Automated screening of gynecologic cytology: a comparison of results.

OBJECTIVE: To compare the results among conventional gynecologic cytology liquid-based cytology and manual screening and liquid-based cytology automatically screened. STUDY DESIGN: The results of 53,311 cervicovaginal samples, corresponding to 53,311 women of Barcelona, Spain are reviewed. The cases are subdivided into 19,742 conventional cervicovaginal samples; 17,596 liquid-based cytology, manually screened samples; and 15,973 liquid-based automated-screened samples. RESULTS: The automated screening increases the atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesion detection, in respect to liquid-based, manual screening and conventional cytology. In the follow-up, automated screening increases the diagnosis of squamous intraepithelial lesion (low-grade squamous intraepithelial lesion and high-grade squamous intraepithelial lesion). CONCLUSION: Automated screening increases detection of all categories and increases the specificity for high-grade squamous intraepithelial lesion.

Detection of HPV by in situ hybridization in thin-layer (ThinPrep) cervicovaginal samples.

We have studied an automated in situ hybridization (ISH) method as a possible alternative approach for detecting high-risk human papillomavirus (HPV) in monolayer (ThinPrep) cervico-vaginal samples, comparing the results with those obtained by polymerase chain reaction (PCR) using consensus primers and studying the relationship between the ISH staining pattern and the viral integration in HPV 16-positive cases. Eighty atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LSIL) cases were used for our purposes. The patients were monitored through periodic cytologies. ISH with was performed with an automated Ventana System, analysis by PCR was performed with consensus primers and integration of HPV16 was performed by realtime PCR analyzing E2 and E6 genes. Additionally, 27 HSIL cases were also studied to observe the ISH staining patterns. HPV infection was detected by ISH in 21.7% of the ASCUS cases and 55.8% of the LSIL cases. Two distinct staining patterns were observed: multipunctated (MP) and diffuse (DI). In some cases, a mixed pattern (MP + DI) was observed and these cases were considered as MP. The MP pattern increased with the degree of lesion and seemed to have a prognostic value in ASCUS/LSIL cases. The lesion in MP pattern cases persisted throughout the entire study in 77% of cases, whereas in cases with a DI staining pattern, only 41% of them showed persistence of the lesion (p <0.001). No correlation was found between HPV integration and the ISH staining pattern. Given the lower sensitivity and negative predictive value of ISH and its incapacity to demonstrate the integration of high-risk HPV in ASCUS and LSIL cases using liquid-based cytology, we do not recommend this technique for the triage of ASCUS and LSIL cases.

Citología en medio líquido (Thin Prep Pap Test). Un año de experiencia / Liquid-based cytology (Thin Prep Pap Test). A one-year experience

Objetivos: Evaluar nuestra experiencia en citología en medio líquido (Thin Prep Pap Test) durante un año, evaluando el seguimiento de las pacientes diagnosticadas. Comparar estos datos con nuestros resultados obtenidos previamente con citología convencional. Sujetos y métodos: Se realizaron 11.150 citologías cervicovaginales, 8.086 convencionales y 3.064 en medio líquido (Thin Prep Pap Test) y se evaluaron los resultados. Se efectuó un seguimiento de las pacientes y una evaluación de éste en los casos diagnosticados como células escamosas atípicas de significado incierto y como lesión escamosa intraepitelial de bajo grado. Resultados: Los resultados obtenidos demuestran un incremento de los diagnósticos en todas las categorías, si bien sólo de forma estadísticamente significativa si evaluamos los resultados en conjunto, no por separado. En cuanto al seguimiento, los resultados son similares en la citología convencional y en el Thin Prep. Conclusiones: La citología en medio líquido incrementa de forma más o menos significativa la detección de las lesiones cervicales preneoplásicas y, por tanto, mejora el rendimiento de la citología cervicovaginal

Objectives: To describe our experience of liquid-based cytology (Thin Prep Pap Test) over a 1-year period by evaluating the follow-up of patients with an abnormal result and to compare the results obtained with the Thin Prep Pap Test with those previously obtained with conventional cytology. Subjects and methods: The results of 11,150 cervico-vaginal pap tests (8,086 conventional tests and 3,064 liquid-based tests [Thin Prep]) were evaluated. The follow-up of patients with a diagnosis of atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LSIL) was evaluated. Results: Diagnosis of abnormal results in all categories increased, although this increase was only statistically significant when the results were evaluated as a whole. The results of follow-up were similar with both methods. Conclusions: Liquid-based cytology (Thin Prep Pap Test) substantially increases the detection of preneoplastic cervical lesions and consequently improves the yield of cervico-vaginal cytology