Unsatisfactory rates vary between cervical cytology samples prepared using ThinPrep and SurePath platforms: a review and meta-analysis

Abstract

ObjectiveTo compare unsatisfactory rates between the two major liquid-based cytology (LBC) platforms, namely ThinPrep (Hologic) and SurePath (Becton Dickinson).DesignThe authors performed both a systematic review and a meta-analysis. Inclusion criteria were English language, data presented on unsatisfactory rates for either ThinPrep or SurePath, utilising actual patient samples (ie, not laboratory manipulated samples) and no manipulation using acetic acid to increase the satisfactory rate. The authors searched PubMed for articles using the keywords ‘SurePath’ or ‘ThinPrep’ and ‘unsatisfactory’. References of retrieved studies were searched for additional articles. Key researchers in the field were also contacted.Participants and interventionsEligible studies were reviewed for rates of unsatisfactory cervical cytology smears processed on either the ThinPrep or SurePath platforms (compared with a general linear model) or data on unsatisfactory rates for both platforms for the same laboratory and the same patient population (compared with a meta-analysis using a random effects model and pooled RR).Primary Outcome MeasureUnsatisfactory rate of cervical cytology smears.ResultsA total of 1 120 418 cervical cytology smears were reported in 14 different studies using the SurePath platform for an overall unsatisfactory rate (weighted average) of 0.3%. 28 studies reported on 1 148 755 smears prepared using the ThinPrep platform for an overall unsatisfactory rate (weighted average) of 1.3%. The general linear model did not show a difference between LBC platforms when other variables were controlled for; however, the power to detect a difference (0.087) was very low. The meta-analysis performed on four studies where both ThinPrep and SurePath results were reported from the same laboratory showed fewer unsatisfactory tests from the SurePath platform (RR 0.44, 95% CI 0.25 to 0.77, p=0.004).ConclusionsMultiple factors affect LBC unsatisfactory rates. In a meta-analysis, cervical cytology samples prepared on the SurePath platform show significantly fewer unsatisfactory smears than those prepared on the ThinPrep platform.

Diagnostic efficacy of liquid‐based cytology for solid pancreatic lesion samples obtained with endoscopic ultrasound‐guided fine‐needle aspiration: Propensity score‐matched analysis

“…In a meta-analysis of LBC for cervical cytology, the SurePath method had a significantly lower unsatisfactory sample rate than the ThinPrep method because of differences in cellular loss during the collection process. 20 In contrast, in the present study, LBC with the SurePath method had high accuracy and sensitivity.…”

Cervical cancer incidence after normal cytological sample in routine screening using SurePath, ThinPrep, and conventional cytology: population based study

“…Fontaine et al have shown that unsatisfactory rates are significantly lower when using SurePath instead of ThinPrep. 44 Although this was not shown in our previous study, 19 we then found similar results (an odds ratio of 0.74, 0.72 to 0.75) when comparing unsatisfactory rates between SurePath and ThinPrep.…”

A comparison of different human papillomavirus tests in PreservCyt versus SurePath in a referral population—PREDICTORS 4

“…Slide preparation procedures from these media are different [1], [2]. Cells are normally collected using a Cervex-Brush (Rovers Medical Devices, Oss, Netherlands) but in PreservCyt cells are rinsed into the medium, dispersed by vortexing, and transferred to a microscope slide after vacuum filtration.…”