Depuydt C E, Benoy I H, Bailleul E J, Vandepitte J, Vereecken A J, Bogers J J
Laboratory for Clinical Pathology (Labo RIATOL), Antwerp, Belgium.
Cytopathology. 2006 Dec;17(6):374-81. doi: 10.1111/j.1365-2303.2006.00386.x.
Liquid-based cytology (LBC) for cervical screening is becoming increasingly used. Together with SurePath LBC, various collecting devices can be utilized, among which the Cervex-Brush is the most widely used. The new Rovers Cervex-Brush Combi combines the advantages of the Cervex-Brush with the EndoCervex-Brush increasing sampling of the endocervical canal. The objective of this study was to analyse and to compare the Cervex-Brush Combi with the Cervex-Brush for the collection of squamous and endocervical cells, human papillomavirus (HPV) typing/quantification and disease detection in SurePath LBC.
Using either the Cervex-Brush or the Cervex-Brush Combi 100 consecutive SurePath LBC samples were collected using each brush type. All 200 slides were read by the FocalPoint and screened by guided screening using slide wizards. The viral load of HPV type 16 E7, 18 E7, 31 E6, 33 L1, 33 E6, 35 E4, 39 E7, 45 E7, 51 E6, 52 L1, 52 E7, 53 E6, 56 E7, 58 L1, 58 E6, 59 E7, 66 E6 and 68 E7 was determined using a TaqMan-based real-time quantitative PCR analysis.
The mean number of sampled squamous cells did not differ between the two brush types (54 963 versus 54 595 cells). The use of the Cervex-Brush Combi, however, resulted in a two- to threefold increase in the number of sampled endocervical cells (P < 0.00001). Using the Cervex-Brush Combi slightly more lesions were detected (three versus two low-grade squamous intraepithelial lesions), and resulted in the detection of more atypical squamous cells of undetermined significance (six versus three). In the Cervex-Brush group, 60% (3/5) of abnormal smears were positive for oncogenic HPV types, whereas 66.7% (6/9) of abnormal smears in the Cervex-Brush Combi group tested positive. The median HPV viral load for samples taken with the Cervex-Brush Combi was 0.1825 copies/cell and was significantly higher than in samples taken with the Cervex-Brush (0.0042 copies/cell) (P = 0.02).
Sampling with the Cervex-Brush Combi resulted in the collection of the same amount of squamous cells, but in a two to threefold harvest of endocervical cells. This led to the detection of a higher viral load for oncogenic HPV and an increase in the number of detected abnormal smears.
宫颈筛查的液基细胞学检查（LBC）应用越来越广泛。除了SurePath LBC外，还可使用多种采集装置，其中Cervex-Brush使用最为广泛。新型Rovers Cervex-Brush Combi结合了Cervex-Brush和EndoCervex-Brush的优点，增加了子宫颈管的采样。本研究的目的是分析和比较Cervex-Brush Combi与Cervex-Brush在SurePath LBC中采集鳞状和子宫颈细胞、人乳头瘤病毒（HPV）分型/定量及疾病检测方面的情况。
分别使用Cervex-Brush或Cervex-Brush Combi连续采集100份SurePath LBC样本，每种刷子类型各采集100份。所有200张玻片均由FocalPoint阅片，并使用玻片向导进行引导筛查。采用基于TaqMan的实时定量PCR分析测定16 E7、18 E7、31 E6、33 L1、33 E6、35 E4、39 E7、45 E7、51 E6、52 L1、52 E7、53 E6、56 E7、58 L1、58 E6、59 E7、66 E6和68 E7型HPV的病毒载量。
两种刷子类型采集的鳞状细胞平均数量无差异（分别为54 963个细胞和54 595个细胞）。然而，使用Cervex-Brush Combi采集的子宫颈细胞数量增加了2至3倍（P < 0.00001）。使用Cervex-Brush Combi检测到的病变略多（3例低级别鳞状上皮内病变对2例），且检测到的意义不明确的非典型鳞状细胞更多（6例对3例）。在Cervex-Brush组中，60%（3/5）的异常涂片致癌型HPV检测呈阳性，而Cervex-Brush Combi组中66.7%（6/9）的异常涂片检测呈阳性。Cervex-Brush Combi采集样本的HPV病毒载量中位数为0.1825拷贝/细胞，显著高于Cervex-Brush采集的样本（0.0042拷贝/细胞）（P = 0.02）。
使用Cervex-Brush Combi采样采集到的鳞状细胞数量相同，但子宫颈细胞收获量增加了2至3倍。这导致致癌型HPV的病毒载量检测值更高，且检测到的异常涂片数量增加。
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