title: Evaluation of the CytoRich technique for cervical smears.
abstract: 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.
authors.affiliation: Division of Tissue Pathology, Institute of Medical and Veterinary Science, Adelaide, South Australia.
authors.forename: M W
authors.initials: MW
authors.lastname: Stevens
authors.forename: W W
authors.initials: WW
authors.lastname: Nespolon
authors.forename: A J
authors.initials: AJ
authors.lastname: Milne
authors.forename: R
authors.initials: R
authors.lastname: Rowland
mesh_terms: D002278:Carcinoma in Situ / Q000175:diagnosis*; D002584:Cervix Uteri / Q000473:pathology*; D019411:Clinical Laboratory Techniques; D004311:Double-Blind Method; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation; D015203:Reproducibility of Results; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears / Q000379:methods*