Evaluation of p16INK4a immunostaining for the detection of high-grade changes in cervical cytology
In this study, the sensitivity and specificity of p16 immunostaining in detection of underlying HG lesions was evaluated in a cohort of 454 women undergoing surgical treatment for biopsy proven cervical dysplasia. Overall, p16 positive cells were detected in 321 (71%) of cytology preparations evaluated. Comparison of p16 staining on cytological preprations to histology diagnosis available on 212 patients, showed 26 (54%), 41 (78%) and 80 (90%) of cytology preparations to be p16 positive in women with CIN1, CIN2 and CIN3, respectively (p (Source: Pathology)
Source: Pathology - May 8, 2015 Category: Pathology Tags: Anatomical Pathology Source Type: research
High reproducibility of histological diagnosis of human papillomavirus-related intraepithelial lesions of the anal canal
Summary: In a natural history study of anal human papillomavirus (HPV) infection and HPV-related lesions, we examined the reproducibility of histological high-grade squamous intraepithelial lesion (HSIL). Three expert anogenital pathologists share the reporting of histological specimens from the Study of the Prevention of Anal Cancer (SPANC), utilising Lower Anogenital Squamous Terminology (LAST) criteria. In total, 194 previously reported biopsies were randomly chosen within diagnostic strata [50 HSIL–anal intraepithelial neoplasia (AIN) 3; 45 HSIL–AIN 2; 49 ‘flat’ low-grade squamous intraepithelial lesion (LSIL);...
Source: Pathology - May 8, 2015 Category: Pathology Tags: Anatomical Pathology Source Type: research
Loss of expression of BAP1 predicts longer survival in mesothelioma
Summary: BRCA1-associated protein 1 (BAP1) is a tumour suppressor gene frequently inactivated in mesothelioma, rarely also in association with germline mutation. BAP1 mutations have been associated with improved prognosis and distinct clinicopathological features. We sought to determine the clinicopathological significance of BAP1 immunohistochemistry (IHC) in mesothelioma.
We performed IHC on a tissue microarray (TMA) cohort comprising all available thoracic mesotheliomas encountered during the period 1991-2014 at our institution (n = 229). All cases were independently reviewed to confirm the diagnosis and subclassify...
Source: Pathology - May 8, 2015 Category: Pathology Tags: Anatomical Pathology Source Type: research
Langerhans cell histiocytosis: a comprehensive review
Summary: Langerhans cell histiocytosis (LCH) is currently regarded as a myeloid neoplasm, with remarkably broad clinical spectrum, ranging from isolated skin or bone lesions to a disseminated disease that can involve nearly any organ. LCH is generally regarded as a sporadic disease that occurs predominantly in the paediatric population. The diagnosis of LCH is confirmed by immunohistochemistry (IHC) by demonstrating the presence of dendritic cell markers such as S100 protein, in addition to CD1a and langerin. Contrary to previous beliefs, recent literature reveals that the pathogenesis of LCH might involve a clonal process...
Source: Pathology - May 8, 2015 Category: Pathology Tags: Reviews Source Type: research
Acute myeloid leukaemia and myelodysplastic syndromes with 50% or greater erythroblasts: a diagnostic conundrum
Summary: Acute myeloid leukaemia (AML) and myelodysplastic syndromes (MDS) with ≥50% erythroblasts comprise up to 5% of all cases of AML and 15% of MDS. The classification of these entities is currently fraught with difficulty and requires integration of clinical, morphological and cytogenetic features. The current World Health Organization classification of haematopoietic tumours recognises the entities of pure erythroid leukaemia and acute erythroid leukaemia (erythroid/myeloid), however, some cases of AML with erythroid predominance may also fulfil criteria for AML with myelodysplasia-related changes or therapy-relate...
Source: Pathology - May 8, 2015 Category: Pathology Tags: Reviews Source Type: research
Approach to thyroid cytology: rationale for standardisation
No abstract available (Source: Pathology)
Source: Pathology - May 8, 2015 Category: Pathology Tags: Editorial Source Type: research
Resistance mechanisms in Enterobacteriaceae
Summary: Enterobacteriaceae are responsible for a large proportion of serious, life-threatening infections and resistance to multiple antibiotics in these organisms is an increasing global public health problem. Mutations in chromosomal genes contribute to antibiotic resistance, but Enterobacteriaceae are adapted to sharing genetic material and much important resistance is due to ‘mobile’ resistance genes. Different mobile genetic elements, which have different characteristics, are responsible for capturing these genes from the chromosomes of a variety of bacterial species and moving them between DNA molecules. If tran...
Source: Pathology - March 13, 2015 Category: Pathology Tags: Molecular Diagnostics in Microbiology Source Type: research
Contemporary genomic approaches in the diagnosis and typing of Staphylococcus aureus
Summary: Staphylococcus aureus is a major human pathogen, causing disease in both community and healthcare settings. Over the past two decades, the epidemiology of S. aureus disease has changed dramatically, with the emergence and spread of community-associated methicillin-resistant S. aureus clones. This epidemiological shift, coupled with the association between delayed antimicrobial therapy and increased mortality in S. aureus bacteraemia, has greatly facilitated advances in the rapid molecular diagnosis of S. aureus. Rapid molecular testing for S. aureus can greatly reduce laboratory turnaround time, and in some circum...
Source: Pathology - March 13, 2015 Category: Pathology Tags: Molecular Diagnostics in Microbiology Source Type: research
Molecular diagnostic methods for invasive fungal disease: the horizon draws nearer?
Summary: Rapid, accurate diagnostic laboratory tests are needed to improve clinical outcomes of invasive fungal disease (IFD). Traditional direct microscopy, culture and histological techniques constitute the ‘gold standard’ against which newer tests are judged. Molecular diagnostic methods, whether broad-range or fungal-specific, have great potential to enhance sensitivity and speed of IFD diagnosis, but have varying specificities. The use of PCR-based assays, DNA sequencing, and other molecular methods including those incorporating proteomic approaches such as matrix-assisted laser desorption ionisation-time of fligh...
Source: Pathology - March 13, 2015 Category: Pathology Tags: Molecular Diagnostics in Microbiology Source Type: research
Molecular diagnostics for tuberculosis
Summary: The phenotypic methods of smear microscopy, culture and indirect drug susceptibility testing (DST) remain the ‘gold standard’ diagnostics for tuberculosis (TB) in 2015. However, this review demonstrates that genotypic methods are in the ascendancy. Current-generation nucleic acid amplification tests (NAATs) are important supplementary tests for the rapid direct detection of (multidrug-resistant) TB in specific clinical settings. Genotypic detection is already the preferred method of detecting rifampicin and pyrazinamide resistance. Next-generation NAATs able to detect about 10 colony forming units/mL of sputum...
Source: Pathology - March 13, 2015 Category: Pathology Tags: Molecular Diagnostics in Microbiology Source Type: research
Molecular diagnosis of respiratory viruses
Summary: The increasing availability of nucleic acid amplification tests since the 1980s has revolutionised our understanding of the pathogenesis, epidemiology, clinical and laboratory aspects of known and novel viral respiratory pathogens. High-throughput, multiplex polymerase chain reaction is the most commonly used qualitative detection method, but utilisation of newer techniques such as next-generation sequencing will become more common following significant cost reductions. Rapid and readily accessible isothermal amplification platforms have also allowed molecular diagnostics to be used in a ‘point-of-care’ format...
Source: Pathology - March 13, 2015 Category: Pathology Tags: Molecular Diagnostics in Microbiology Source Type: research
Advances in molecular diagnosis of parasitic enteropathogens
Summary: Here, recent developments in the detection and identification of parasites causing enteric infection are reviewed including the utility and challenges of multi-target molecular assays. Difficulties in clinical interpretation arising from increased detection of parasites, of co-infection with other enteropathogens and of asymptomatic carriage are discussed. Published approaches for detection across a broad range of organisms are described, including commercial assays available to Australian laboratories. Using local data, the impact of introduction of modern molecular assays is assessed. In addition, recent advance...
Source: Pathology - March 13, 2015 Category: Pathology Tags: Molecular Diagnostics in Microbiology Source Type: research
Molecular testing for viral and bacterial enteric pathogens: gold standard for viruses, but don’t let culture go just yet?
Summary: Contemporary diagnostic microbiology is increasingly adopting molecular methods as front line tests for a variety of samples. This trend holds true for detection of enteric pathogens (EP), where nucleic acid amplification tests (NAAT) for viruses are well established as the gold standard, and an increasing number of commercial multi-target assays are now available for bacteria and parasites. NAAT have significant sensitivity and turnaround time advantages over traditional methods, potentially returning same-day results. Multiplex panels offer an attractive ‘one-stop shop’ that may provide workflow and cost adv...
Source: Pathology - March 13, 2015 Category: Pathology Tags: Molecular Diagnostics in Microbiology Source Type: research
Opportunities and pitfalls of molecular testing for detecting sexually transmitted pathogens
Summary: In the last 20 years, nucleic acid amplification tests (NAATs) have gradually replaced traditional methods for the detection of sexually transmitted infections. NAAT technology comes with some considerable benefits for diagnosis, including increased sensitivity, rapid result turnaround and suitability for high throughput screening of asymptomatic individuals using more-readily available specimens. However, the transition to NAAT has not come without its problems. False-negative and false-positive results have been reported owing to various technical issues. Furthermore, increased reliance on NAATs for diagnosis ha...
Source: Pathology - March 13, 2015 Category: Pathology Tags: Molecular Diagnostics in Microbiology Source Type: research
Molecular methods for detecting and typing of Clostridium difficile
Summary: Since the early 2000s, Clostridium difficile has emerged as a major international pathogen. Recently, strains of C. difficile in circulation appear to be changing, with greater diversity, leading to challenges for diagnostics and surveillance. Currently molecular diagnostic methods are favoured for their high sensitivity and rapid processing times; however, a number of issues still exist with molecular tests, in particular high cost, low clinical specificity and failure to detect some variant C. difficile strains. Molecular typing methods are used to determine the continually evolving epidemiology of C. difficile ...
Source: Pathology - March 13, 2015 Category: Pathology Tags: Molecular Diagnostics in Microbiology Source Type: research
