Cervical specimens collected in liquid buffer are suitable for both cytologic screening and ancillary human papillomavirus testing

Sherman, Mark E.; Schiffman, Mark; Lörincz, Attila T.; Herrero, Rolando; Hutchinson, Martha L.; Bratti, Concepción; Zahniser, David J.; Morales, Jorge; Hildesheim, Allan; Helgesen, Kay; Kelly, Deidra; Alfaro, Mario; Mena, Fernando; Balmaceda, Ileana; Mango, Laurie J.; Greenberg, Mitchell

doi:10.1002/(sici)1097-0142(19970425)81:2<89::aid-cncr2>3.3.co;2-b

Cited by 23 publications

(26 citation statements)

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“…The usefulness of cell block in gynecological cytology has been hampered largely by the inherent limitations of the sampling method and technical issues of efficiently collecting cells. In most cases, after ThinPrep Pap tests are made, there remains residual material that may contain valuable diagnostic material for supplementary diagnostic studies such as additional ThinPrep slides and human papillomavirus typing . The Cellient CB system provides a new platform in this field.…”

Section: Discussionmentioning

confidence: 99%

The cellient automated cell block system is useful in the differential diagnosis of atypical glandular cells in Papanicolaou tests

Wei

Hou

Fischer

et al. 2013

Cancer Cytopathology

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BACKGROUND: Atypical glandular cells (AGC) is a very important diagnosis in gynecological cytology. In the current study, the authors investigated the usefulness of Cellient cell blocks (CB) for characterizing AGC on Papanicolaou (Pap) tests. METHODS: A total of 148 patients with an AGC diagnosis based on Pap tests by cytotechnologists and referred to cytopathologists were studied. Among these patients, there were 68 patients with CB preparations and 80 patients with Pap tests only (TP-AGC group). Follow-up results by Pap tests or biopsies were obtained in 117 of 148 patients. The median follow-up was 13 months (range, 1 month-36 months). RESULTS: Of the 68 patients with CBs, 31 (46%) were reclassified as negative for dysplasia or low-grade intraepithelial lesion; 30 patients (44%) retained a diagnosis of AGC (CB-AGC group); and 7 patients (10%) were given specific diagnoses of high-grade intraepithelial lesion (3 patients), endocervical adenocarcinoma in situ (1 patient), and invasive adenocarcinoma (3 patients). On follow-up, the CB-AGC group was found to have a significantly lower rate of negative=low-grade squamous intraepithelial lesion diagnoses compared with the TP-AGC group (55% vs 85%; P 5.006). The CB-AGC group had a significantly higher rate of endocervical or endometrial adenocarcinoma compared with the TP-AGC group (36% vs 8%; P 5.003) at the time of follow-up. The rates of high-grade squamous intraepithelial lesion were not found to be statistically different between these 2 groups (9% vs 7%; P 5.66). CONCLUSIONS: The Cellient CB is a useful technique to further categorize a diagnosis of AGC on Pap tests. Using the Cellient CB system, the pathologist has the ability to improve the diagnostic accuracy of AGC so that unnecessary colposcopic evaluation or biopsies can be avoided. Cancer (Cancer Cytopathol) 2014;122:8-14. V C 2013 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

The cellient automated cell block system is useful in the differential diagnosis of atypical glandular cells in Papanicolaou tests

Wei

Hou

Fischer

et al. 2013

Cancer Cytopathology

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“…Although cervical cytology has reduced the incidence of cervical carcinoma worldwide, 21–24 its poor sensitivity (30–87%) has led to the suggestion that other tests such as HPV‐DNA testing may be of value either in the primary screening setting to reduce screening frequency or, perhaps more appropriately, as an adjunct to the management of women with ASCUS or inconclusive smears – so called ‘reflex testing’ 8,11,25–28 …”

Section: Discussionmentioning

confidence: 99%

Women with low‐grade abnormalities on Pap smear should be referred for colposcopy

Fairman¹,

Tan

Quinn

2004

Aust NZ J Obst Gynaeco

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Given these findings and the current medico-legal climate, immediate referral of women with low-grade changes on routine cytology is indicated, and seems a safer option than the more conservative approach of a repeat smear in 6 or 12 months. Further study of the usefulness of separating smears of uncertain significance into high-grade and low-grade categories is warranted. Consumer input into recommendations for management of Pap smear abnormalities is required.

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“…Because only a portion of the collected cells is typically needed for the preparation of a liquid‐based cytologic slide, the remaining specimen can be used for repeat cytology or ancillary testing. For example, human papillomavirus (HPV) DNA testing of ThinPrep cytologic specimens (Cytyc, Boxsborough, MA) by the Hybrid Capture 2 test (HC2; Digene, Gaithersburg, MD) is as sensitive as testing specimens stored in the initially recommended specimen transport medium (STM; Digene) 1. Recent data from the atypical squamous cells of undetermined significance (ASCUS) low‐grade squamous intraepithelial cells (LSIL) Triage Study (ALTS) demonstrated that HPV DNA testing of ThinPrep specimens by HC2 is a sensitive detection method for underlying high‐grade cervical neoplasia in women with equivocal cytologic diagnoses 2…”

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confidence: 99%

Stability of archived liquid-based cervical cytologic specimens

Castle

Solomon

Hildesheim

et al. 2003

Cancer

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BACKGROUND Exfoliated cervical cell specimens collected in PreservCyt®, a methanol‐based medium used in ThinPrep® liquid‐based cytology, have been archived in epidemiologic studies. However, long‐term DNA stability and cytologic stability of these biospecimens have not been evaluated. METHODS Cervical specimens were collected into PreservCyt from participants in a natural history study of human papillomavirus (HPV) infection and cervical carcinoma in Guanacaste, Costa Rica (1993–2000), and stored at ambient temperatures. Thirty specimens classified as low‐grade squamous intraepithelial lesions by liquid‐based cytology were randomly chosen from each collection year (except for 1994) and selectively assessed for molecular and cytologic stability. Specimens were tested in 2001 for 1) HPV DNA by the Hybrid Capture 2 test, 2) β‐globin DNA by polymerase chain reaction amplification of multiple length fragments (268, 610, and 1327 bp), and 3) nuclear preservation by visual inspection of newly made liquid‐based cytology slides. All testing was done masked to year of collection. Associations of stability and storage time were evaluated using standard contingency tables and chi‐square tests for trend. RESULTS Human papillomavirus DNA, as detected by the Hybrid Capture 2 test, was unaffected by storage time. Stability of β‐globin DNA (PTrend < 0.0001) and nuclear preservation (PTrend < 0.0001) declined with increasing storage time. Approximately 15% of specimens could not be amplified for any β‐globin DNA fragment after 5 years of storage (collected in 1996). In addition, cytology slides made from 41% specimens were rated as marginal (32%) or unsatisfactory (9%) after 8 years of storage (collected in 1993). CONCLUSIONS Cervical specimens archived in PreservCyt underwent partial DNA and cytologic degradation after several years of storage. Methodologic studies to optimize long‐term storage of cervical cells for epidemiologic studies of cervical carcinoma are needed. Cancer (Cancer Cytopathol) 2003;99:89–96. Published 2003 American Cancer Society.

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Cervical specimens collected in liquid buffer are suitable for both cytologic screening and ancillary human papillomavirus testing

Cited by 23 publications

References 0 publications

The cellient automated cell block system is useful in the differential diagnosis of atypical glandular cells in Papanicolaou tests

The cellient automated cell block system is useful in the differential diagnosis of atypical glandular cells in Papanicolaou tests

Women with low‐grade abnormalities on Pap smear should be referred for colposcopy

Stability of archived liquid-based cervical cytologic specimens

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