Protocol for the processing of bloody cervical specimens: Glacial acetic acid and the Thinprep® Pap test™

Haack, Adriana; O’Brien, Brett; Selvaggi, Suzanne M.

doi:10.1002/dc.20437

Cited by 22 publications

(28 citation statements)

References 7 publications

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“…24 Additional studies have further verified these findings and have shown that ThinPrep reprocessing of bloody cervical specimens with a GAC wash results in fewer unsatisfactory diagnoses and an improved ability to detect epithelial abnormalities that are not present on the unsatisfactory slide prior to reprocessing. [20][21][22]24 Bile duct brushings continue to be an important tool for the detection of pancreatic and bile duct abnormalities. Some of the more common methodologies for processing bile duct brushings include direct smears, cytospins, and ThinPrep technology.…”

Section: Discussionmentioning

confidence: 99%

“…It is well known that reprocessing bloody ThinPrep cervicovaginal specimens with glacial acetic acid wash increases sample adequacy and the detection rate of epithelial abnormalities. [19][20][21][22] However, there is little data describing whether a glacial acetic acid wash improves the slide cellularity and ability to detect malignancy when assessing pancreatobiliary tract brushings. The goal of this study was to determine whether the use of a glacial acetic acid washes prior to slide processing would increase the cellularity and improve the quality of pancreatobiliary tract slides.…”

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confidence: 98%

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Improving cellularity and quality of liquid‐based cytology slides processed from pancreatobiliary tract brushings

Campion

Kipp

Humphrey

et al. 2010

Diagnostic Cytopathology

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Cytology has been reported to have suboptimal sensitivity for detecting pancreatobiliary tract cancer in biliary tract specimens partly as a result of low specimen cellularity and obscuring noncellular components. The goal of this study was to determine if the use of a glacial acetic acid wash prior to processing would increase the cellularity and improve the quality of ThinPrep slides when compared to standard non-gyn ThinPrep processing. Fifty consecutive pancreatobiliary tract specimens containing 20 ml of sample/PreservCyt were divided equally for standard non-gyn ThinPrep (STP) and glacial acetic acid ThinPrep processing (GATP). A manual drop preparation was also performed on residual STP specimen to determine the number of cells left in the vial during STP processing. Twenty-six (52%) specimens had more epithelial cell groupings with the GATP methodology while 19 (38%) had equivalent cellularity with both methods. The STP method produced more epithelial cell groupings in 5 (10%) of the specimens. Of the 26 specimens that had less cells with the STP method, 14 (54%) had > or = 50 cell groupings on the manual drop slide processed from the residual STP specimen suggesting that many cells remain in the vial after STP processing. The GATP method was preferred in 25 (50%) of the specimens, the STP method in 5 (10%), while both methodologies provided similar findings in the remaining 20 (40%) of specimens. The data from this study suggests that the GATP method results in more cells being placed on the slide and was preferred over the STP method in a majority of specimens.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 98%

Improving cellularity and quality of liquid‐based cytology slides processed from pancreatobiliary tract brushings

Campion

Kipp

Humphrey

et al. 2010

Diagnostic Cytopathology

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“…Each method offers ‘clean’ slides with proprietary methods for removing obscuring elements such as blood and inflammation. The ThinPrep method has been noted to have some difficulty in handling bloody samples as the filters become overwhelmed with blood [24,25]. This may be managed by reprocessing following a rinse with acetic acid.…”

Section: Discussionmentioning

confidence: 99%

Performance of the CellSolutions Glucyte Liquid-Based Cytology in Comparison with the ThinPrep and SurePath Methods

Alaghehbandan

2013

Acta Cytologica

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Objective: Glucyte liquid-based cytology (LBC; BestPrep™;CellSolutions, LLC, Greensboro, N.C., USA) is a recently developed method. Its performance was assessed in comparison with ThinPrep (Hologic Inc., Marlborough, Mass., USA) and SurePath (BD Diagnostics, Burlington, N.C., USA) LBC platforms. Study Design: Two cervical samples obtained from each of 331 patients presenting for colposcopy were utilized. The first sample was placed in PreservCyt (Hologic) and the second in SurePath medium, and both were processed in accordance with the manufacturers’ protocols. From the residual SurePath sample, a Glucyte slide was prepared, stained, and read as per the manufacturer’s instructions. Results: Considering a threshold cytologic diagnosis of atypical squamous cells of undetermined significance and using a histologic diagnosis of high-grade cervical intraepithelial neoplasia or worse (CIN 2+) as the end point, there was no significant difference in the sensitivity of Glucyte for the detection of CIN 2+ compared with ThinPrep and SurePath (86.9 vs. 81.9% and 83.7%, respectively). However, Glucyte showed a specificity of 49.2% compared with 61.6% for ThinPrep (p = 0.002) and 66.9% for SurePath (p < 0.001). Considering a threshold cytologic diagnosis of high-grade squamous intraepithelial lesion, Glucyte showed a sensitivity of 40.5% for detecting CIN 2+ compared with 20.5% for ThinPrep (p = 0.003) and 54.7% for SurePath (p = 0.013). The corresponding specificities were 93.8, 99.1, and 94.3%. The rate of unsatisfactory specimens for Glucyte was 1.2% compared with ThinPrep (4.8%) and SurePath (0%). Conclusion: Glucyte appeared to perform reasonably well compared with ThinPrep and SurePath. It offers an alternative to these well recognized LBC systems.

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“…Pretreatment of specimens containing grossly visible blood with glacial acetic acid (GAA) is effective in reducing the unsatisfactory rate. 9,11,12,14,15 However, a subgroup of unsatisfactory specimen with too few squamous cells was identified with presence of microscopic red blood cells (TFSQRBC). In this study, we evaluated the effectiveness of reprocessing unsatisfactory TP specimens of TFSQRBC and the follow-up outcomes of these patients.…”

mentioning

confidence: 98%

“…The most frequent causes of unsatisfactory status in TP specimens are too few squamous cells, followed by obscuration of red blood cells, white blood cells, and mucin. [9][10][11][12][13][14][15] Because TP is a filter-based processing technique, non-squamous cell particles, such as white and red blood cells (RBC) and mucin, compete with squamous cells to adhere on the filter, which results in too few squamous cells on the slide. Pretreatment of specimens containing grossly visible blood with glacial acetic acid (GAA) is effective in reducing the unsatisfactory rate.…”

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confidence: 99%

Restoring satisfactory status in ThinPrep Pap test specimens with too few squamous cells and containing microscopic red blood cells

Pang

Smola

et al. 2008

Diagnostic Cytopathology

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Treatment of specimens that contain excessive blood can effectively reduce the unsatisfactory rate; however, a considerable number of unsatisfactory specimens remain. We evaluated the effectiveness of reprocessing unsatisfactory specimens that had too few squamous cells and contained microscopic red blood cells (TFSQRBC).Out of the 688 unsatisfactory specimens at microscopic screening, 197 (28.63%) were TFSQRBC that were reprocessed by treatment of glacial acetic acid (GAA). Red blood cells were observed clogging the pores in the filter of the ThinPrep device. After reprocessing, 129 (68.48%) yielded a satisfactory diagnosis, which accounted for a reduction of the unsatisfactory rate by 18.25%. In the restored satisfactory specimens, abnormal diagnoses of 1 high-grade squamous intraepithelial lesion (HSIL) (0.78%), 3 atypical glandular cells (AGC) (2.33%), and 13 atypical squamous cells of undetermined significance (ASCUS) (10.08%) were made. The abnormal diagnoses in this group of patients were significantly higher than that in the general population screened.Reprocessing unsatisfactory ThinPrep (TP) specimens of TFSQRBC can reduce the unsatisfactory rate of the TP Pap test significantly and is a cost-effective measure. The initially unsatisfactory specimens are more likely to represent cases with an abnormal diagnosis, which also justifies the effort of reprocessing this group of specimens. Adjustment of the pore size on the ThinPrep filter device may reduce the interference of red blood cells.

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Protocol for the processing of bloody cervical specimens: Glacial acetic acid and the Thinprep® Pap test™

Cited by 22 publications

References 7 publications

Improving cellularity and quality of liquid‐based cytology slides processed from pancreatobiliary tract brushings

Improving cellularity and quality of liquid‐based cytology slides processed from pancreatobiliary tract brushings

Performance of the CellSolutions Glucyte Liquid-Based Cytology in Comparison with the ThinPrep and SurePath Methods

Restoring satisfactory status in ThinPrep Pap test specimens with too few squamous cells and containing microscopic red blood cells

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