Alternatives to the Traditional Papanicolaou (Pap) Smear – Liquid Based Cytology (LBC)

Mulford, Donna K.

doi:10.1309/gp3lv8ublru803de

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…While squamous abnormalities identified in ASC-US or lowgrade squamous intraepithelial lesion cases are similar in conventional smear preparations and LBC, significant differences have been noted in cases of HSIL and squamous cell carcinoma. Fewer numbers of HSIL cells were present in LBC, which often occurred singly or in small cell groups in LBC, leading to either misclassification as benign glandular cells or macrophages or being overlooked entirely on manual screening [56]. Other studies noted additional cytomorphologic differences in HSIL cells in LBC compared to conventional smear preparations (e.g., darker staining, smaller nuclear areas, less distinct nuclear chromatin, and thicker 3-dimensional groupings in LBC), which may make detection of these lesional cells more difficult [57,58].…”

Section: Changes In Practice Associated With New Technology Introductionmentioning

confidence: 99%

Computational Cytology: Lessons Learned from Pap Test Computer-Assisted Screening

2020

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Background: In the face of rapid technological advances in computational cytology including artificial intelligence (AI), optimization of its application to clinical practice would benefit from reflection on the lessons learned from the decadeslong journey in the development of computer-assisted Pap test screening. Summary: The initial driving force for automated screening in cytology was the overwhelming number of Pap tests requiring manual screening, leading to workflow backlogs and incorrect diagnoses. Several companies invested resources to address these concerns utilizing different specimen processing techniques and imaging systems. However, not all companies were commercially prosperous. Successful implementation of this new technology required viable use cases, improved clinical outcomes, and an acceptable means of integration into the daily workflow of cytopathology laboratories. Several factors including supply and demand, Food and Drug Administration (FDA) oversight, reimbursement, overcoming learning curves and workflow changes associated with the adoption of new technology, and cytologist apprehension, played a significant role in either promoting or preventing the widespread adoption of automated screening technologies. Key Messages: Any change in health care, particularly those involving new technology that impacts clinical workflow, is bound to have its successes and failures. However, perseverance through learning curves, optimizing workflow processes, improvements in diagnostic accuracy, and regulatory and financial approval can facilitate widespread adoption of these technologies. Given their history with successfully implementing automated Pap test screening, cytologists are uniquely positioned to not only help with the development of AI technology for other areas of pathology, but also to guide how they are utilized, regulated, and managed.

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Section: Changes In Practice Associated With New Technology Introductionmentioning

confidence: 99%

Computational Cytology: Lessons Learned from Pap Test Computer-Assisted Screening

2020

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“…The Pap smear has been a highly effective screening tool in the diagnosis of cervical cancer (CC) 1 since its development by George Papanicolaou more than 70 years ago. 2 More recently, this technique has been modified into a liquid-based Pap smear or liquid-based cytology (LBC) to improve early detection, reduce false-negative rates, and simplify quality control (QC) that is demanded by conventional cervical cytology.…”

Section: Introductionmentioning

confidence: 99%

“…2 More recently, this technique has been modified into a liquid-based Pap smear or liquid-based cytology (LBC) to improve early detection, reduce false-negative rates, and simplify quality control (QC) that is demanded by conventional cervical cytology. 3 These modifications also offer advantages extending to multiple slide preparation, the incorporation of special stains (immunohistochemistry), human papillomavirus (HPV) detection through DNA testing, 1 and even the potential to detect other gynecological malignancies, most notably, endometrial and ovarian cancers. 4,5…”

Section: Introductionmentioning

confidence: 99%

Comparison of Automated and Manual DNA Isolation Methods of Liquid-Based Cytology Samples

Domínguez-Vigil

Barajas-Olmos

Gallardo-Alvarado

et al. 2019

Biopreservation and Biobanking

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Liquid-based cytology (LBC) has been used as a diagnostic tool for cervical cancer for years and is now being adopted for other gynecological cancers. LBC represents an important challenge to ensure that the process yields representative biospecimens for quality control (QC) of diagnostic procedures. In this study, we compare QC parameters (integrity, yield and purity, and polymerase chain reaction [PCR] amplification) of DNA isolated from LBC (N = 296) using two different nucleic acid isolation methods, manual (n = 233) or automated (n = 63). We also evaluated two different types of cytological brushes for sampling from the cervix. Our results suggest that manual isolation (yield 22.81 ± 1.92 μg) resulted in increased DNA recovery when compared with automated isolation (yield 9.96 ± 1.11 μg) from LBC samples, with a p-value of <0.0003. We estimated that 98% (53/54) of the samples preserved the integrity of DNA and were suitable for standard molecular biology analyses. The β-globin gene was amplified in 100% (296/296) of the DNA samples by endpoint PCR. We found no significant difference between the performance of the cytological brushes (p value of <0.6711) in a general overview. However, when looking at the results from using each brush individually, the manual isolation method was statistically superior to the automated method. Our work illustrates the impact of good QC of preanalytic conditions, which will be important for the application of LBC for developing early detection methods for gynecological cancers.

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Cytopreparatory Techniques

Keebler¹,

Facik²

2008

Comprehensive Cytopathology

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Alternatives to the Traditional Papanicolaou (Pap) Smear – Liquid Based Cytology (LBC)

Cited by 3 publications

References 5 publications

Computational Cytology: Lessons Learned from Pap Test Computer-Assisted Screening

Computational Cytology: Lessons Learned from Pap Test Computer-Assisted Screening

Comparison of Automated and Manual DNA Isolation Methods of Liquid-Based Cytology Samples

Cytopreparatory Techniques

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