Comparison of ThinPrep and conventional smears in detecting carcinoma in bile duct brushings

Abstract

BACKGROUND.Bile duct brushing cytology is a common procedure for the exclusion of adenocarcinoma in the bile duct. The authors evaluated the use of ThinPrep (TP) to determine whether the information obtained is equivalent to that found with conventional smear cytology (CS). METHODS.Thirty-eight prospectively collected endoscope retrograde cholangiopancreatography-guided bile duct brushing samples were split in the following manner. First, two to four CS were prepared and immediately spray-fixed or wet-fixed. Second, the remaining sample was rinsed in PreservCyt™ (Cytyc Corp., Boxborough, MA). In the laboratory, one TP slide was prepared from each sample.TP and CS were stained by routine Papanicolaou stain. For the current study, TP and CS were reviewed independently by two cytopathologists. The diagnoses made by the two methods were compared with the final histology. RESULTS.The cytologic diagnoses for both TP and CS were categorized into five main groups: 1) unsatisfactory, 2) negative, 3) reactive, 4) suspicious for malignancy, and 5) malignant. The diagnoses on the 38 TP bile duct brushings and CS were categorized as follows: 1) unsatisfactory-2, 4; 2) negative-7, 4; 3) reactive-10, 14; 4) suspicious for malignancy-9, 9; and 5) malignant-10, 7, respectively. Histologic follow-up was available in 14 cases (reactive-4, suspicious for malignancy-1, and malignant-9). The sensitivity was 77% for TP and 66% for CS. The specificity was 100% for both methods.CONCLUSIONS. The two methods described in the current study detected equivalent disease on bile duct brushings. TP was found to provide better preservation and cytologic detail. However, the diagnostic criteria may require modification. Cancer (Cancer Cytopathol)

Thin-layer liquid-based preparation of non-gynaecological exfoliative and fine-needle aspiration biopsy cytology

“…TLC can be easily applied to the material collected (including brushings) from the biliary and pancreatic ducts and the diagnostic results are quite promising. The series of Siddiqui et al 11 and Duggan et al 12 show that the ThinPrep applied to brushings during ERCP decreases the rate of inadequate diagnoses (including those related to air drying or mechanical artefacts) even when the 'split-sample' method is used. On the other hand, the liquid fixation may induce a relative cellular shrinkage which is responsible for some false-positive diagnoses.…”

Management of Pancreatic Masses

“…75 The overall diagnostic sensitivity and specificity were 59.8% and 98.1% in a series of 406 patients with pancreato-biliary strictures, and these improved from 44.3% and 96.4%, respectively, in the initial one third to 70.7% and 97.1%, respectively, in the final third of cases. 75 The overall diagnostic sensitivity and specificity were 59.8% and 98.1% in a series of 406 patients with pancreato-biliary strictures, and these improved from 44.3% and 96.4%, respectively, in the initial one third to 70.7% and 97.1%, respectively, in the final third of cases.…”

Comparison of ThinPrep UroCyte and cytospin slide preparations for gastrointestinal specimens: Evaluation and retrospective performance review

“…18 A recent review summarized various studies that compared liquid-based with cytocentrifugation or other conventional slide preparations, including associated differences in morphology resulting from the different methods of preparation. 19 Numerous studies have reported diagnostic sensitivities using ThinPrep Non-Gyn filters for GI specimens, 5,10,[12][13]20 with ThinPrep showing improved sensitivity for malignancy over other methods such as cytocentrifugation or conventional smear preparations. 5,10,12 Three large studies reported similar sensitivities of 51-53% for ThinPrep slides, whereas a lower sensitivity of 15% for bile duct cytology using ThinPrep slides has been reported as part of dual cytology/FISH testing for GI specimens.…”

“…Slides prepared using LBC methodologies may offer improved cel-lularity and cellular preservation. [7][8][9] Several studies have addressed the morphology and performance of ThinPrep Non-Gyn filter slide preparations in GI cytology, [10][11][12][13][14][15] but there have been no prior reports on the use of the Thin-Prep UroCyte filter for nonurine specimens. A study evaluating UroCyte filter slide preparations for UroVysion FISH using urine specimens has been reported.…”