Liu Shiguang, Gibbons-Fideler I-Sanna, Tonkovich Dena, Shen Rulong, Li Zaibo
Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio.
J Am Soc Cytopathol. 2019 May-Jun;8(3):128-132. doi: 10.1016/j.jasc.2018.11.003. Epub 2018 Nov 29.
The interpretation of atypical glandular cells (AGCs) remains a major challenge in gynecologic cytopathology using liquid-based cytology (LBC) (ThinPrep and SurePath). The comparison of performance of detecting glandular abnormalities using these 2 methods is lacking. We investigated the reporting rates of AGCs, human papillomavirus (HPV) testing, and histologic follow-up results in ThinPrep (TP) and SurePath (SP) samples.
In our institution, both TP and SP were utilized during the period between January 2014 and June 2017. A retrospective search was conducted to identify patients with AGCs from 58,591 LBCs (27,041 TP and 31,550 SP). Roche (Pleasanton, CA) cobas HPV testing and histologic follow-up results were collected.
The reporting rates of AGCs for TP (0.7%) or SP (0.2%) were within the College of American Pathologists benchmark ranges, but the reporting for TP was significantly greater than that for SP (P < 0.0001). The HPV-positive rates were 26.0% and 19.4% in TP-AGCs and SP-AGCs, respectively, with no statistical significance. A total of 137 (74.9%) TP-AGCs and 54 (74%) SP-AGCs had histologic follow-up. High-grade squamous intraepithelial lesions (HSIL)/squamous cell carcinoma were identified in 8.8% (12 of 137) of TP-AGCs and 13% (7 of 54) of SP-AGCs. Adenocarcinomas including endocervical and endometrial adenocarcinomas were identified in 9.5% (13 of 137) of TP-AGCs and 13% (7 of 54) of SP-AGCs. Together, 18.2% (25 of 137) of TP-AGCs and 25.9% (14 of 54) of SP-AGCs showed either HSIL or carcinoma in histologic follow-up, but with no statistical significance.
TP preparation detected considerably more AGCs than SP preparation. There was no statistical significant difference in HPV-positive rates or histologic follow-up outcomes between TP-detected AGCs and SP-detected AGCs.
在使用液基细胞学(LBC)(ThinPrep和SurePath)的妇科细胞病理学中,非典型腺细胞(AGC)的解读仍然是一项重大挑战。目前缺乏对使用这两种方法检测腺性异常的性能比较。我们调查了ThinPrep(TP)和SurePath(SP)样本中AGC的报告率、人乳头瘤病毒(HPV)检测情况以及组织学随访结果。
在我们机构,2014年1月至2017年6月期间同时使用了TP和SP。进行回顾性检索,从58591例LBC样本(27041例TP和31550例SP)中识别出AGC患者。收集了罗氏(加利福尼亚州普莱森顿)cobas HPV检测结果和组织学随访结果。
TP(0.7%)或SP(0.2%)的AGC报告率在美国病理学家学会的基准范围内,但TP的报告率显著高于SP(P < 0.0001)。TP-AGC和SP-AGC的HPV阳性率分别为26.0%和19.4%,无统计学意义。共有137例(74.9%)TP-AGC和54例(74%)SP-AGC进行了组织学随访。在TP-AGC中,8.8%(137例中的12例)发现高级别鳞状上皮内病变(HSIL)/鳞状细胞癌,在SP-AGC中为13%(54例中的7例)。在TP-AGC中,9.5%(137例中的13例)发现包括宫颈管腺癌和子宫内膜腺癌在内的腺癌,在SP-AGC中为13%(54例中的7例)。总体而言,在组织学随访中,18.2%(137例中的25例)的TP-AGC和25.9%(54例中的14例)的SP-AGC显示HSIL或癌,但无统计学意义。
TP制片检测到的AGC比SP制片多得多。TP检测到的AGC和SP检测到的AGC在HPV阳性率或组织学随访结果方面无统计学显著差异。