Stevens M W, Nespolon W W, Milne A J, Rowland R
Division of Tissue Pathology, Institute of Medical and Veterinary Science, Adelaide, South Australia.
Diagn Cytopathol. 1998 Mar;18(3):236-42. doi: 10.1002/(sici)1097-0339(199803)18:3<236::aid-dc15>3.0.co;2-l.
The aim of the study was to assess the ability of the CytoRich System to prepare optimal gynaecological smears for diagnosis. The diagnostic results obtained from evaluating 1,325 matched slide-pairs, prepared using conventional methods and thin-layer technology, were compared. Cytological material for study was obtained using the combined spatula-cytobrush sampling technique. An assessment of the pitfalls associated with the interpretation of these smears was also undertaken. Diagnostic agreement was achieved in 1,272 of the 1,325 matched slide-pairs (96.0%), and these included 1,172 negative, 50 atypical, 24 low-grade squamous intraepithelial lesion (LSIL), 24 high-grade SIL (HSIL), and two malignancies. A total of 1,309 cases showed the same diagnosis within one diagnostic grade for an agreement of 98.8%. Evaluation of the 53 discordant diagnoses revealed that the conventional smear identified a significantly greater number of abnormal smears than the CytoRich technique (P < .001). It is suspected that the use of the combined spatula-cytobrush sampling technique did not provide adequate residual specimen for CytoRich after conventional smear preparation. This limitation is evidenced by the fact that the CytoRich preparations showed a lower yield of endocervical cells (P < .001) and infectious organisms (P < .001) than was demonstrated on conventional smears. Despite a number of diagnostic pitfalls associated with the interpretation of thin-layer smears, these preparations were easier and faster to screen and showed well-preserved and evenly distributed cells. Thin-layer smears were also characterised by a marked reduction in thick cell groups, air drying artifact, and obscuring inflammation and blood. The results confirm the limitation of the combined spatula-cytobrush technique in these types of comparative studies.
本研究的目的是评估CytoRich系统制备用于诊断的最佳妇科涂片的能力。比较了使用传统方法和薄层技术制备的1325对匹配玻片的诊断结果。研究的细胞学材料采用联合刮匙-细胞刷采样技术获取。还对这些涂片解读过程中存在的问题进行了评估。在1325对匹配玻片中，有1272对（96.0%）达成了诊断一致，其中包括1172例阴性、50例非典型、24例低级别鳞状上皮内病变（LSIL）、24例高级别鳞状上皮内病变（HSIL）和2例恶性肿瘤。共有1309例病例在一个诊断级别内显示相同诊断，一致率为98.8%。对53例不一致诊断的评估显示，传统涂片识别出的异常涂片数量明显多于CytoRich技术（P <.001）。怀疑联合刮匙-细胞刷采样技术在传统涂片制备后未为CytoRich提供足够的剩余标本。CytoRich制片显示宫颈管细胞（P <.001）和感染性生物体（P <.001）的检出率低于传统涂片，这一事实证明了这一局限性。尽管薄层涂片解读存在一些诊断问题，但这些制片更容易、更快地进行筛查，且细胞保存良好、分布均匀。薄层涂片的特点还包括厚细胞团明显减少、空气干燥假象以及炎症和血液遮盖现象减少。结果证实了联合刮匙-细胞刷技术在这类比较研究中的局限性。
