Cancer Cytopathol. 2014 May;122(5):343-8. doi: 10.1002/cncy.21408.
The frequency of unsatisfactory gynecologic specimens has increased in the study laboratory over the last few years due to the advent of personal lubricants. Similarly, lysed blood, protein, and necrotic debris present a challenge in terms of negative cell transference caused by a clogged filter. In the current study, the authors evaluated the potential use of a modified SurePath reprocessing technique to decrease the frequency of unsatisfactory specimens.
An aliquot for human papillomavirus testing was set aside and the remaining specimen in the ThinPrep vial was submitted for sedimentation. A methanol wash was performed using preservative that was added to the remaining sediment. The specimen was vortexed and a protein wash of Tris-buffered deionized water was added before processing. The specimens were stained using the ThinPrep staining protocol. Both the original specimen and the reprocessed specimens were manually reviewed by 1 cytotechnologist and 2 pathologists to determine specimen adequacy.
A total of 1937 ThinPrep Papanicolaou tests were reprocessed and examined. Of these, 1093 (56%) specimens were satisfactory, 624 of which (57%) demonstrated evidence of a transformation zone component. Epithelial cell abnormalities were identified in 116 specimens (10.6%), including 11 high-grade squamous intraepithelial lesion specimens (1.0%); 5 specimens with a classification of atypical squamous cells, cannot rule out a high-grade lesion (0.5%); 21 low-grade squamous intraepithelial lesion specimens (1.9%); and 79 specimens classified as atypical squamous cells of undetermined significance (7.2%).
The modified SurePath processing technique was adept at handling nearly all of the challenges that biological and environmental conditions (blood, protein, lubricant, etc) present in liquid-based filter preparations. A total of 1093 (56%) of 1937 unsatisfactory ThinPrep Papanicolaou tests were converted to a satisfactory state, resulting in 116 abnormalities (10.6%) being diagnosed that otherwise would have gone undetected
由于个人润滑剂的出现，近年来研究实验室中不满意的妇科标本频率有所增加。同样，溶血、蛋白质和坏死碎片也带来了挑战，因为堵塞的过滤器会导致负细胞转移。在本研究中，作者评估了改良 SurePath 再处理技术的潜在用途，以降低不满意标本的频率。
留出一份用于人乳头瘤病毒检测的标本，将 ThinPrep 小瓶中的剩余标本进行沉淀。用添加到剩余沉淀物中的防腐剂进行甲醇洗涤。将标本涡旋，然后加入 Tris 缓冲去离子水的蛋白质洗涤液，再进行处理。使用 ThinPrep 染色方案对标本进行染色。由 1 位细胞技术专家和 2 位病理学家手动审查原始标本和再处理标本，以确定标本的充分性。
共对 1937 例 ThinPrep 巴氏试验进行了再处理和检查。其中，1093 例（56%）标本满意，其中 624 例（57%）显示有转化区成分。116 例（10.6%）标本发现上皮细胞异常，包括 11 例高级别鳞状上皮内病变标本（1.0%）；5 例分类为非典型鳞状细胞，不能排除高级病变（0.5%）；21 例低级别鳞状上皮内病变标本（1.9%）；和 79 例诊断为意义不明确的非典型鳞状细胞（7.2%）。
改良 SurePath 处理技术能够很好地处理生物和环境条件（血液、蛋白质、润滑剂等）在液基过滤器制备中带来的几乎所有挑战。1937 例不满意的 ThinPrep 巴氏试验中，有 1093 例（56%）转换为满意状态，诊断出 116 例异常（10.6%），否则这些异常将无法被发现。
