Comparison of ThinPrep preparations with conventional cervicovaginal smears. Practical considerations.
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.
Bur
M
M
Department of Pathology, Baystate Medical Center, Springfield, Massachusetts 01199, USA.
Knowles
K
K
Pekow
P
P
Corral
O
O
Donovan
J
J
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002584:Cervix Uteri / Q000382:microbiology / Q000473:pathology; D004717:Endometrium / Q000473:pathology; D005260:Female; D016591:Histocytological Preparation Techniques; D006801:Humans; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D009181:Mycoses / Q000175:diagnosis; D012680:Sensitivity and Specificity; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014626:Vaginal Smears / Q000191:economics / Q000379:methods*; D015003:Yeasts / Q000302:isolation & purification