Department of Pathology, Baylor College of Medicine, Houston, Texas 77030, USA.
Arch Pathol Lab Med. 2010 Jan;134(1):19-22. doi: 10.5858/2008-0673-CPR1.1.
The cytomorphology of liquid-based preparations in urine cytology is different than classic slide preparations.
To compare the performance of liquid-based preparation specimens to classically prepared urine specimens with a malignant diagnosis in the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytology.
Participant responses between 2000 and 2007 for urine specimens with a reference diagnosis of high-grade urothelial carcinoma/carcinoma in situ/dysplasia (HGUCA), squamous cell carcinoma, or adenocarcinoma were evaluated. ThinPrep and SurePath challenges were compared with classic preparations (smears, cytospins) for discordant responses.
There were 18 288 pathologist, 11 957 cytotechnologist, and 8086 "laboratory" responses available. Classic preparations comprised 90% (n = 34 551) of urine challenges; 9% (n = 3295) were ThinPrep and 1% (n = 485) were SurePath. Concordance to the general category of "positive-malignant" was seen in 92% of classic preparations, 96.5% of ThinPrep, and 94.6% of SurePath challenges (P < .001). These results were statistically different for the exact reference interpretation of HGUCA (P < .001) but not for adenocarcinoma (P = .22). Cytotechnologists demonstrate statistically better performance for the general category of "positive-malignant" compared with pathologists for all urinary slide types and for the exact reference interpretation of HGUCA (94% versus 91.1%; P < .001) but not adenocarcinoma (96.3% versus 95.8%; P = .77) or squamous cell carcinoma (93.6% versus 87.7%; P = .07).
Liquid-based preparations performed significantly better in urinary cytology challenges when evaluating malignant categories in the College of American Pathologists interlaboratory comparison program. The liquid-based preparation challenges also performed better for the exact reference interpretation of HGUCA, but no difference was observed for adenocarcinoma challenges. Cytotechnologists perform better than pathologists for all slide types, as well as those demonstrating HGUCA. These results suggest that liquid-based preparations facilitate a more accurate diagnosis than conventional preparations.
与经典载玻片制备相比，液基制备的尿液细胞学的细胞形态学不同。
在非妇科细胞学美国病理学家学院间比较计划中，比较液基制备标本与经典制备的尿液标本在恶性诊断中的性能。
评估 2000 年至 2007 年期间具有高级尿路上皮癌/原位癌/发育不良（HGUCA）、鳞状细胞癌或腺癌参考诊断的尿液标本的参与者反应。将 ThinPrep 和 SurePath 挑战与经典制剂（涂片、细胞旋涂器）进行比较，以检测不一致的反应。
有 18288 名病理学家、11957 名细胞技术专家和 8086 名“实验室”应答可用。经典制剂占尿液挑战的 90%（n=34551）；9%（n=3295）为 ThinPrep，1%（n=485）为 SurePath。92%的经典制剂、96.5%的 ThinPrep 和 94.6%的 SurePath 挑战与“阳性-恶性”的一般类别相符（P<0.001）。对于 HGUCA 的精确参考解释，这些结果在统计学上有所不同（P<0.001），但对于腺癌（P=0.22）则不然。细胞技术专家在所有尿液载玻片类型和 HGUCA 的精确参考解释方面，与病理学家相比，统计学上表现出更好的“阳性-恶性”一般类别性能（94%对 91.1%；P<0.001），但腺癌（96.3%对 95.8%；P=0.77）或鳞状细胞癌（93.6%对 87.7%；P=0.07）则不然。
在评估美国病理学家学院间比较计划中的恶性类别时，液基制备在尿液细胞学挑战中表现明显优于经典制备。液基制备挑战在 HGUCA 的精确参考解释方面表现更好，但腺癌挑战没有差异。细胞技术专家在所有载玻片类型以及显示 HGUCA 的情况下的表现均优于病理学家。这些结果表明，液基制备比传统制剂更能促进准确诊断。
