Comparison of Unsatisfactory Samples from Conventional Smear versus Liquid-Based Cytology in Uterine Cervical Cancer Screening Test

Abstract

BackgroundCervical cytology for uterine cervical cancer screening has transitioned from conventional smear (CS) to liquid-based cytology (LBC), which has many advantages. The aim of this study was to compare the proportion of unsatisfactory specimens from CS versus LBC at multiple institutions including general hospitals and commercial laboratories. MethodsEach participating institution provided a minimum of 500 Papanicolaou (Pap) test results for analysis. Pap tests were classified according to the participating institution (commercial laboratory or general hospital) and the processing method (CS, ThinPrep, SurePath, or CellPrep). The causes of unsatisfactory results were classified as technical problems, scant cellularity, or complete obscuring factors. ResultsA total of 38,956 Pap test results from eight general hospitals and three commercial laboratories were analyzed. The mean unsatisfactory rate of LBC was significantly lower than that of CS (1.26% and 3.31%, p = .018). In the LBC method, samples from general hospitals had lower unsatisfactory rates than those from commercial laboratories (0.65% vs 2.89%, p = .006). The reasons for unsatisfactory results were heterogeneous in CS. On the other hand, 66.2% of unsatisfactory results in LBC were due to the scant cellularity. ConclusionsUnsatisfactory rate of cervical cancer screening test results varies according to the institution and the processing method. LBC has a significantly lower unsatisfactory rate than CS.

Follow‐up with histopathology and HPV testing on LSIL cytology in China’s largest academic woman’s hospital

“…Although conventional cytology has been replaced by LBC testing as the primary test method in the majority of developed countries within the last 10 to 15 years, it remains an option for women in China. Numerous earlier studies have compared the performance of LBC with conventional cytology and demonstrated the advantages of LBC, including increased sensitivity, lower rates of unsatisfactory slides, and the ability to perform HPV DNA testing on the same specimen . However, others also addressed the issue of decreased specificity with LBC and the cost of follow‐up .…”

Reducing DNA damage by formaldehyde in liquid‐based cytology preservation solutions to enable the molecular testing of lung cancer specimens

“…Recently, liquid‐based cytology (LBC) has become a useful cytopathological method for diagnosis. In the early 2000s, the LBC method began to be used widely, especially in gynecological malignancies . LBC has advantages in that uniform specimens can be prepared, drying is avoided, and there is less sample loss.…”

“…LBC has advantages in that uniform specimens can be prepared, drying is avoided, and there is less sample loss. Consequently, fewer unsatisfactory specimens are produced . Therefore, the use of LBC specimens for the clinical diagnosis of respiratory malignancies also is expected …”

“…In the early 2000s, the LBC method began to be used widely, especially in gynecological malignancies. [1][2][3][4][5][6][7][8][9][10][11] LBC has advantages in that uniform specimens can be prepared, drying is avoided, and there is less sample loss. Consequently, fewer unsatisfactory specimens are produced.…”

“…Consequently, fewer unsatisfactory specimens are produced. [5][6][7][8][9][10] Therefore, the use of LBC specimens for the clinical diagnosis of respiratory malignancies also is expected. 12 Lung cancer has many histological types, and a histological diagnosis of the disease is very important for informing therapeutic strategies.…”