Luthra Usha K, Chishti Mariam, Dey Pranab, Jolly Sil Vipat, Abdulla Mohamed, Das Dilip K, Sugathan T N, Ajrawi M Tareq, George Josely, George Sara Shirly, Aziz Azza Abdul, al-Juwaiser Ahlam, Karim Fatma Abdul, Mallik Mrinmay Kumar, Sheikh Zafar A, Khan Shaheed
Department of Pathology, Faculty of Medicine, Kuwait University, Kuwait.
Acta Cytol. 2002 Mar-Apr;46(2):303-10. doi: 10.1159/000326726.
To compare ThinPrep (TP) Papanicolaou smears (Cytyc Corp., Box-borough, Massachusetts, U.S.A.) with matching conventional Papanicolaou (CP) smears for specimen adequacy, cytologic quality, diagnostic accuracy and screening time.
In this prospective study of 1,024 women a split-sample, matched-pair design in favor of CP slides based on single-blind criteria was followed with a smear on a glass slide for CP and the remaining material collected in Preserv-Cyt solution (Cytyc) for a TP smear. A Cytobrush (Medscand, Hollywood, Florida, U.S.A.) was used for smear preparation for CP. TP smears were processed in ThinPrep 2000 (Cytyc). Smears were stained with Papanicolaou stain and were interpreted according to the Bethesda system.
The number of satisfactory but limited (SBL) cases with TP were 77 (7.5%) as compared to 127 (12.4%) with the CP method. This reduction in SBL smears with the TP method and consequent increase in satisfactory smears were highly significant (P < .001) by McNemar's test. As regards unsatisfactory smears in discordant pairs, although the number of unsatisfactory smears was higher with TP (41 cases) as against CP (27 cases), the difference was not statistically significant (P < .05). The split-sample method showed a high correlation between the CP and TP diagnoses. TP smears had a significant advantage over CP smears in the reduction in the number of ASCUS and AGUS cases (14 vs. 29) (P < .05) and increased the pickup rate of LSIL, 6 vs. 1. Time taken to screen the TP smears was half that of CP smears. No cases of LSIL or HSIL were missed on TP smears.
The liquid-based processor significantly improved the adequacy and quality of smears, resulting in fewer recall cases for SBL smears, leading to more definitive diagnoses in atypical cases, increasing the pickup rate of LSILs and reducing the screening time. A machine handling multiple specimens automatically would decrease cost and be an asset to a cytopathology laboratory.
比较ThinPrep（TP）巴氏涂片（美国马萨诸塞州博克斯伯勒市Cytyc公司）与配对的传统巴氏（CP）涂片在标本充足率、细胞学质量、诊断准确性和筛查时间方面的差异。
在这项对1024名女性的前瞻性研究中，采用基于单盲标准的分样本、配对设计，倾向于CP玻片，一张载玻片上制作CP涂片，其余样本收集于Preserv-Cyt溶液（Cytyc）中制作TP涂片。使用Cytobrush（美国佛罗里达州好莱坞市Medscand公司）制作CP涂片。TP涂片在ThinPrep 2000（Cytyc）中处理。涂片用巴氏染色，并根据贝塞斯达系统进行解读。
TP涂片的满意但有限（SBL）病例数为77例（7.5%），而CP方法为127例（12.4%）。通过McNemar检验，TP方法导致的SBL涂片减少以及满意涂片相应增加具有高度统计学意义（P < .001）。对于不一致配对中的不满意涂片，尽管TP的不满意涂片数（41例）高于CP（27例），但差异无统计学意义（P < .05）。分样本方法显示CP和TP诊断之间具有高度相关性。TP涂片在减少非典型鳞状细胞不能明确意义（ASCUS）和非典型腺细胞不能明确意义（AGUS）病例数方面（14例对29例）比CP涂片具有显著优势（P < .05），并提高了低度鳞状上皮内病变（LSIL）的检出率，分别为6例对1例。筛查TP涂片所需时间是CP涂片的一半。TP涂片未漏诊任何LSIL或高度鳞状上皮内病变（HSIL）病例。
液基处理仪显著提高了涂片的充足率和质量，减少了SBL涂片的召回病例数，在非典型病例中得出更明确的诊断，提高了LSIL的检出率并缩短了筛查时间。一台能自动处理多个标本的机器将降低成本，对细胞病理学实验室是一项资产。
