Bur M, Knowles K, Pekow P, Corral O, Donovan J
Department of Pathology, Baystate Medical Center, Springfield, Massachusetts 01199, USA.
Acta Cytol. 1995 Jul-Aug;39(4):631-42.
This study compared cytologic quality, diagnostic accuracy, detection of endocervical and endometrial cells and yeast, screening times and costs for 128 ThinPrep preparations (TP) to the corresponding conventional cervicovaginal cytologic smears (CCVS). Final diagnoses agreed in 114 (89%) cases. There were four discrepancies between atypical squamous cells of undetermined significance and low grade squamous intraepithelial lesion. The number of abnormal cells was lower in TP than in CCVS. Endocervical and endometrial cells were detected less frequently in TP than in CCVS. Yeast forms were seen rarely but were identified in both CCVS and TP. Inflammation and blood were less prominent on TP. While some CCVS showed artifacts related to fixation, cell preservation was optimal in all TP. Screening times were significantly shorter for TP than for CCVS. The combined cost of reagents, preparation and screening for an average TP was $1.78 higher than for a CCVS. We conclude that the use of TP for cervicovaginal smears reduces screening time and produces better cytologic preparations. However, cost-benefit analyses, readjustments in criteria for diagnosis of dysplasia and improvements in the recovery of glandular cells may be necessary before this method is used instead of CCVS.
本研究比较了128份ThinPrep制片（TP）与相应的传统宫颈阴道细胞学涂片（CCVS）在细胞学质量、诊断准确性、宫颈管和子宫内膜细胞及酵母菌的检测、筛查时间和成本等方面的差异。最终诊断在114例（89%）病例中达成一致。意义不明确的非典型鳞状细胞与低级别鳞状上皮内病变之间存在4例差异。TP中异常细胞数量低于CCVS。TP中宫颈管和子宫内膜细胞的检出频率低于CCVS。酵母菌形态很少见，但在CCVS和TP中均有发现。TP上炎症和血液不那么明显。虽然一些CCVS显示出与固定相关的人为假象，但所有TP中的细胞保存都很理想。TP的筛查时间明显短于CCVS。平均每份TP的试剂、制片和筛查总成本比CCVS高1.78美元。我们得出结论，使用TP进行宫颈阴道涂片可缩短筛查时间并产生更好的细胞学制片。然而，在使用该方法替代CCVS之前，可能需要进行成本效益分析、调整发育异常的诊断标准以及改进腺细胞的回收率。
