Department of Pathology & Lab Medicine, AIIMS, Kalyani, India.
Department of Pathology, AIIMS, Mangalagiri, India.
Acta Cytol. 2022;66(6):513-523. doi: 10.1159/000526330. Epub 2022 Oct 10.
Carcinoma of the uterine cervix is a major health problem faced by Indian women. Screening techniques like visual inspection with acetic acid, Lugol's iodine, Papanicolaou smear, and human papillomavirus DNA testing have been suggested. Pap smear is a simple, safe, cost-effective, and reliable technique used for screening cervical lesions. Rapid on-site evaluation (ROSE) using the 1% aq. toluidine blue staining method has been less studied in cervical cytology.
Our study was a prospective study done over a period of 2 years. All the cervical cytology smears were reported as per the Bethesda system 2014. Rapid stain using aqueous toluidine blue (1%) and conventional Pap stain was done on the smears received.
We evaluated a total of 1,300 cases, with 97.6% satisfactory samples. The spectrum of cases included 96.3% of negative for malignancy cases (including bacterial vaginosis, trichomonas, candida, and atrophic smears), atypical squamous cell of undetermined significance and atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion in 0.5% cases, low-grade squamous intraepithelial lesion and high-grade intraepithelial lesion in 0.3% cases, squamous cell carcinoma in 0.3% cases, and atypical glandular cells/adenocarcinoma in 0.2% cases. Turnaround time was within 48 h in 77% cases. With rapid stain, our unsatisfactory rate was reduced from 12% to approx. 2.4%.
ROSE has been attempted on routine FNA cytology samples with success. However, the use of ROSE in cervical cytology has not been attempted to date. Lower unsatisfactory rate is an important indicator for the successful implementation of cervical cancer screening technique.
宫颈癌是印度女性面临的主要健康问题。已经提出了一些筛查技术，如醋酸视觉检查、卢戈氏碘液、巴氏涂片和人乳头瘤病毒 DNA 检测。巴氏涂片是一种用于筛查宫颈病变的简单、安全、具有成本效益且可靠的技术。使用 1%甲苯胺蓝染色法的快速现场评估（ROSE）在宫颈细胞学中研究较少。
我们的研究是一项为期 2 年的前瞻性研究。所有宫颈细胞学涂片均按照 2014 年巴氏系统报告。对收到的涂片进行快速染色，使用水溶性甲苯胺蓝（1%）和常规巴氏染色。
我们共评估了 1300 例病例，其中 97.6%的样本令人满意。病例谱包括 96.3%的恶性肿瘤阴性病例（包括细菌性阴道病、滴虫、念珠菌和萎缩性涂片）、非典型鳞状细胞意义不明和非典型鳞状细胞不能排除高级别鳞状上皮内病变占 0.5%、低级别鳞状上皮内病变和高级别上皮内病变占 0.3%、鳞状细胞癌占 0.3%、非典型腺细胞/腺癌占 0.2%。77%的病例在 48 小时内完成周转。使用快速染色后，我们的不满意率从 12%降低到约 2.4%。
已经在常规 FNA 细胞学样本上尝试了 ROSE，并取得了成功。然而，到目前为止，尚未尝试在宫颈细胞学中使用 ROSE。较低的不满意率是成功实施宫颈癌筛查技术的一个重要指标。
