Rabiu Kabiru Afolarin, Nzeribe-Abangwu Ugochi O, Akinlusi Fatimat Motunrayo, Alausa Taiwo Ganiyat, Durojaiye Idayat Adejumoke
Department of Obstetrics and Gynaecology, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria.
Department of Obstetrics and Gynaecology, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria.
Niger Med J. 2019 May-Jun;60(3):126-132. doi: 10.4103/nmj.NMJ_49_19.
The Papanicolaou (Pap) smear is a standard test for cervical cancer screening; however, the most important challenge is high false-negative results due to inadequate sampling using the Ayres spatula. The cytobrush has been used in combination with the Ayres spatula (cytobrush-spatula) in an attempt to improve the quality of smears with additional costs. The aim of this study was to compare the Pap smear quality with the anatomical spatula (with extended tip) and the cytobrush-spatula.
This was a prospective single-bind clinical trial. One hundred and ten sexually active women aged between 22 and 65 years were randomized into groups, each having two smears at the same time: one with a cytobrush-spatula and another with an anatomical spatula. Fifty-five patients were randomized to have the anatomical spatula first to obtain their smears and 55 were randomized to have the cytobrush-spatula first to obtain their smears. Slides were assessed by a pathologist.
There was no significant difference in the quality of the smears using the two devices with respect to cellular adequacy ( = 0.3532), absent blood staining ( = 0.7766), presence of endocervical cells ( = 0.3502), and evidence of transformation zone sampling using the Bethesda criteria (0.4028). Kappa analysis shows moderate inter-rater agreement between the two devices by ability to show evidence of transformation zone using British Society for Clinical Cytology and Bethesda criteria.
There was no significant difference in the quality of smears obtained using the two different methods. The anatomical spatula can be used as a single device in conventional cytology in place of the cytobrush-spatula with the aim of improving the quality of smears without necessarily increasing the cost.
巴氏涂片是宫颈癌筛查的标准检测方法；然而，最重要的挑战是使用艾尔斯刮匙取样不足导致的高假阴性结果。细胞刷已与艾尔斯刮匙联合使用（细胞刷 - 刮匙），试图在增加成本的情况下提高涂片质量。本研究的目的是比较使用解剖学刮匙（带延长尖端）和细胞刷 - 刮匙的巴氏涂片质量。
这是一项前瞻性单盲临床试验。110名年龄在22至65岁之间的性活跃女性被随机分组，每组同时进行两次涂片：一次使用细胞刷 - 刮匙，另一次使用解剖学刮匙。55名患者被随机分配先使用解剖学刮匙获取涂片，55名患者被随机分配先使用细胞刷 - 刮匙获取涂片。玻片由病理学家评估。
就细胞充足率（ = 0.3532）、无血染（ = 0.7766）、宫颈管细胞存在情况（ = 0.3502）以及使用贝塞斯达标准进行转化区取样的证据（0.4028）而言，使用两种器械获得的涂片质量没有显著差异。kappa分析显示，根据英国临床细胞学学会和贝塞斯达标准，两种器械在显示转化区证据的能力方面具有中等程度的评分者间一致性。
使用两种不同方法获得的涂片质量没有显著差异。解剖学刮匙可作为传统细胞学中的单一器械替代细胞刷 - 刮匙，目的是提高涂片质量而不一定增加成本。
