• 대한세포병리학회지
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• 제15권2호
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• pp.86-91
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• 2004

Liquid-Based Uterine Cervicovaginal Cytology is known to be a sensitive and effective screening method for cervical neoplasm $MonoPrep^{TM},\;ThinPrep^{TM},\;and\;SurePath^{TM}$ methods have been recently used as Liquid-Based Uterine Cervicovaginal Cytology techniques, and the $SurePath^{TM}$ method has been used in Sung-Yoon Reference Laboratory since 2003. The goal of Liquid-Based Uterine Cervicovaginal Cytology is to separate cervical epithelial cells from non-target cells, red blood cells and neutrophils. This report describes a study which evaluated cellularity, stainablilty, and cellular changes of epithelial cels in samples processed using a manual technique as compared to samples processed using $SurePath^{TM}$ automated method. The samples processed by means of a manual technique contained a cellularity of epithelial cells similar to that of the samples processed using the $SurePath^{TM}$ automated method. In addition, we compared variable density gradient reagents, including dextran, dextrose, and sucrose, to $SurePath^{TM}$ gradient media in order to evaluate cell fractionation and cellularity of epithelial cells. 10% dextran of gradient media shows good fractionation. The samples processed with 10% dextran demonstrated sufficient cellularity of epithelial cells and shows the fewest cellular changes. In conclusion, using a manual technique on these samples is easier to read than those results obtained using the $SurePath^{TM}$ automated method.

• 대한세포병리학회지
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• 제16권1호
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• pp.10-17
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• 2005

This study was performed to compare manual liquid-based preparation with conventional Papanicolaou tests in view of the cytologic diagnoses and specimen adequacy. The specimens of 5,979 women from 33 local clinics and 1 general hospital were prepared by both manual liquid-based preparation and conventional Papanicolaou test. The cytologic diagnoses and specimen adequacy were evaluated in Department of Fathology in Kyoungpook National University School of Medicine. A conventional Papanicolaou test was always prepared first, after that residual material on the sampling device was rinsed into a liquid preservative, and then thin-layer slides were prepared using manual method of liquid-based cervicovaginal cytology. Conventional and liquid-based slides were read independently, and cytologic diagnoses and specimen adequacy were classified using the Bethesda System. Of the cases, 5,763 (96.3%,) had the same interpretation, and there was no significant diagnostic difference in 5,853 (97.8%) cases. When evaluating cases with more than one diagnostic class difference, the manual liquid-based preparation demonstrated a statistically significant overall improvement (2.1%) in the detection of squamous intraepithelial lesion and invasive cancer. Using manual method of liquid-based preparation, there was 14.1%, reduction in unsatisfactory slides through excellent cellular presentation. In conclusion, the manual liquid-based preparation produces standardized quality, superior sensitivity and improved adequacy as compared to the conventional method.

• Asian Pacific Journal of Cancer Prevention
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• 제16권2호
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• pp.579-583
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• 2015

This study was conducted on female patients with different gynecological problems attending the gynecology out-patient departments of two tertiary care hospitals in Peshawar city of Khyber Pakhtunkhwa, Pakistan between August 2012 and October 2013. The 200 patients had an age range of 21-65 years. Smears were taken with cervical brushes and preserved in preservative medium and processed for manual liquid based cytology (MLBC) for Pap staining. Out of 200 collected samples, 30 samples were found inadequate on cytology. Of the remaining 170 samples, 164 (96.47%) were normal, 5 (2.94%) were of atypical squamous cells of unknown significance (ASCUS) and 1 (0.6%) was of high grade squamous intraepithelial lesion (HSIL). On PCR all the samples were positive for beta globin gene fragment including those reported inadequate on cytology. Out of the 5 ASCUS samples, 2 samples were positive for HPV, one each for HPV 16 and HPV 18, and the rest of the 3 samples were negative for HPV DNA. The 1 sample of HSIL was positive for HPV 16 on PCR. Out of 164 normal samples on cytology, only 1 sample was HPV 16 positive. So overall, 4 (2%) out of 200 samples were positive for HPV DNA, where 3 were HPV 16 (1.5%), and 1 was HPV 18 (0.5%) positive, and thus the ratio of infection with of HPV 16 to HPV 18 was 3:1 in the general population. In conclusion, PCR based HPV detection is a more sensitive method for screening of HPV infection than cytology as sample inadequacy does not affect the results. However, it can be combined with cytology methods in a HPV positive female to achieve the maximum results.

• 대한세포병리학회지
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• 제19권1호
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• pp.34-40
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• 2008

Fine needle aspiration (FNA) cytology of the breast is a useful method for diagnosing breast lesions. Yet making the definite diagnosis with performing FNA is limited by some problems, such as the low cellularity, the poor preservation and the obscuring background. Recent studies have found that liquid-based cytology solves such problems, but it is an expensive method and it is limited by the loss of the background information. The purpose of this study is to compare the Liqui-$PREP^{TM}$, a new manual liquid-based method of cytology, and the conventional smears for analyzing breast FNA cytology materials. A total of 31 randomized FNA specimens of breast were studied. In each case, both the conventional smears and the Liqui-$PREP^{TM}$ method were performed, and the smears were evaluated for cellularity, cellular preservation, the background, the cytologic features and the architectural arrangement. The cellularity and architectural arrangement were equal for both preparations. The Liqui-$PREP^{TM}$ specimens showed better cellular preservation, loss of the obscuring background, no overlapping of cells and a smaller area to screen compared with the conventional smears. Moreover, it has the potential advantages of being able to use the remaining specimens for immunohistochemical study and ploidy analysis, and it can reduce the costs for preparation compared with the other liquid-based methods of cytology. But some background information is lost in the Liqui-$PREP^{TM}$ specimens, the same as the other liquid-based methods of cytology. In conclusion, the Liqui-$PREP^{TM}$ and conventional smears showed good correlation, but they have their respective advantages and disadvantages. These results suggest that Liqui-$PREP^{TM}$ can contribute to making the accurate diagnosis with performing breast FNA cytology when it is used along with other methods.

• 대한세포병리학회지
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• 제15권1호
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• pp.33-39
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• 2004

We compared the diagnostic accuracy of liquid-based cervicovaginal cytology using $MonoPrep2^{TM}$ system (Monogen, Herndon, Virginia, USA), a manual system based on membrane filtration method, with conventional Pap smear. Study population included 92 patients visiting the gynecologic department under the suspicion of uterine cervical disease. In thirty of them, surgical biopsy was performed. $MonoPrep2^{TM}$ system provided well-preserved monolayer specimen with good nuclear morphology. However, about 19% of specimens were inadequate to interpret due to low cellularity. The detection rate of abnormal cells more than ASCUS (atypical squamous cells of unknown significance) was 23.9% and higher than 19.4 % of conventional Pap smear. Diagnostic concordance rate with conventional Pap smear was 81%, and severe discordance rate influencing on the management of patient was 7.6 %. Among these seven cases, $MonoPrep2^{TM}$ system was more diagnostic only in four. In comparison with histology, the sensitivity of diagnosis of $MonoPrep2^{TM}$ system was 78.9% and slightly higher than 73.5% of conventional Pap smear. However, the specificity was 81.1% and lower than 90.9% of Pap smear. In conclusion, $MonoPrep2^{TM}$ system provided diagnostic accuracies similar to the conventional Pap smear. The inexpertness of slide preparation and the low cellularity were considered to endow a limitation in more accurate evaluation.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.975-981
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• 2014

Cervical cancer is an issue of foremost importance globally, specifically affecting the developing nations. Significant advances have taken place with regard to diagnosis of cervical cancer, especially with screening. Appropriate screening measures can thus reduce the incidence of cervical cancer. The most desirable screening technique should be less invasive, easy to perform, cost-effective and cover a wide range of diagnostic icons. Manual liquid based cytology (MLBC) can be considered as one of the suitable technique for screening with the above-mentioned benefits. The aim of the current study was to compare two cervical screening techniques on the basis of different morphological parameters and staining parameters by using modified acetic acid Pap staining to see the possibility of reducing time economy involved in conventional Pap staining (CPS). The study was conducted on a total 88 cases and all were analyzed with both MLBC and CPS. Forty eight cases that were regarded as satisfactory on the basis of Bethesda system by both methods were further recruited for investigation. Their morphological parameters and staining quality were compared and scored according to a scoring system defined in the study. Quality indices was calculated for both staining procedures and smear techniques.

• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.3645-3651
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• 2012

Conventional pap smear (CPS) examination has been the mainstay for early detection of cervical cancer. However, its widespread use has not been possible due to the inherent limitations, like presence of obscuring blood and inflammation, reducing its sensitivity considerably. Automated methods in use in developed countries may not be affordable in the developing countries due to paucity of resources. On the other hand, manual liquid based cytology (MLBC) is a technique that is cost effective and improves detection of precursor lesions and specimen adequacy. Therefore the aim of the study was to compare the utility of MLBC with that of CPS in cervical cancer screening. A prospective study of 100 cases through MLBC and CPS was conducted from October 2009 to July 2010, in a Medical College in India, by two independent pathologists and correlated with histopathology (22 cases). Morphological features as seen through MLBC and CPS were compared. Subsequently, all the cases were grouped based on cytological diagnosis according to two methods into 10 groups and a subjective comparison was made. In order to compare the validity of MLBC with CPS in case of major diagnoses, sensitivity and specificity of the two methods were estimated considering histological examination as the gold standard. Increased detection rate with MLBC was 150%. The concordance rate by LBC/histopathology v/s CPS/histopathology was also improved (86% vs 77%) The percentage agreement by the two methods was 68%. MLBC was more sensitive in diagnosis of LSIL and more specific in the diagnosis of inflammation. Thus, MLBC was found to be better than CPS in diagnosis of precursor lesions. It provided better morphology with increased detection of abnormalities and preservation of specimen for cell block and ancillary studies like immunocytochemistry and HPV detection. Therefore, it can be used as alternative strategy for cervical cancer prevention in limited resource settings.

• 대한세포병리학회지
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• 제18권1호
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• pp.46-54
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• 2007

Cerebrospinal fluid (CSF) cytology is an effective tool for evaluating diseases involving the central nervous system, but this technique is usually limited by its low cellularity and poor cellular preservation. Here we compared the manual liquid-base $Liqui-PREP^{TM}$ (LP) to the cytospin (CS) with using a mononuclear cell suspension and we applied both methods to the CSFs of pediatric leukemia patients. The cytopresevability, in terms of cell yield and cell size, and the clinical efficacy were evaluated. When 2000 and 4000 mononuclear cells were applied, LP was superior to CS for the cell yield, 16.8% vs 1.7% (P=0.001) and 26.2% vs 3.5% (P=0.002), respectively. The mean size of the smeared cells was 10.60 ${\mu}m$ in the CS, 5.01 ${\mu}m$ in the LP and 6.50 ${\mu}m$ in the direct smear (DS), and the size ratio was 1.7 (CS to DS), 0.8(LP to DS) and 2.1 (CS to LP), respectively. As compared to the cells in the DS, the cells in the CS were significantly enlarged, but those in the LP were slightly shrunken. Upon application to 109 CSF samples, 4 were diagnosed as positive for leukemia (positive), 4 had atypical cells and 101 were negative by CS; 6 were positive, one had atypical cells and 102 were negative by LP. For six cases, in which 4 were positive for leukemia and 2 of 4 had atypical cells by CS, they were positive by LP and they were also confirmed as positive according to the follow-up study. Three cases diagnosed as atypical cells (two by CS and one by LP), were confirmed as negative. In conclusion, these results suggest that LP is superior to CS for the cytopresevability and for rendering a definite diagnosis of cerebrospinal fluid.