Rosa Marilin, Pragasam Premila, Saremian Jinous, Aoalin Ana, Graf William, Mohammadi Amir
Department of Pathology and Laboratory Medicine, University of Florida College of Medicine, Jacksonville, FL 32209, USA.
Diagn Cytopathol. 2013 Jul;41(7):588-94. doi: 10.1002/dc.22904. Epub 2012 Jul 26.
ThinPrep® preparation is a widely-used method for processing gynecologic specimens due to the many advantages of the technique. However, the presence of blood, inflammation, and lubricant, among other factors, can significantly interfere with specimen adequacy. The aim of this study was to identify and overcome the most common reasons for unsatisfactory ThinPrep® Pap Test™ results in our laboratory. From October 2010 to January 2011, we reprocessed cases categorized as "unsatisfactory for evaluation" to determine whether reprocessing these specimens would impact the unsatisfactory rate. Reasons for unsatisfactory results were classified as: technical reasons, scant cellularity, and complete obscuring factors. Two hundred fifty-three cases were initially classified as unsatisfactory. Of these, 226 cases were reprocessed. Ninety cases became satisfactory after reprocessing with an overall improvement of 40%. The most common reasons for unsatisfactory results were the presence of lubricant (96 cases), presence of blood (64 cases), and technical problems (33 cases). Cases affected by blood or technical issues showed a significant improvement after reprocessing (56.2% and 90.9%, respectively). However, unsatisfactory cases owed to the presence of lubricant showed a relatively low percentage of improvement (16.6%). The main reasons for unsatisfactory results, the presence of blood and lubricant, can be avoided in many cases if sampling is not performed during bleeding and if the use of lubricants is limited during sample collection. Our study showed that reprocessing of selected cases can improve the overall unsatisfactory rate and can potentially reduce the risk of missing significant lesions.
ThinPrep® 制片法是一种因具有诸多优点而被广泛用于处理妇科标本的方法。然而，血液、炎症、润滑剂以及其他因素的存在会显著干扰标本的充分性。本研究的目的是识别并克服我们实验室中ThinPrep® 巴氏试验™ 结果不理想的最常见原因。从2010年10月至2011年1月，我们对分类为“评估不满意”的病例进行重新处理，以确定重新处理这些标本是否会影响不满意率。结果不满意的原因分为：技术原因、细胞数量不足和完全遮盖因素。最初有253例被分类为不满意。其中，226例进行了重新处理。90例重新处理后变为满意，总体改善率为40%。结果不满意的最常见原因是存在润滑剂（96例）、存在血液（64例）和技术问题（33例）。受血液或技术问题影响的病例重新处理后有显著改善（分别为56.2%和90.9%）。然而，因存在润滑剂导致不满意的病例改善率相对较低（16.6%）。如果在出血期间不进行采样并且在样本采集期间限制润滑剂的使用，在许多情况下可以避免结果不满意的主要原因，即血液和润滑剂的存在。我们的研究表明，对选定病例进行重新处理可以提高总体不满意率，并有可能降低漏诊重大病变的风险。
