Maximizing the adequacy of Hologic® Cervista® H<scp>PV HR</scp> results on Thin<scp>P</scp>rep® Pap samples treated with glacial acetic acid

Mahajan, Aparna; Kucher, C T Erek; Hoefle, M T Wanda; Engelhardt, C.; Accola, Molly A.; Barasch, Samuel; Rehrauer, William M.; Selvaggi, Suzanne M.

doi:10.1002/dc.23426

Cited by 2 publications

(3 citation statements)

References 13 publications

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“…To our knowledge, all related studies of GAA have been reported only in pathology journals. [1][2][3][4][5][6][7][8][9][10][11][12] Because not all laboratories offer this method, clinicians should inquire about the use of GAA in the laboratory responsible for interpreting their patients' specimens.…”

Section: Discussionmentioning

confidence: 99%

“…Reducing the number of uninterpretable cervical smear tests that are unsatisfactory for evaluation would aid efforts to prevent cancer through earlier detection and would avoid costly repeat testing. Cost‐effective laboratory methods, such as adding glacial acetic acid (GAA) during slide processing of ThinPrep (TP) (Hologic, Marlborough, MA, USA) cervical smear test specimens, can improve the detection of early disease in bloody samples . GAA improves the visibility and cellularity of epithelial cells by lysing the erythrocytes in the blood that clings to the filter during slide processing .…”

Section: Introductionmentioning

confidence: 99%

“…GAA improves the visibility and cellularity of epithelial cells by lysing the erythrocytes in the blood that clings to the filter during slide processing . Using GAA converts previously uninterpretable slides from unsatisfactory to satisfactory for evaluation (Fig. ).…”

Section: Introductionmentioning

confidence: 99%

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Precancerous cervical lesions and HPV genotypes identified in previously unsatisfactory cervical smear tests after inexpensive glacial acetic acid processing

Risley

Geisinger

Robinson

et al. 2018

Intl J Gynecology & Obste

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Objective To determine the effectiveness of using glacial acetic acid (GAA) to convert unsatisfactory bloody ThinPrep (TP) cervical smear test to satisfactory, and identify associated missed diagnoses and high-risk HPV (hrHPV) genotypes. Methods In a retrospective descriptive cross-sectional analysis, all TP tests performed in Mississippi, USA, 2012–2016, were evaluated for unsatisfactory results owing to blood. Tests that were converted to satisfactory by GAA treatment, and corresponding anomalies and HPV genotypes were identified. Results Among 106 384 TP tests, there were 1460 (1.37%) unsatisfactory results, of which 1442 (98.77%) were converted to satisfactory after GAA treatment. Laboratory preprocessing with GAA increased costs minimally. Precancerous lesions were detected in 166 (11.51%) of 1442 GAA-treated samples, of which 12 (7.2%) were high-grade lesions, 110 (66.3%) were atypical squamous cells of undetermined significance, and 63 (57.3%) tested positive for hrHPV. Of 60 genotyped samples, 39 (65%) had non-HPV16 and non-HPV18. Including mixed infections, 48 (80%) contained less-common hrHPV types, reflecting an unexpected distribution in bloody specimens. Conclusions GAA pretreatment of bloody TP tests would reduce the incidence of unsatisfactory results and missed high-grade lesions, and prevent the cost of repeat tests and delayed treatment. Clinicians without access to GAA should consider HPV testing.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Precancerous cervical lesions and HPV genotypes identified in previously unsatisfactory cervical smear tests after inexpensive glacial acetic acid processing

Risley

Geisinger

Robinson

et al. 2018

Intl J Gynecology & Obste

View full text Add to dashboard Cite

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Unsatisfactory Pap Test Results: A Critical Patient Management Problem Pre‐Analytically Addressed by the Cytopathology Laboratory

Gafeer,

Alperstein,

Appleby

et al. 2024

Diagnostic Cytopathology

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BackgroundThe unsatisfactory rate of Pap tests (PT) is an important quality assurance (QA) metric for a cytopathology laboratory. At our institution, an unsatisfactory PT slide is followed by a second ThinPrep (TP) slide. The aim of this study is to evaluate this QA practice.MethodsOur laboratory processes an unsatisfactory TP PT with a follow‐up second TP slide with or without glacial acetic acid. The correlation between the unsatisfactory rate and the second slide rate test was examined.ResultsA total of 2739 cases with a second TP slide were prepared for an unsatisfactory initial TP PT. After second slide preparation, 780 cases (28%) remained unsatisfactory. Using Spearman's rank correlation test, there was a notable negative correlation between the unsatisfactory rate and the second slide rate (rho = −0.42). Of those PTs recategorized as satisfactory TP, 1742 were negative for intraepithelial lesion or malignancy (NILM) (89%), 135 as atypical squamous cells of undetermined significance (ASC‐US) (7%), 37 as low‐grade squamous intraepithelial lesion (LSIL) (1.9%), 11 as atypical squamous cells cannot exclude high‐grade squamous intraepithelial lesion (ASC‐H) (0.6%), 8 as high‐grade squamous intraepithelial lesion (HSIL) (0.4%), and 20 as atypical glandular cells (AGC) (1%). The final Bethesda categorization for all cases and the human papilloma virus (HPV) data was tabulated.ConclusionsA second slide preparation significantly reduced the unsatisfactory rate of the PT. This also had a significant impact by detecting clinically significant lesions. HPV testing can also be performed on slides reclassified from unsatisfactory to ASC‐US or higher.

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Maximizing the adequacy of Hologic^® Cervista^® HPV HR results on ThinPrep^® Pap samples treated with glacial acetic acid

Abstract: The levels of genomic DNA were significantly decreased in GAA treated vs non-treated TP samples. Aliquoting from the TP sample prior to treatment with GAA enables accurate measurement of DNA without affecting the adequacy of the TP cytology slide.

Cited by 2 publications

References 13 publications

Precancerous cervical lesions and HPV genotypes identified in previously unsatisfactory cervical smear tests after inexpensive glacial acetic acid processing

Precancerous cervical lesions and HPV genotypes identified in previously unsatisfactory cervical smear tests after inexpensive glacial acetic acid processing

Unsatisfactory Pap Test Results: A Critical Patient Management Problem Pre‐Analytically Addressed by the Cytopathology Laboratory

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Maximizing the adequacy of Hologic® Cervista® HPV HR results on ThinPrep® Pap samples treated with glacial acetic acid

Abstract: The levels of genomic DNA were significantly decreased in GAA treated vs non-treated TP samples. Aliquoting from the TP sample prior to treatment with GAA enables accurate measurement of DNA without affecting the adequacy of the TP cytology slide.

Cited by 2 publications

References 13 publications

Precancerous cervical lesions and HPV genotypes identified in previously unsatisfactory cervical smear tests after inexpensive glacial acetic acid processing

Precancerous cervical lesions and HPV genotypes identified in previously unsatisfactory cervical smear tests after inexpensive glacial acetic acid processing

Unsatisfactory Pap Test Results: A Critical Patient Management Problem Pre‐Analytically Addressed by the Cytopathology Laboratory

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Maximizing the adequacy of Hologic^® Cervista^® HPV HR results on ThinPrep^® Pap samples treated with glacial acetic acid