Application of a New Liquid-Based Procedure (TACAS) for the Screening of Cervical Cancer: A Preliminary Study

Abstract

Objective: To evaluate the usefulness of a new liquid-based cytological procedure in a population screening program for cervix cancer. Subjects and Methods: Subjects were 1,000 women who underwent primary screening at the Kanagawa Health Service Association. The cytological specimens obtained by either cotton stick and Cytobrush® or Cervex-Brush® were processed using the Thinlayer Advanced Cytology Assay System (TACAS™), following the manufacturer’s instructions. Results: (1) Cells were evenly distributed on specimens and stained evenly; (2) shrinkage of cells was 5% based on measurement of the nuclear diameters of granulocytes in comparison with those of the conventional procedure; (3) incidences of cells that occupied the whole area, 1/20≤, 1/4≤, 1/4> of the observation fields were 58.8, 26.2, 12.0 and 3.0%, respectively; (4) number of the squamous cells in cases with 1/4> was <5,000, in which specimen cells were correctly obtained from the squamocolumnar junction except in 3 cases (0.3%); (5) bleeding at cellular sampling was 5%, but did not disturb cell analysis; (6) inflammation caused by organisms was easily diagnosed; (7) detection rate of abnormal cytology was 4.3%, including ASC-US in 2.8% and ASC-H in 0.1%. Conclusion: TACAS is a feasible and useful cytological procedure.

Optimal Sampling Devices for Liquid-Based Procedure in Screening for Cervical Cancer: Comparison between Cotton Stick/Cytobrush and Cervex-Brush

“…The cells obtained either with the cotton stick/Cytobrush or Cervex-Brush method were observed in each slide, and the squamous epithelial cells were evaluated depending on their localization on the whole area of the observation field, and grouped into either the full field, ≥1/2, ≥1/4 or <1/4 of the field as reported elsewhere [7]. The numbers of endocervical and squamous metaplastic cells on the whole area were calculated using a manual counter, and grouped into either ≥500, ≥100, ≥50, ≥10 or <10.…”

“…Therefore, liquid-based cytological procedures (LBPs) [1,2,3,4,5,6,7] have become more widely used for cervical cancer screening, and this may be due to the clear cytological specimens in the limited field on glass slides that are produced with an automated smearing system. The efficacy of cellular sampling devices, however, has not been considered from the aspect of an adverse effect of bleeding except for its effect on the quality of cellular sampling.…”

Overview of Nongynecological Samples Prepared with Liquid-Based Cytology Medium

“…A number of non-FDA-approved methods have been developed for use outside of the USA. These include LiquiPrep [4], Turbitec [5], PapSpin [6], TACAS [7,8], Siriraj-LBC [9], DNA-Citoliq (Digene) [10], GluCyte [11], and some other devices [12,13]. Specimen materials collected in the preservation medium are routinely used for cell blocks, which can provide additional diagnostic information, including architectural pattern, immunocytochemistry (ICC) and special stains.…”

Usefulness of Evaluation of Nuclear Color by Visible-Microscopic Spectroscopy for Objective Differentiation between Non-Cancer and Cancer Cells Prepared Using Liquid-Based Cytology

“…These characteristics tend to make cancer cell judgment difficult in well-differentiated adenocarcinoma lacking atypia [16][17][18][19][20][21]. According to the cellular findings in our study, non-cancerderived and cancer cells were similar with regard to many of the points, and differentiation of them was difficult.…”

“…Using a residual LBC sample remaining in a vial, additional tests (immunocytochemistry and gene analysis) can be performed, increasing the diagnostic accuracy [11][12][13][14][15][16]. However, increased staining intensity of the nuclear chromatin and nuclear size reduction in LBC samples may make cancer cell judgment difficult in well-differentiated adenocarcinoma lacking atypia [17][18][19][20][21][22].…”