In-Depth Assessment of Cytologic Features in 106 Cervical Papanicolaou Tests of Transgender Male Patients on Testosterone: An Institutional Experience.

IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY
Juanita E Ferreira, Nikki Chiang, Xin Jing, Brian Smola, Richard L Cantley, Judy C Pang, Madelyn Lew
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Abstract

Background: There is a decreased cervical cancer screening rate among female to male transgender (FTMTG) patients. Data on the distinct cytologic features present in cervical cytology (CC) of those on testosterone therapy is limited.

Methods: An 2017-2023 electronic database search identified CC specimens from a cohort of FTMTG patients on testosterone therapy (TT). A morphologic retrospective review of CC for cellularity and presence of key morphologic features was performed. Records were reviewed for original cytologic diagnoses and concurrent HPV test results for comparison with a cisgender female (CF) cohort.

Results: 106 of 132,363 (0.08%) identified CC specimens were from FTMTG patients on TT. Diagnostic rates were compared to the CF population. The most common diagnosis for both groups was "negative for intraepithelial lesion or malignancy". The unsatisfactory rate was significantly higher in the FTMTG cohort at 21.7% (vs. 2.7%). The comparative HPV positivity rate of FTMTG and CF cohorts was 13.2% and 10.7%, respectively. Of 83 FTMTG satisfactory CC specimens, 67% showed low cellularity (narrowly meeting the adequacy threshold of 5000 well-visualized squamous cells) and 78% showed extensive squamous atrophy. Nuclear grooves and irregular contours (features associated with transitional cell metaplasia) were observed in 18% and 23%, respectively. High N:C ratio was noted in 20% of cases.

Conclusion: The higher unsatisfactory rate in FTMTG patients raises the question of whether adequacy criteria for this cohort should be adjusted. To enhance diagnostic accuracy, providing an accurate clinical history may prevent overinterpretation of features associated with transitional cell metaplasia.

深入评估跨性别男性患者106例宫颈巴氏染色试验中睾丸激素的细胞学特征:一个机构经验。
背景:女变男(FTMTG)患者的宫颈癌筛查率有所下降。在睾酮治疗的宫颈细胞学(CC)中存在的独特细胞学特征的数据是有限的。方法:通过2017-2023年的电子数据库检索,从接受睾酮治疗(TT)的FTMTG患者队列中识别出CC标本。对CC的细胞结构和关键形态学特征进行了形态学回顾。回顾了原始细胞学诊断和并发HPV检测结果的记录,并与顺性别女性(CF)队列进行了比较。结果:132,363例CC标本中有106例(0.08%)来自TT的FTMTG患者。将诊断率与CF人群进行比较。两组最常见的诊断都是“上皮内病变或恶性肿瘤阴性”。FTMTG组的不满意率明显更高,为21.7% (vs. 2.7%)。FTMTG组和CF组的HPV比较阳性率分别为13.2%和10.7%。在83例FTMTG满意的CC标本中,67%显示低细胞性(勉强满足5000个清晰可见的鳞状细胞的充分性阈值),78%显示广泛的鳞状萎缩。核槽和不规则轮廓(与移行细胞化生相关的特征)分别占18%和23%。20%的病例出现高氮碳比。结论:FTMTG患者较高的不满意率提出了是否应该调整该队列的充分性标准的问题。为了提高诊断的准确性,提供准确的临床病史可以防止过度解释与移行细胞化生相关的特征。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Diagnostic Cytopathology
Diagnostic Cytopathology 医学-病理学
CiteScore
2.60
自引率
7.70%
发文量
163
审稿时长
3-6 weeks
期刊介绍: Diagnostic Cytopathology is intended to provide a forum for the exchange of information in the field of cytopathology, with special emphasis on the practical, clinical aspects of the discipline. The editors invite original scientific articles, as well as special review articles, feature articles, and letters to the editor, from laboratory professionals engaged in the practice of cytopathology. Manuscripts are accepted for publication on the basis of scientific merit, practical significance, and suitability for publication in a journal dedicated to this discipline. Original articles can be considered only with the understanding that they have never been published before and that they have not been submitted for simultaneous review to another publication.
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