title: Restoring satisfactory status in ThinPrep Pap test specimens with too few squamous cells and containing microscopic red blood cells.
abstract: Treatment of specimens that contain excessive blood can effectively reduce the unsatisfactory rate; however, a considerable number of unsatisfactory specimens remain. We evaluated the effectiveness of reprocessing unsatisfactory specimens that had too few squamous cells and contained microscopic red blood cells (TFSQRBC).Out of the 688 unsatisfactory specimens at microscopic screening, 197 (28.63%) were TFSQRBC that were reprocessed by treatment of glacial acetic acid (GAA). Red blood cells were observed clogging the pores in the filter of the ThinPrep device. After reprocessing, 129 (68.48%) yielded a satisfactory diagnosis, which accounted for a reduction of the unsatisfactory rate by 18.25%. In the restored satisfactory specimens, abnormal diagnoses of 1 high-grade squamous intraepithelial lesion (HSIL) (0.78%), 3 atypical glandular cells (AGC) (2.33%), and 13 atypical squamous cells of undetermined significance (ASCUS) (10.08%) were made. The abnormal diagnoses in this group of patients were significantly higher than that in the general population screened.Reprocessing unsatisfactory ThinPrep (TP) specimens of TFSQRBC can reduce the unsatisfactory rate of the TP Pap test significantly and is a cost-effective measure. The initially unsatisfactory specimens are more likely to represent cases with an abnormal diagnosis, which also justifies the effort of reprocessing this group of specimens. Adjustment of the pore size on the ThinPrep filter device may reduce the interference of red blood cells.
authors.affiliation: Department of Pathology, University of Michigan, Ann Arbor, Michigan 48109, USA. ypang@umich.edu
authors.forename: Yijun
authors.initials: Y
authors.lastname: Pang
authors.forename: Brian
authors.initials: B
authors.lastname: Smola
authors.forename: Robert T
authors.initials: RT
authors.lastname: Pu
authors.forename: Claire W
authors.initials: CW
authors.lastname: Michael
mesh_terms: D003362:Cost-Benefit Analysis; D004847:Epithelial Cells / Q000473:pathology*; D004912:Erythrocytes / Q000473:pathology*; D005260:Female; D016591:Histocytological Preparation Techniques / Q000191:economics / Q000592:standards*; D006801:Humans; D008867:Microtomy; D015203:Reproducibility of Results; D013048:Specimen Handling; D014626:Vaginal Smears / Q000191:economics / Q000379:methods* / Q000592:standards