Abstract
Objective: Shinkokai Sendai Medical Clinic changed the procedure of cervical brush cytology from conventional cytology to liquid based cytology (LBC) by the ThinPrep method in April, 2014, in order to improve the accuracy of cervical cancer screening. In this study, we compared the detection rates for conventional cytology and LBC, and reported on the effectiveness of LBC.
Methods: In this this study at our clinic, 20,341 instances of conducting cervical brush cytology by conventional cytology in 2013 (Jan - Dec) and 21,690 instances of conducting it by LBC in 2015 (Jan - Dec) were investigated. We compared the appearance rates of unacceptable specimens and the detection rates of atypical cells. The specimens for LBC were made using the ThinPrep system (autoloader).
Results: The appearance rates of unacceptable specimens were 0.39% for conventional cytology and 0.1% for LBC. The detection rates of atypical cells were given in the following. ASC-US: 0.84% for conventional cytology and 0.77% for LBC, ASC-H: 0.01% for conventional cytology and 0.03% for LBC, LSIL: 0.3% for conventional cytology and 0.6% for LBC, HSIL: 0.22% for conventional cytology and 0.29% for LBC.
Discussion: Compared to conventional cytology, the appearance rate of unacceptable specimens decreased with LBC. For LBC, the advantages are considered to be that it can maintain a high cell recovery rate and that it is not affected by level of skill of the cytotechnologist in the preparation of specimens. However, we consider that the burden of screeners in the microscopy process needs to be further reduced and that training in cell observation is required when switching to LBC. Some disadvantages of LBC are the high initial investment, increased running costs and the complicated pretreatment process.
Conclusion: We consider that the switch to LBC led to a reduction in unacceptable specimens and improvement in the atypical cell detection rate as well as a decrease in the burden of cytotechnologists.
