• Tuberculosis and Respiratory Diseases
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• 제62권6호
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• pp.523-530
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• 2007

연구배경: ThinPrep$^{(R)}$검사는 원심분리를 통해 불필요한 혈액이나 점액들을 제거, 선택적으로 진단에 필요한 다량의 세포들만 모아 기존의 세포검사의 한계를 극복하여 진단율을 높일 수 있는 것으로 알려져 있으며, 현재 여러 분야에서 암의 조기 진단 방법으로 사용되고 있다. 본 연구는 기관지 세척액의 Thin-Prep$^{(R)}$검사와 기존의 세포검사의 진단율을 비교하여 ThinPrep$^{(R)}$검사의 유용성에 대해 알아보고자 시행하였다. 방 법: 2002년 1월부터 2006년 12월까지 기관지 내시경 검사를 시행한 1,116명의 환자 중 암세포에 대한 검사가 필요하다고 판단되었던 790명의 기관지 세척액 검체를 대상으로 세척액을 양분하여 기존의 세포 검사와 ThinPrep$^{(R)}$ 검사를 시행하였다. 결 과: 대상환자는 남자 446명, 여자 344명이었고 평균나이는 58.3(${\pm}16.7$)세였으며, 이 중 197명이 기관지 내시경이나 경피적 폐생검 등의 표준진단방법을 통해 암을 진단 받았다. 암의 진단에 있어 ThinPrep$^{(R)}$ 검사는 민감도 71.1%, 특이도 98.0%, 양성 예측도 92.1%, 음성 예측도 91.1%, 위음성률 8.9%였다. 기존의 세포검사의 경우에는 민감도 57.9%, 특이도 98.0%, 양성 예측도 90.5%, 음성 예측도 87.5%, 위음성률 12.5%였다. 중심형 병변인 경우 ThinPrep$^{(R)}$의 민감도는 82.8%였고 세포검사의 민감도는 70.1%였다. 결 론: 기관지 세척액 검체를 대상으로 한 폐암의 진단에 있어서 ThinPrep$^{(R)}$검사는 기존 세포검사에 비해 민감도가 높았으며 낮은 위음성률을 보였다. 이와같은 결과는 폐암의 조직학적 분류와 상관 없이 나타났고, 특히 중심형 병변일 경우의 민감도는 ThinPrep$^{(R)}$ 검사법에서 매우 높게 나타났다. 따라서 기관지 세척액 검사에서 ThinPrep$^{(R)}$을 활용할 경우 폐암의 진단율을 높이는데 기여할 수 있을 것으로 생각된다.

• 대한세포병리학회지
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• 제18권1호
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• pp.29-35
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• 2007

This study purposed to evaluate a $CellPrep^{(R)}$ (CP) of liquid-based cytology (LBC) to search for a less expensive and automated alternative cytologic preparation technique applicable to usually encountered cytologic specimens. Cervicovaginal direct-to-vial split samples from 457 gynecologic patients, 40 body fluid samples, and 34 urine samples were processed with the CP technique and the results were compared with those of currently used $ThinPrep^{(R)}$ (TP) method. Both CP and TP methods provide evenly distributed thin layers of cells with little cellular overlaps or significant obscuring elements in most of cases. Staining quality of both preparations showed a little difference due to the difference of fixative solutions without significant distractions in cytologic interpretation. On the supposition that TP was a gold standard, sensitivity, specificity, positive predictive value, and negative predictive value of CP cytology were 89%, 98%, 86%, and 99% in the cervicovaginal smear, 89%, 82%, 80%, and 90% in body fluid, and all of these values were 100% in urine samples. To testify the availability of immunohistochemistry on CP preparations, cytokeratin, vimentin, and Ki-67 were applied on body fluid specimens, and all of these antibodies were specifically stained on targeted cells. Conclusively, the CP method gave comparable results to those of TP in terms of smear quality and cytologic diagnostic evaluation, and was available on immunohistochemistry. The CP method could offer a cost-effective and automated alternative to the current expensive techniques of liquid-based cytology on popular cytologic materials including cervicovaginal, body fluid, and urine specimens.

• 대한세포병리학회지
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• 제19권2호
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• pp.136-143
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• 2008

Urothelial carcinoma accounts for 90% of all the cases of bladder cancer. Although many cases can be easily managed by local excision, urothelial carcinoma rather frequently recurs, tends to progress to muscle invasion, and requires regular follow-ups. Urine cytology is a main approach for the follow-up of bladder tumors. It is noninvasive, but it has low sensitivity of around 50% with using the conventional cytospin preparation. Liquid-based cytology (LBC) has been developed as a replacement for the conventional technique. We compared the cytomorphometric parameters of $ThinPrep^{(R)}$ and cytospin preparation urine cytology to see whether there are definite differences between the two methods and which technique allows malignant cells to be more effectively discriminated from benign cells. The nuclear-to-cytoplasmic ratio value, as measured by digital image analysis, was efficient for differentiating malignant and benign urothelial cells, and this was irrespective of the preparation method and the tumor grade. Neither the $ThinPrep^{(R)}$ nor the conventional preparation cytology was definitely superior for distinguishing malignant cells from benign cells by cytomorphometric analysis of the adequately preserved cells. However, the $ThinPrep^{(R)}$ preparation showed significant advantages when considering the better preservation and cellularity with a clear background.

• 대한세포병리학회지
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• 제18권1호
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• pp.55-61
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• 2007

Once diagnosed as "cell paucity"or "atypia" by the cytospin (CS) preparation, this CS preparation does not secure a precise diagnosis by repeated testing alone. Although the ThinPrep (TP) preparation is acknowledged to show increased cellularity, performing the screening tests for the cases that have enough cellularity, according to CS, raises issues for the cost-effectiveness. To obtain a more precise diagnosis through increasing the cellularity by performing TP, we selected the cases that were diagnosed as "cell paucity" or "atypia" by CS, but they required a more precise diagnosis, and the samples were processed via both CS and TP to compare the results. 11 patients diagnosed as "cell paucity" and 22 patients diagnosed as "atypia" by CS participated in this study. When the detection rate of atypical cells in both preparations with repeated urine cytology was compared, the overall detection rate of TP (16cases, 48.5%) was superior than that of CS (11cases, 33.3%), with statistical significance. The cellularity of both preparations was compared on repeated urine cytology; the general cellularity of TP (29cases, 87.9%) was higher than that of CS (20cases, 60.6%), but there was no statistical significance. Particularly, we repeated the TP for the 1 case that was diagnosed as "atypia" and we performed polyoma virus immunohistochemical staining, which confirmed polyoma virus. In conclusion, we can avoid obtaining negative diagnosis from cases with uncertain "atypia" or "cell paucity" by performing repeated TP testing.

• 대한세포병리학회지
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• 제18권2호
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• pp.119-125
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• 2007

Urine cytology is an important screening tool for urinary tract neoplasms. Liquid-based preparation methods, such as $ThinPrep^{(R)}$, have been introduced for non-gynecological samples. We aimed to assess the diagnostic accuracy of liquid-based preparations in urine cytology by comparing the results of the conventional Cytospin preparation method for the same samples. A total of 236 cases subject to urine cytology were enrolled in this study from January 2005 to December 2005. All cases were subjected to cystoscopy and if a malignancy was suspected, a biopsy was performed. Urine cytology slides were made using the $ThinPrep^{(R)}$ preparation method and the conventional Cytospin and/or direct smear method from the individual samples. The results of urine cytology were compared with the final cystoscopic or histological diagnoses. We analyzed the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of both cytology preparation methods. A total of 236 slides made using the liquid based method were satisfactory for slide quality, whereas 5 slides (2.1%) prepared by conventional methods were unsatisfactory because of air-drying, a thick smear, or a bloody or inflammatory background. The $ThinPrep^{(R)}$ method showed 53.1% sensitivity, 92.6% specificity, a 92,6% positive predictive value, a 94.1% negative predictive value and 85,6% accuracy, while the conventional method showed 51% sensitivity, 98.4% specificity, a 92.6% positive predictive value, a 98.4% negative predictive value and 88,6% accuracy. Although the diagnostic values were equivalent between the use of the two methods, the quality of the cytology slides and the time consumed during the microscopic examination for a diagnosis were superior for the $ThinPrep^{(R)}$ method than for the conventional method. In conclusion, our limited studies have shown that the use of the liquid based preparation method is beneficial to improve the quality of slides and reduce the duration for a microscopic examination, but did not show better sensitivity, accuracy and predictive values.

• 분석과학
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• 제30권2호
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• pp.102-111
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• 2017

Here we reported a methodology for identification of triacylglycerols (TAGs) and diacylglycerols (DAGs) in coix seed by preparative thin layer chromatography (prep-TLC) and non-aqueous reversed-phase liquid chromatography (NARP LC)-atmospheric pressure chemical ionization (APCI) tandem mass spectrometry (MS/MS). Lipid components were extracted from coix seed by reflux extraction using n-hexane for 3 hr. TAGs and DAGs in coix seed extract were effectively purified and isolated from matrix interferences by prep-TLC and then analyzed by LC-APCI-MS and MS/MS for identification. TAGs were effectively identified taking into consideration of their LC retention behavior, APCI-MS spectra patterns, and MS/MS spectra of $[DAG]^+$ ions. In MS/MS spectra of TAGs, diacylglycerol-like fragment $[DAG]^+$ ions were useful to identify TAGs with isobaric fragment ions. Based on an established method, 27 TAGs and 8 DAGs were identified in coix seed extract. Among them, 15 TAGs and 8 DAGs were for the first time observed in coix seed. Interestingly, some of TAGs isolated by prep-TLC were partly converted into DAGs through probably photolysis process during storing in room temperature. Thus, degradation phenomenon of TAGs should be considered in the quality evaluation and nutritional property of coix seed. LC-APCI-MS/MS combined with prep-TLC will be practical method for precise TAG and DAG analysis of other herbal plants.

• Asian Pacific Journal of Cancer Prevention
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• 제13권4호
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• pp.1651-1655
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• 2012

Background: Our aim was to investigate the efficacy of the Pap test in combination with the ThinPrep cytological test (TCT) in screening for cervical cancer in China. Design: From March 2006 to October 2008, 988 women with the mean age $46.4{\pm}10.5$ years (range, 23-80 years) were recruited to receive cervical cancer screening. Pap test results ${\geq}$ grade III and TCT findings ${\geq}$ ASCUS/AGUS were considered abnormal. Subjects with a Pap test result ${\geq}$ grade IIb received TCT. Colposcopy and biopsies were performed in all participants, and final diagnosis was based on pathological findings. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Youden index for predicting CIN I or above were determined. Results: The sensitivity, specificity, PPV, NPV and Youden index of the Pap test were 43.1%, 97.2%, 70.0%, 91.9%, and 40.3%, respectively. The same values for TCT in predicting CIN were 80.0%, 63.2%, 16.0%, 97.3%, and 43.2%, respectively. The two tests in combination gave values for predicting CIN of 64.8%, 87.6%, 43.6%, 94.4%, and 53.5%, respectively. Combined testing exhibited the highest Youden index (53.4%). Conclusion: The Pap test with a reduced threshold in combination with the TCT has high sensitivity and high specificity in screening for cervical cancer.

• Journal of Gastric Cancer
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• 제8권4호
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• pp.189-197
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• 2008

목적: 진행성 위암에서 복막 세포진 검사는 복강 내 미세전이를 진단하는 유용한 방법으로 사용되고 있으나 아직까지 국내외에서 액상세포검사를 사용한 복막 세포진 검사의 의의에 대한 연구가 보고되지 않고 있다. 본 연구는 수술 중 수집된 복막 세척액을 이용한 액상세포($ThinPrep^{(R)}$) 검사의 임상적 의의를 분석하기 위해 시행되었다. 대상 및 방법: 2001년부터 2006년까지 본원에서 위암 진단하에 수술 중 위장막의 침범 또는 노출이 의심되어 복막 세포진 검사를 시행 받은 424예의 진행성 위암 환자들의 임상 병리학적 자료와 세포진 검사 결과를 후향적으로 조사하여 분석하였다. 결과: 복막 세포진 양성은 31%였으며, 복막 세포진 결과는 단변량 및 다변량 분석에서 T 병기, N 병기, P 병기와 밀접한 관계를 보였다. 3년 생존율은 복막 세포진 음성에서 68% 양성에서 26%였으며, 복막전이(P)와 복막 세포진(CY)을 기준으로 분류하였을 때 P0CY0 71%, P0CY1 39%, P1/2/3CY0 39%, 그리고 P1/2/3CY1 11%의 3년 생존율을 보였다. 그리고 단변량 및 다변량 생존분석 결과, 복막 세포진 결과가 성별, T 병기, N 병기, P 병기, 복막 외 원격 전이, 혈청 CEA와 함께 독립적인 예후 인자로 증명되었고, 또한 근치적 절제 군에서 복막 세포진 결과는 복막 재발의 위험 인자임이 밝혀졌다. 결론: 본 연구는 복막 세포진 검사가 복강 내 미세전이를 진단 할 수 있는 신뢰성 높은 진단 방법이며 진행성 위암에서 강력한 예후 인자이며 복막 재발의 위험 인자임을 증명하였다.

• 대한세포병리학회지
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• 제18권1호
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• pp.1-12
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• 2007

Approximately 70% of cervical cancers are caused by HPV types 16/18 and thus the implementation of vaccination programmes with vaccines against HPV types 16/18 will have a major impact on the incidence of cervical cancer worldwide. However, this reduction will not be seen until several decades after full implementation of such vaccination programmes since the vaccines must be given to young adolescents before exposure to the virus and women who are already sexually active are not likely to be protected. Both GSK and Merck insist that even vaccinated women must continue to participate in regular cervical screening by the most sensitive method available since the vaccine can only give protection against up to 70% of cervical cancers. It is unlikely that the current vaccines will be modified to include additional high risk HPV types in the foreseeable future. While HPV testing is highly sensitive, it is not recommended for women under 30 years of age nor for vaccinated women. Additionally, HPV testing has poor specificity. The Digene Hybrid Capture 2 test is licensed for use only in conjunction with a cytology test, not as a stand-alone test, and the high risk panel has recognised cross reactivity with low risk HPV types. None of the other HPV test methods currently commercially available are FDA approved and all must be internally validated before use. This makes comparison of test results between laboratories difficult. The most sensitive and specific screening test currently available for women of all ages is the Cytyc ThinPrep System consisting of the ThinPrep Pap Test (TPPT) and the ThinPrep Imaging System (Imager). The TPPT was the first LBC system approved by the US FDA in 1996 and there are about 4,000 processors in use worldwide. The Imager was FDA approved in 2003 and over 350 systems are in routine use, mainly in the US. 40% of TPPT in the US are processed on Imager. There is clear evidence in peer reviewed literature that the Imager increases laboratory productivity by 100% and growing evidence that Imager detects more high grade SIL than the conventional smear or manual evaluation of TPPT. This aspect is particularly important since the number of cytological abnormalities will decrease as vaccination programmes are implemented. Cytotechnologists will see fewer and fewer abnormal smears and their skills will be put at risk. By doubling throughput, Imager will allow cytotechnologists to maintain their skills.

• 대한세포병리학회:학술대회논문집
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• 대한세포병리학회 2007년도 제21차 춘계학술대회
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• pp.21-21
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• 2007