apparatus was determined to be able to produce high-quality slides under the condition of 4 and for NON-GYN, the apparatus would come up with other slides of high-quality under the condition of 2. The study carried out a repetitive test on selected conditions and proved 96% of the repetitive success rate. By the results of what has been learned so far, the study presents that the apparatus has a possibility to replace device from South Korea as one of those other currently-applied systems to run the LBC and that the system will also present a new paradigm for cancer diagnosis as it makes a contribution to the improvement in the LBC.

• Asian Pacific Journal of Cancer Prevention
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• 제13권9호
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• pp.4487-4490
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• 2012

This study aimed to screen for anal cancer and to determine its cytomorphology using liquid-based cytology (LBC) with specimens preserved in 95% ethyl alcohol. Anal swabs were collected for cytological examination from 177 adult, HIV-infected patients. After collection, sample slides were reviewed and classified according to their cytomorphology using the modified Bethesda 2001 system. An abnormal anal Pap smear was found in 26.0% of the patients. The diagnoses were: 66.7% negative for intraepithelial lesions (NIL), 14.1% with atypical squamous cells of undetermined significance (ASC-US), 10.7% (19) with low-grade squamous intraepithelial lesions (LSIL), and 1.13% with high-grade squamous intraepithelial lesions (HSIL). The cytological evaluation was an unsatisfactory result only with 6.67%. The present modified LBC using 95% ethyl alcohol as the preservative could thus be used for anal cancer screening. The number of SILs in Thai HIV-infected patients is lower than that in Western countries. We found anal cytology a satisfactory tool for early screening and detection of anal dysplasia commonly found in high-risk, HIV-infected patients.

• 대한세포병리학회지
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• 제18권2호
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• pp.133-142
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• 2007

Cytologic diagnosis of the metastatic tumors to the thyroid is important in the management of the patients. There have been rare reports analyzing fine-needle aspiration (FNA) cytology of metastatic tumors to the thyroid. This study examines comprehensive cytologic findings of metastatic tumors to the thyroid with radiologic findings. The FNA cytology slides obtained from 12 cases with metastatic tumors of the thyroid; lung cancer (n=5), tongue and tonsil cancer (n=3), esophageal cancer (n=2), and breast cancer (n=2) were reviewed. Radiological study showed single mass with heterogeneous texture or multiple masses without calcification. Metastatic tumor was easily considered in a differential diagnosis of FNA cytology because they had peculiar cytological features which were not seen in primary thyroid tumor. The smear background varied from predominantly necrotic, bloody, and inflammatory to colloid. The aspirates exhibited a mixture of benign follicular cells and malignant cells in 6 cases. The characteristic cytoplasmic features of the tumor cells, such as keratin, mucin and melanin, were found in 9 cases. Although some cases mimic primary thyroid neoplasm, a careful examination of the cytological characteristics may help cytopathologists to recognize a metastatic tumor in the thyroid by FNA, and may help the clinicians to establish a proper treatment plan.

• 한국임상수의학회지
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• 제26권5호
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• pp.419-422
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• 2009

개의 림프종을 분자유전자학적으로 진단하고자 본 연구를 수행하였다. 이를 위하여 12개의 염색 및 고정된 도말 표본으로부터 DNA를 추출한 후, 임파육종에 특이적인 재배열된 항원 수용체 유전자를 중합효소연쇄반응으로 증폭시켰다. 그 결과 6개의 type-B 림프종에서 type-B 세포의 림프종에 특이적인 IgH (immunoglobulin H) 주유전자(major gene)와 type-B 림프종의 부유전자(minor gene)가 증폭되었다. 또한, 3개의 type-T 세포의 림프종의 경우에도 이에 특이적인 $TCR{\gamma}$ 유전자가 증폭되었다. 한편, 에를리키아증에 이환된 표본은 $TCR{\gamma}$ 유전자가 위양성으로 증폭되었지만, 활성화된 림프절 샘플의 경우에는 어떤 유전자의 재배열도 관찰되지 않았다. 따라서 림프종의 진단에 있어서 혈액 또는 조직 도말 표본의 DNA를 이용하여 재배열된 항원 수용체 유전자의 검출을 시도한다면, 특이적이고 객관적으로 림프종을 감별진단 할 수 있을 것이며, 나아가 회고적 분석에도 유용하게 활용될 수 있을 것으로 사료된다.

• 대한세포병리학회지
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• 제19권1호
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• pp.27-33
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• 2008

Although subacute granulomatous thyroiditis(SGT) is usually diagnosed clinically, papillary carcinoma or other thyroid conditions must be considered in the differential diagnosis. We retrospectively reviewed the clinical and fine-needle aspiration(FNA) cytologic findings seen in 10 SGT cases to decide what are the most reliable cytologic findings and the most helpful molecular tools for reaching a confident cytologic diagnosis. The most representative smear slides were retrieved to perform immunocytochemistry for cytokeratin 19(CK19) and Ret protein. Five papillary carcinomas(PTCs) were included as controls. The constant and typical cytologic findings of SGT were multinucleated giant cells(MGCs) (100%), epithelioid granulomas(90%), an inflammatory dirty background(90%) and plump transformed follicular cells(80%) without fire-flare cells, oncocytic cells or transformed lymphocytes. The immunoreactivities for CK19(37.5%) and Ret(10%) of the follicular cells of SGT were less than those(CK19 and Ret:100%) of PTC. CK19 immunoreactivity of the MGCs was seen in only one case of PTC. There was no significant difference between CK19 and Ret immunocytochemical staining for the MGCs of both SGT and PTC. The results of this study demonstrate that the cytological diagnosis of SGT can be improved by employing a combination of the typical and constant diagnostic cytological features and immunocytochemical results.

• 대한세포병리학회지
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• 제18권2호
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• pp.143-152
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• 2007

Sono-guided fine needle aspiration (FNA) of the thyroid is widely used, but the aspirated samples are typically not well preserved and low cellularity makes diagnosis difficult in many cases. The object of the current study is to evaluate the adequacy and diagnostic accuracy of the use of $SurePath^{TM}$ liquid-based cytology (SP-LBC) in the sonoguided fine needle aspiration of the thyroid nodule and to compare its use with that of the use of a conventional smear (CS). A total of 172 sono-guided FNAs of thyroid nodules from April to June, 2006 were prepared by the use of the split method with either SP-LBC or CS; the samples were stained with the use of hematoxylin-eosin (H&E) and Papanicolaou (Pap) stains. A cyto-histological correlation was performed in 69 (30 SP and 39 CS) cases that had been histologically confirmed. The rate of producing unsatisfactory slides by the use of the SP-LBC method (9.3%) was less than that of the use of the CS method (20.9%). The diagnostic accuracy of the SP method (93.3%) was better than that of the CS method (85.3%). The sensitivity and specificity of the SP method (94.4% and 92.3%) was better than that of the CS method (83.3% and 70%), respectively (p < 0.05). The CS of sono-guided aspirated specimens had some unavoidable limitations related to inadequate sampling such as a bloody background, low cellularity and an indication that some clinicians smeared many useless slides (averaging four to ten slides), and that most slides showed only blood that included few follicular cells. The SP method resulted in more thinly smeared slides and showed cleaner background and greater cellularity than the use of the CS method. Each follicular cell shows superior nuclear detail, and more distinct cytoplasmic features than with the use of the CS method. SP-LBC appears to be an easy, highly accurate, and reliable cytological method for employ for a diagnostic approach of thyroid disease and thyroid nodules. The SP-LBC method is a suitable alternative to the CS method to overcome diagnostic difficulties.

• 대한세포병리학회지
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• 제19권2호
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• pp.126-135
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• 2008

Malignant mesothelioma (MM) is a highly lethal neoplasm arising in pleura and the peritoneum and a rapid and accurate diagnosis is crucial for treatment of the disease. However, the sensitivity of cytological analysis using pleural or ascitic fluid is relatively low, yielding an accurate diagnosis in only $32{\sim}79%$ of cases. We tested the diagnostic value of epigenetic alterations in body fluid cytology as a supplement to conventional methods. Paraffin-embedded tissue blocks from 21 MM patients and associated body fluid cytology slides considered no evidence of malignancy were used to test for epigenetic alteration. Using methylation-specific PCR, we detected methylation of RASSF1A and p16 in 47.6% (10/21) of both surgically resected tumor samples, respectively. Body fluid samples of MM also showed abnormal methylation of RASSF1A and p16INK4a genes in 38.1% (8/21) and 33.3% (7/21) of cases. The concordance in the rates of RASSF1A and p16INK4a gene-methylation abnormalities determined from cytology samples and tissue samples were 61.9% (13/21) and 66.7% (14/21), respectively. Combining both genes increases the sensitivity of the test to 57.1 % (12 of 21) of cases. Our results suggest that testing for methylation abnormalities in selected individual genes or gene combinations has diagnostic value as an alternative or adjunct method to conventional cytological diagnosis.

• Asian Pacific Journal of Cancer Prevention
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• 제15권5호
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• pp.2051-2055
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• 2014

Background: To evaluate the performance of Siriraj liquid-based cytology (LBC) for cervical neoplasia screening after increasing use of this technology. Materials and Methods: Cytological reports of 103,057 Siriraj-LBC specimens obtained in 2007-2009 were compared with those of 23,676 specimens obtained in 2006. Results: Comparing with the year 2006, the 2007-2009 patients were slightly older ($43.4{\pm}12.yr$ vs $42.7{\pm}12.2yr$, p <0.001), and their specimens had much lower proportion of unsatisfactory slides (OR=0.06, 95%CI 0.04-0.09) with comparable detection rates (3.96% vs 3.70%, p=0.052) but different proportions of various cytological abnormalities (p<0.001). The 2007-2009 Siriraj-LBC had a negative predictive value (NPV) for cervical intraepithelial neoplasia 2+ (CIN2+) of 97.6% and an overall positive predictive value (PPV) of 43.9%. The PPV for CIN2+ varied with types of abnormal cytology, from 13.7% to 93.8% in atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), atypical squamous cells cannot exclude HSIL (ASC-H), high-grade squamous intraepithelial lesion (HSIL), atypical glandular cells (AGC), to squamous cell carcinoma (SCC), respectively. The PPVs for CIN2+ in ASCUS and LSIL were comparable, but the PPV for CIN1 was higher for LSIL than for ASCUS (41.63% vs 16.32%). Conclusions: Siriraj-LBC has demonstrated a stable detection rate and NPV for CIN2+ of >95% since the first year of use. The comparable PPVs for CIN2+ of ASCUS and LSIL suggests that these two conditions may undergo similar management; other cytological abnormalities need immediate evaluation.

• 한국지능정보시스템학회:학술대회논문집
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• 한국지능정보시스템학회 2007년도 한국지능정보시스템학회
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• pp.389-398
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• 2007

Case-based reasoning (CBR) is one of the most popular prediction techniques for medical diagnosis because it is easy to apply, has no possibility of overfitting, and provides a good explanation for the output. However, it has a critical limitation - its prediction performance is generally lower than other artificial intelligence techniques like artificial neural networks (ANNs). In order to obtain accurate results from CBR, effective retrieval and matching of useful prior cases for the problem is essential, but it is still a controversial issue to design a good matching and retrieval mechanism for CBR systems. In this study, we propose a novel approach to enhance the prediction performance of CBR. Our suggestion is the simultaneous optimization of feature weights, instance selection, and the number of neighbors that combine using genetic algorithms (GAs). Our model improves the prediction performance in three ways - (1) measuring similarity between cases more accurately by considering relative importance of each feature, (2) eliminating redundant or erroneous reference cases, and (3) combining several similar cases represent significant patterns. To validate the usefulness of our model, this study applied it to a real-world case for evaluating cytological features derived directly from a digital scan of breast fine needle aspirate (FNA) slides. Experimental results showed that the prediction accuracy of conventional CBR may be improved significantly by using our model. We also found that our proposed model outperformed all the other optimized models for CBR using GA.