Comparison of diagnostic accuracy between CellprepPlus® and ThinPrep® liquid‐based preparations in effusion cytology

Abstract

Liquid-based cytology (LBC) is being increasingly used for body fluid specimens and has improved diagnostic accuracy when compared to conventional smears. We compared the diagnostic accuracy and cellular morphologic features between CellprepPlus® LBC and ThinPrep® LBC in effusion cytology. One hundred and eighty body fluid specimens, consisting of 119 pleural fluid specimens, 59 peritoneal fluid specimens, and 2 pericardial fluid specimens, were obtained from 166 patients. Equal volumes of body fluid from each specimen were used in the CellprepPlus® and ThinPrep® preparations. Sensitivity, specificity, and positive and negative predictive values were evaluated. In addition, we selected 16 specimens from patients with metastatic adenocarcinoma, confirmed them by both LBC preparations, and measured the size of the nucleus in the tumor cells in these specimens. The sensitivity of the CellprepPlus® and ThinPrep® methods was 73.1% and 50.0%, respectively. The specificity and positive predictive values were 100% for both LBC methods, and the negative predictive values of the CellprepPlus® and ThinPrep® methods were 90.9% and 83.3%, respectively. The average nuclear size of the tumor cells was calculated as 20.87 μm using the CellprepPlus® method and 15.08 μm using the ThinPrep® method (P < 0.05). The CellprepPlus® method provided better diagnostic accuracy of effusion cytology compared to the ThinPrep® method and revealed the characteristic morphological features of tumor cells, including large and hypochromatic nuclei, prominent nucleoli, distinct nuclear membranes, and high cellularity.

The Role of Liquid Based Cytology and Ancillary Techniques in the Peritoneal Washing Analysis: Our Institutional Experience

“…Several papers highlighted the improvements in the sensitivity and specificity of peritoneal washings from gynecological and gastro-intestinal cancers using a wide range of markers to define either a primary or a metastatic origin [20–23]. This adjunct seems to be empowered by the use of a panel of immunomarkers that is more easily applied when LBC is adopted [1–4]. The well-known controversial data concerning the efficacy of LBC are counter-parted by the reliable and feasible yields, including cost-effectiveness; time-sparing and easy application of ancillary techniques up to 3–4 months on the LBC stored material [1–5, 24–26, 30, 32, 34].…”

“…This adjunct seems to be empowered by the use of a panel of immunomarkers that is more easily applied when LBC is adopted [1–4]. The well-known controversial data concerning the efficacy of LBC are counter-parted by the reliable and feasible yields, including cost-effectiveness; time-sparing and easy application of ancillary techniques up to 3–4 months on the LBC stored material [1–5, 24–26, 30, 32, 34]. Besides, an article by Hoda evaluated all the known literature for the morphological aspects of LBC in non-gynecological cytology as well as the accuracy of both TP and SurePath in the interpretations of effusions in alignment with the data from Ylagan et al [3, 17].…”

“…The role of the analysis of peritoneal washing, mostly employed in gynecological diseases, has not been completely defined in its entire diagnostic and prognostic potentialities [1–5]. …”

“…A general evaluation of body effusions by Lee et al underlined that one-fifth of body serous membrane effusions per year are malignant with about 50% as metastatic adenocarcinomas followed by pulmonary large cell carcinomas and lymphomas/leukaemia (about 15% each) [1–3]. It stands to reason that the diagnostic detection of malignant cells in effusions serves as a mainstream diagnostic tool and a predictor of the spread of diseases with impact on prognosis and upstages prognostic morbidity.…”

“…It stands to reason that the diagnostic detection of malignant cells in effusions serves as a mainstream diagnostic tool and a predictor of the spread of diseases with impact on prognosis and upstages prognostic morbidity. Hence, the routinely cytological preparations represent a simple, safe and cost-effective method limiting the amount of issues associated with biopsy procedures, which often result in non-diagnostic histological results [1–5]. Specifically, Creasman and Rutledge, reported that the majority of positive peritoneal washings are associated with gynecological cancers (the highest percentage of positive washings was in ovarian followed by endometrial and rarely cervical cancers); so that their cytological evaluation may stratify patients in either the initial diagnosis of symptomatic gynecological cancers or the management and survival [6].…”