Do Liquid-Based Preparations of Pulmonary Bronchial Brushing Specimens Perform Differently From Classically Prepared Cases for the Diagnosis of Malignancies? Observations From the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytology

Abstract

Context.-Pulmonary bronchial brushing specimens can be processed by liquid-based or conventional methods. The ability to accurately diagnose a pulmonary malignancy with a liquid-based preparation (LBP) versus a conventional preparation may differ.Objective.-To compare the performance of LBPs of malignant pulmonary bronchial brushing specimens with the performance of conventional preparations.Design.-Participant responses from 553 malignant pulmonary bronchial brushing samples were evaluated for concordance with the general diagnosis. The performance of LBPs was compared with that of classic preparations. A nonlinear mixed model was used to analyze the performance by reference diagnosis, preparation type, program years, participant type, and the interaction terms between these 4 factors.Results.-Concordance with the general category of malignant disease was observed in 95.2% of conventional Papanicolaou-stained, 90.9% of modified Giemsa-stained, and 96.9% of LBP (P , .001) samples. The results were significantly different between individual reference diagnoses (P , .001). The performance of LBPs was consistently higher for most diagnoses and was significantly better for squamous cell carcinoma (P ¼ .005), small cell carcinoma (P , .001), and metastatic carcinoma not otherwise specified (P , .001). All participant types performed significantly better with LBPs of small cell carcinoma. Pathologists and cytotechnologists performed significantly better with LBPs of squamous cell carcinoma. A significantly higher concordance was observed between the general diagnosis and program years 2007-2011 versus 2001-2006 (P ¼ .006).Conclusions.-Liquid-based preparations performed better than conventional methods, with significantly higher performance in squamous cell, small cell, and metastatic carcinomas. Improved performance over time may reflect more frequent use of LBP methods and increased familiarity with interpreting the morphologic findings.

Performance Characteristics of Body Fluid Cytology Analysis of 344 380 Responses From the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytopathology

“…However, cytotechnologists had higher concordance rates when diagnosing non-small cell carcinoma and adenocarcinoma. 4 In the gastrointestinal cytology study, cytotechnologists had higher concordance rates for cases of squamous cell carcinoma, whereas pathologists have higher rates for spindle cell neoplasms. 5 These performance differences may be related to the level of exposure the individual has had to a particular tumor type.…”

“…This result is consistent with those of the urinary tract cytology 2 and another CAP NGC study evaluating conventional and liquid-based preparations of pulmonary bronchial brushing specimens. 4 This result may be related to the frequency of primary screening performed by cytotechnologists compared with pathologists 2 and that cytotechnologists rely more heavily on morphology alone in their daily practice, whereas pathologists more often use special studies. However, there was no difference between the concordance rates of cytotechnologists and pathologists in the general category in a CAP NGC study evaluating different preparations of gastrointestinal cytology specimens.…”

“…This observation is consistent with the findings of other studies comparing ThinPrep to other methods. 1,[4][5][6] When looking at the general category concordance rate by fluid type, the only statistically significant changes in concordance rates were for pericardial fluid, with SurePath performing best (99.7%) and modified Giemsa slides performing the worst (76.7%). However, the relevance of that observation is minimal because nearly all of the pericardial fluid slides were adenocarcinoma cases, and none of the pericardial fluid adenocarcinoma cases were stained with modified Giemsa.…”

Clinical and cytological characteristic of a condition of the oral cavity at pregnant women with various types of a diabetes mellitus

“…Это иссле-дование активно проводится в различных об-ластях медицины, например, для диагностики рака шейки матки [14][15][16][17]. Предлагается шире использовать данный метод в стоматологии для исследования содержимого зубодесневого со-единения с целью диагностики и определения лечебной тактики.…”

Caracterização morfológica e imunofenotípica dos linfomas caninos através de citologia de meio líquido e imunocitoquímica em emblocado celular

“…Como resultado, houve maior número de falsos-positivos em casos de citologia convencional e maior número de falsos-negativos em CML(FISCHER et al, 2013). Em outra série de revisões do CAP, mas com casos de escovado brônquico, observou-se menor número de discordâncias na CML, que reduziu-se com o passar dos anos, numa comparação entre duas séries históricas(2001 - 2006 versus 2007 -2011) (TABATABAI et al, 2015). O colégio justifica isto pela…”