Department of Pathology, Radboud University Nijmegen Medical Centre, The Netherlands.
Arch Pathol Lab Med. 2012 Jan;136(1):76-83. doi: 10.5858/arpa.2011-0113-OA.
Recent randomized controlled trials have shown a significant decrease in unsatisfactory rates for liquid-based cytology (LBC) compared with conventional Papanicolaou test (CP). The underlying causes and relevance of unsatisfactory results for LBC and CP have never been compared within the setting of a randomized controlled trial.
To examine differences in causes and relevance of unsatisfactory and satisfactory but limited by (SBLB) results for LBC and CP.
Data from the Netherlands ThinPrep Versus Conventional Cytology (NETHCON) trial were used, involving 89 784 women. Causes and relevance of unsatisfactory and SBLB results were analyzed.
The primary cause for unsatisfactory results for CP and LBC was scant cellularity. Other causes for unsatisfactory CPs were virtually eliminated with LBC. The same was true for SBLB subcategories, with the exception of SBLB absence of transformation zone component and SBLB scant cellularity. The SBLB absence of transformation zone component showed a statistically significant 22% and SBLB scant cellularity a 12% nonsignificant increase with LBC. The detection rates of abnormalities found during 18 months of follow-up of unsatisfactory test results did not differ significantly between the 2 study arms, nor did they differ from the initial test positivity rates from the NETHCON trial.
Liquid-based cytology shows an almost complete elimination of most causes for unsatisfactory CP, with scant cellularity remaining as the sole cause for unsatisfactory LBC. On the other hand, with LBC a significant increase of smears without a transformation zone component was noted. Women with an unsatisfactory test result are not at increased risk for cervical abnormalities either with LBC or with CP.
Nederlands Trial Register, NTR1032, www.trialregister.nl .
最近的随机对照试验表明，与传统巴氏涂片（CP）相比，液基细胞学（LBC）的不满意率显著降低。在随机对照试验的背景下，从未比较过 LBC 和 CP 不满意结果的根本原因和相关性。
检查 LBC 和 CP 的不满意和满意但有限（SBLB）结果的原因和相关性的差异。
使用来自荷兰薄涂片与传统细胞学（NETHCON）试验的数据，涉及 89784 名女性。分析不满意和 SBLB 结果的原因和相关性。
CP 和 LBC 不满意结果的主要原因是细胞稀少。LBC 几乎消除了 CP 不满意的其他原因。SBLB 亚类也是如此，除了 SBLB 缺乏转化区成分和 SBLB 细胞稀少。SBLB 缺乏转化区成分的发生率增加了 22%，具有统计学意义，SBLB 细胞稀少的发生率增加了 12%，但无统计学意义。在不满意测试结果的 18 个月随访期间，异常的检出率在两个研究臂之间没有显著差异，也与 NETHCON 试验的初始测试阳性率没有差异。
液基细胞学几乎完全消除了 CP 不满意的大多数原因，细胞稀少仍然是 LBC 不满意的唯一原因。另一方面，随着 LBC 的使用，注意到没有转化区成分的涂片明显增加。无论是使用 LBC 还是 CP，不满意测试结果的女性发生宫颈异常的风险都没有增加。
荷兰试验注册处，NTR1032，www.trialregister.nl。
