Okodo Mitsuaki, Okayama Kaori, Fukui Tadasi, Shiina Natsuko, Caniz Timothy, Yabusaki Hiromi, Fujii Masahiko
Department of Medical technology, Faculty of Health Sciences, Kyorin University, Japan. Email:
Asian Pac J Cancer Prev. 2017 Sep 27;18(9):2507-2511. doi: 10.22034/APJCP.2017.18.9.2507.
Purpose: Binucleation is a reactive cellular change (RCC) in Pap smears due to Candida infection. However, the origin of these binucleated cells as RCCs remains unclear. The purpose of this study was to examine binucleation in patients negative for intraepithelial lesion or malignancy (NILM) and infected with Candida and those infected with high-risk human papillomavirus (hr-HPV) and to clarify the origin of the binucleated cells. Methods: A total of 115 endocervical swab specimens with a combined diagnosis of NILM, Candida infection, and RCCs were used for this study. Pap smears were used to identify binucleated cells and then separate them into two groups, compression-positive and compression-negative. In addition, hr-HPV was detected using polymerase chain reaction (PCR) with a specific primer on the DNA extracted from the remaining residual cytology specimens. To make the hr-HPV-infected binucleated cells visible, an in situ PCR assay was performed on the Pap smear. Result: Of the 115 specimens, 69.6% contained binucleated cells, 26 (32.5%) showed only the compressed form, 35 (43.8%) showed only the non-compressed form, and 19 showed both the compressed and non-compressed forms of binucleated cells. Also, 34 specimens (29.6%) were positive for hr-HPV. The sensitivity and specificity of compression-positive binucleated cells were 91.2% and 82.7% (p < 0.001), but they were not significant in the compression-negative group (p = 0.156). Also, 34 cases with hr-HPV contained 99 compression-positive and 24 compression-negative cells. The hr-HPV-positive cells accounted for 68 (68.7%) of the 99 compression-positive and 2 (8.3%) of the 24 compression-negative binucleated cells as determined by an in situ PCR assay for hr-HPV. The relationship between compression and hr-HPV was statistically significant (p < 0.001). Conclusion: Compression-positive binucleated cells may be present as a result of hr-HPV infection and not RCC, which is caused due to inflammation in NILM cases infected with Candida.
双核化是念珠菌感染导致的巴氏涂片反应性细胞变化（RCC）。然而，这些作为RCC的双核细胞的起源仍不清楚。本研究的目的是检查上皮内病变或恶性肿瘤阴性（NILM）且感染念珠菌的患者以及感染高危人乳头瘤病毒（hr-HPV）的患者中的双核化情况，并阐明双核细胞的起源。方法：本研究共使用了115份宫颈拭子标本，这些标本综合诊断为NILM、念珠菌感染和RCC。巴氏涂片用于识别双核细胞，然后将其分为两组，即挤压阳性和挤压阴性。此外，使用聚合酶链反应（PCR）和从剩余的残余细胞学标本中提取的DNA上的特异性引物检测hr-HPV。为了使感染hr-HPV的双核细胞可见，对巴氏涂片进行原位PCR检测。结果：在115份标本中，69.6%含有双核细胞，26份（32.5%）仅显示挤压形式，35份（43.8%）仅显示非挤压形式，19份显示双核细胞的挤压和非挤压形式。此外，34份标本（29.6%）hr-HPV呈阳性。挤压阳性双核细胞的敏感性和特异性分别为91.2%和82.7%（p<0.001），但在挤压阴性组中无统计学意义（p=0.156）。此外，34例hr-HPV阳性病例中含有99个挤压阳性细胞和24个挤压阴性细胞。通过hr-HPV原位PCR检测确定，hr-HPV阳性细胞占99个挤压阳性双核细胞中的68个（68.7%）和24个挤压阴性双核细胞中的2个（8.3%）。挤压与hr-HPV之间的关系具有统计学意义（p<0.001）。结论：挤压阳性双核细胞可能是由于hr-HPV感染而非RCC导致的，RCC是由感染念珠菌的NILM病例中的炎症引起的。
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