Rinas Allen C, Mittman Benjamin W, Le Linda Van, Hartmann Katherine, Cayless Jennifer, Singh Harsharan K
Cytotechnology Program, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, USA.
Acta Cytol. 2006 Jan-Feb;50(1):55-62. doi: 10.1159/000325895.
To examine cells that were retained on sampling devices used to collect ThinPrep (Cytyc Corp., Boxborough, Massachusetts, U.S.A) Pap smears in order to evaluate both the number and significance of cells that are routinely discarded with these devices after liquid-based specimens are collected.
One hundred Pap smears from 100 women were prospectively procured after gynecologic Pap smears were collected for the ThinPrep Pap test. The sampling end of the collection devices was cut off and placed in a vial that contained SUREPATH preservative fluid (TriPath Imaging, Inc., Burlington, North Carolina, U.S.A). The residual cell samples were processed using the SurePath PREPSTAIN slide processor (TriPath). A single liquid-based slide was prepared from the sampling devices from each of the 100 specimens collected. The slides produced from the discarded devices were reviewed for the following: squamous cells, endocervical component, epithelial cell abnormalities and miscellaneous findings. The slides prepared from the "throw-away" (TA) material were subsequently compared with the primary ThinPrep Pap smear slide.
Twenty-five percent of the TA samples had an equal or greater number of squamous cells per high-power microscopic field when compared to the primary ThinPrep slide, with 8% of the TA slides demonstrating greater overall cellularity. An endocervical component was present on 27 of 66 cervical samples (40.9%). Three of five cases (60%) interpreted as atypical squamous cells of undetermined significance had similar cells on the TA slides. Two cases of atypical glandular cells of undetermined significance had no abnormal cells on the TA slides. Twelve of 14 cases (85.71%) of low grade squamous intraepithelial lesion contained similar cells on the TA slides. Two of four cases (50%) of high grade squamous intraepithelial lesion also had similar abnormal cells on the TA slides. Miscellaneous findings included 1 case of benign endometrial cells and 4 Candida infections present on both preparations, along with 1 case of Trichomonas vaginalis organisms present on the ThinPrep slide only. In 1 specimen, several multinucleated histiocytic giant cells were present only on the TA slide.
Specimens prepared from TA collecting devices used for the ThinPrep Pap test are less sensitive than the primary specimen for the detection of cervical lesions. This is in contrast to split-sample studies involving ThinPrep and conventional smears. Our study documented the presence of normal and abnormal cells discarded from ThinPrep sampling devices in a high percentage of cases. Discarded abnormal cells on the TA slides were, however, few when compared to the primary specimen, with only 1 exception involving a high grade lesion.
检查保留在用于收集美国马萨诸塞州博克斯伯勒市赛迪科公司的薄层液基制片（ThinPrep）巴氏涂片的采样装置上的细胞，以评估在收集液基标本后通常随这些装置丢弃的细胞数量及其重要性。
在为薄层液基制片巴氏试验采集妇科巴氏涂片后，前瞻性地获取了100名女性的100份巴氏涂片。将采集装置的采样端切断，放入装有SurePath保存液（美国北卡罗来纳州伯灵顿市TriPath影像公司）的小瓶中。使用SurePath PREPSTAIN玻片处理器（TriPath）处理残余细胞样本。从收集的100个标本中的每个标本的采样装置制备一张液基玻片。对从丢弃装置产生的玻片进行以下检查：鳞状细胞、宫颈管成分、上皮细胞异常和其他发现。随后将从“丢弃”（TA）材料制备的玻片与原始薄层液基制片巴氏涂片玻片进行比较。
与原始薄层液基制片玻片相比，25%的TA样本在每个高倍显微镜视野中的鳞状细胞数量相等或更多，8%的TA玻片显示总体细胞数量更多。66个宫颈样本中有27个（40.9%）存在宫颈管成分。在5例被解释为意义不明确的非典型鳞状细胞的病例中，有3例（60%）在TA玻片上有类似细胞。2例意义不明确的非典型腺细胞在TA玻片上没有异常细胞。14例低级别鳞状上皮内病变病例中有12例（85.71%）在TA玻片上有类似细胞。4例高级别鳞状上皮内病变病例中有2例（50%）在TA玻片上也有类似异常细胞。其他发现包括两份制片上均出现1例良性子宫内膜细胞和4例念珠菌感染，以及仅在薄层液基制片玻片上出现1例阴道毛滴虫。在1个标本中，仅在TA玻片上出现几个多核组织细胞巨细胞。
用于薄层液基制片巴氏试验的TA采集装置制备的标本在检测宫颈病变方面比原始标本敏感性低。这与涉及薄层液基制片和传统涂片的分流样本研究相反。我们的研究记录了在高比例病例中从薄层液基制片采样装置丢弃的正常和异常细胞的存在。然而，与原始标本相比，TA玻片上丢弃的异常细胞很少，只有1例高级别病变除外。
