Islam Shahidul, West Ann Marie, Saboorian M Hossein, Ashfaq Raheela
Department of Pathology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75390-9073, USA.
Cancer. 2004 Apr 25;102(2):67-73. doi: 10.1002/cncr.11932.
The objective of the current study was to determine the effect of reprocessing bloody ThinPrep (TP) samples using a glacial acetic acid technique on the unsatisfactory rate.
During a 12-month study period, all TP gynecologic samples received by the Cytology Laboratory from inpatient, outpatient, and community-based clinics at the University of Texas Southwestern Medical Center and the Parkland Health and Hospital System in Dallas, Texas, were enrolled prospectively into the study. The initial TP slides were evaluated for specimen adequacy based on the 2001 Bethesda System. Any TP sample that contained abnormal cells, by definition, was not considered unsatisfactory. The criteria for reprocessing included scant cellularity in a background of abundant blood. Biopsy correlations for all abnormal cytologic diagnoses were established between TP smears and follow-up biopsies.
During the course of the 1-year study period, a total volume of 57,296 TP samples were evaluated by the study laboratory. Prior to reprocessing, the laboratory unsatisfactory rate was 8.32% (4767 of 57,296 TP samples). After reprocessing those samples that were compromised by blood (2593 of 4767 TP samples), the unsatisfactory rate was reduced to 5.47% (3134 of 57,296 TP samples), with an overall reduction by 34.25% (2.85 of 8.32 TP samples). Of 2593 samples that were reprocessed, 62.98% (1633 of 2593 TP samples) changed from inadequate to adequate for the purposes of evaluation. Of those 1633 adequate samples, 1509 samples (92.41%) were negative for intraepithelial lesion or malignancy, 72 samples (4.40%) were atypical squamous cells of unknown significance, 5 samples (0.31%) were atypical glandular cells of undetermined significance, 36 samples (2.20%) were low-grade squamous intraepithelial lesions, 10 samples (0.61%) were high-grade squamous intraepithelial lesions, and 1 sample (0.06%) was adenocarcinoma.
The authors conclude that the reprocessing of unsatisfactory ThinPrep cervicovaginal cytology samples decrease the unsatisfactory rate considerably, with an increase in the detection of significant abnormal cervicovaginal lesions.
本研究的目的是确定使用冰醋酸技术对血性液基薄层制片（TP）样本进行重新处理对不满意率的影响。
在为期12个月的研究期间，德克萨斯大学西南医学中心和德克萨斯州达拉斯帕克兰健康与医院系统的细胞学实验室从住院、门诊和社区诊所接收的所有TP妇科样本均被前瞻性纳入研究。根据2001年贝塞斯达系统对最初的TP玻片进行标本充分性评估。根据定义，任何含有异常细胞的TP样本都不被视为不满意样本。重新处理的标准包括在大量血液背景下细胞数量稀少。在TP涂片和后续活检之间建立了所有异常细胞学诊断的活检相关性。
在为期1年的研究期间，研究实验室共评估了57296份TP样本。在重新处理之前，实验室的不满意率为8.32%（57296份TP样本中的4767份）。对那些因血液而质量受损的样本（4767份TP样本中的2593份）进行重新处理后，不满意率降至5.47%（57296份TP样本中的3134份），总体降低了34.25%（8.32份TP样本中的2.85份）。在2593份重新处理的样本中，62.98%（2593份TP样本中的1633份）在评估目的上从不充分变为充分。在这1633份充分样本中，1509份样本（92.41%）上皮内病变或恶性肿瘤为阴性，72份样本（4.40%）为意义不明确的非典型鳞状细胞，5份样本（0.31%）为意义不明确的非典型腺细胞，36份样本（2.20%）为低级别鳞状上皮内病变，10份样本（0.61%）为高级别鳞状上皮内病变，1份样本（0.06%）为腺癌。
作者得出结论，对不满意的液基薄层制片宫颈阴道细胞学样本进行重新处理可显著降低不满意率，并增加对重要宫颈阴道病变的检出率。
