title: Increasing the sensitivity of endocervical curettings by performing ThinPrep® Pap on transport container fluid: is diagnostic material going down the drain?
abstract: OBJECTIVE
  The sensitivity of endocervical curettage (ECC) can be suboptimal because of limited epithelial tissue. The false-negative rate for ECC in patients with cervical intraepithelial neoplasia involving the endocervical canal has been reported to be 45%. ECC samples are transported to pathology in formalin- or saline-filled containers; this fluid is discarded after the specimen has been submitted. We evaluated the utility of performing liquid-based cytological preparations from ECC transport container fluid as a way to increase the sensitivity of ECC specimens.
  
  
  METHODS
  Consecutive ECC specimens received at one of the two participating institutions were selected prospectively. A surgical pathology mesh bag was placed over a ThinPrep(®) CytoLyt(®) solution container, and the specimen was filtered through the bag, collecting the transport fluid in the container. The CytoLyt(®) was processed to obtain a container fluid ThinPrep(®) (CF-TP) liquid-based Papanicolaou (Pap) slide. The CF-TP slides were reviewed and the findings were compared with those from the ECC and follow-up specimens.
  
  
  RESULTS
  The cohort included 53 patients. Discrepancies between CF-TP and ECC were seen in 14 of the 53 patients (26%); a more significant lesion was identified in CF-TP relative to ECC in 13 of these cases. CF-TP diagnosis was confirmed in eight of 11 cases with histological follow-up. A positive CF-TP result was confirmed by histology in six of nine cases with negative ECC.
  
  
  CONCLUSIONS
  Combining the pathological evaluation of ECC specimens with liquid-based cytology performed on the transport container fluid can increase the diagnostic sensitivity of the ECC procedure for the detection of cervical lesions.
authors.affiliation: Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: R R
authors.initials: RR
authors.lastname: Lastra
authors.affiliation: Department of Pathology and Laboratory Medicine, Pennsylvania Hospital, Philadelphia, PA, USA.
authors.forename: S E
authors.initials: SE
authors.lastname: Meykler
authors.affiliation: Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Z W
authors.initials: ZW
authors.lastname: Baloch
authors.affiliation: Department of Pathology and Laboratory Medicine, Pennsylvania Hospital, Philadelphia, PA, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Barroeta
mesh_terms: D000328:Adult; D000368:Aged; D002584:Cervix Uteri / Q000473:pathology* / Q000601:surgery; D003475:Curettage; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test / Q000379:methods*; D012680:Sensitivity and Specificity; D013048:Specimen Handling; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000473:pathology*
keywords: Pap tests; colposcopy; endocervical curettage; liquid-based cytology; sensitivity