Sherman M E, Friedman H B, Busseniers A E, Kelly W F, Carner T C, Saah A J
George Washington University School of Medicine, Washington, DC, USA.
Mod Pathol. 1995 Apr;8(3):270-4.
To investigate the optimal cytologic method for detecting anal intraepithelial neoplasia, the quality and diagnostic findings in 117 conventionally prepared smears and 191 CYTYC Thin-Preps were compared. Samples were obtained with a dacron swab from subjects participating in a longitudinal study of gay or bisexual men known as the Study to Help the AIDS Research Effort (SHARE). The smear takers were general clinicians who had no experience in obtaining cytologic specimens from the anus. Smears were entirely satisfactory in 48 (41.0%) subjects, limited for interpretation in 41 (35.0%), and unsatisfactory in 28 (23.9%). CYTYC preparations were satisfactory in 158 (82.7%) cases and unsatisfactory in 33 (17.3%). Insufficient cellularity was the most frequent reason for both unsatisfactory smears and CYTYC preparations, but air drying artifact was present in nearly every smear. Squamous intraepithelial lesions (SILs) were detected in four (4.5%) smears compared to 53 (33.6%) CYTYC slides. The detection of SIL correlated with the presence of glandular and metaplastic cells in CYTYC preparations, but this association disappeared if only satisfactory specimens were considered. In conclusion, CYTYC Thin-Preps were satisfactory twice as often as conventional smears (P < 0.005) and detected nearly eight times as many SILs (P < 0.005).
为研究检测肛管上皮内瘤变的最佳细胞学方法，对117份传统涂片和191份CYTYC液基薄层制片的质量及诊断结果进行了比较。样本由参与一项名为“助力艾滋病研究项目（SHARE）”的男同性恋或双性恋男性纵向研究的受试者用涤纶拭子采集。涂片采集者为普通临床医生，他们在获取肛门细胞学标本方面没有经验。在48名（41.0%）受试者中涂片完全满意，41名（35.0%）受试者的涂片因细胞数量有限难以判读，28名（23.9%）受试者的涂片不满意。CYTYC制片在158例（82.7%）中满意，33例（17.3%）不满意。细胞数量不足是涂片和CYTYC制片不满意的最常见原因，但几乎每份涂片都存在空气干燥假象。在4份（4.5%）涂片中检测到鳞状上皮内病变（SIL），而在53份（33.6%）CYTYC载玻片中检测到。CYTYC制片中SIL的检测与腺细胞和化生细胞的存在相关，但如果仅考虑满意的标本，这种关联就消失了。总之，CYTYC液基薄层制片的满意度是传统涂片的两倍（P<0.005），检测到的SIL数量几乎是传统涂片的八倍（P<0.005）。
