title: Comparative analysis of cervical cytology screening methods and staining protocols for detection rate and accurate interpretation of ASC-H: Data from a high-volume laboratory in Turkey.
abstract: BACKGROUND
  This study evaluated the effectiveness of the ThinPrep(®) Imaging System (TIS) and ThinPrep(®) Pap Stain (TPPS). A comparative analysis was conducted to determine the detection rates of atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H), the ASC:squamous intraepithelial lesion (SIL) ratio, biopsy follow-up for ASC-H in terms of the screening method used (manual screening [MS] vs. TIS screening [TISS]) and the staining protocol (regular Pap stain [RPS] vs. TPPS).
  
  
  METHODS
  This study was performed over two periods. The RPS period included manually screened slides, whereas the TPPS period included TIS + manually screened slides. All data from the study periods were compared using statistical analysis.
  
  
  RESULTS
  The detection rate of ASC-H was significantly higher during the TPPS period than during the RPS period (0.49% vs. 0.23%); this finding is in contrast to the insignificant difference between the screening method periods. The positive predictive value (PPV) of ASC-H cytodiagnosis for cervical intraepithelial neoplasia of grade 2 or more severe histologies was significantly different between manually screened and TIS slides (22.10% vs. 38.55%), in contrast to an insignificant difference between RPS and TPPS periods (37.14% vs. 29.77%).
  
  
  CONCLUSIONS
  Implementation of the TIS did not change the ASC-H detection rates appreciably. However, the new technology improved PPV for ASC-H cytodiagnosis and enabled the detection of true disease. Our laboratory statistics indicate that the TPPS is not a superior staining protocol and did not increase our diagnostic accuracy for ASC-H compared with RPS.
authors.affiliation: Acibadem University, Medical School, Department of Pathology, Istanbul, Turkey.
authors.forename: Aydin
authors.initials: A
authors.lastname: Ozlem
authors.affiliation: Acibadem University, Medical School, Department of Pathology, Istanbul, Turkey.
authors.forename: Ince
authors.initials: I
authors.lastname: Umit
mesh_terms: D065309:Atypical Squamous Cells of the Cervix / Q000166:cytology*; D001706:Biopsy; D019411:Clinical Laboratory Techniques / Q000379:methods*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D013194:Staining and Labeling / Q000379:methods*; D014421:Turkey; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology*; D014626:Vaginal Smears / Q000379:methods; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000473:pathology*
keywords: ASC-H; ThinPrep® Pap stain; ThinPrep® imaging system; cervical cytology; detection rate