PART THREE
Special Techniques in Cytology
F ig . 3 4 .9 (A1 & A2) M o n o P re p p r e p a r a tio n m e th o d . The M o no P re p vial conta in s a h o llo w stirring rod th a t w h e n ro ta te d h om o g e nize s th e specim en.
F o llo w in g h o m o g e n iz a tio n , th e sam ple is d ra w n th ro u g h th e h o llo w ce n te r and d ep o site d on a filter, w h ic h is th e n b lo tte d o n to th e glass slide surface. (B) T h e
M o n o P re p p ro c e s s in g d e v ic e is a n a u to m a te d s y s te m , a llo w in g m u ltip le sam ples to be run in a "w a lk aw ay" fashion.
T a b le 34.1 Liqu id-based P erform ance Data
In itia l c lin ic a l tria ls
P o s ta p p ro v a l s tu d ie s
LS IL+ (% )
U n s a tis fa c to ry ra te (% )
H S IL+ (% )
US F o o d a n d D ru g A d m in is tr a tio n c lin ic a l tr ia l d a ta a
ThinP rep
+18
1.9
58
SurePath
+ 7
0.6
64
In d e p e n d e n t s tu d ie s "
ThinP rep
+ 102 (+40 to +224)
- 2 4 (-8 1 to +215)
+ 100 (+59 to +112)
SurePath
+61 (+59 to +67)
- 8 3 (-1 0 0 to +9)
+65 (+46 to +78)
HSIL, high-grade squamous intraepithelial lesion; LSIL, low-grade squamous intraepithelial lesion.
aIn comparison with conventional cytology.
Based on the data presented, as w e ll as o u r ow n experience
u tiliz in g liquid-based technology, it is clear th a t perform ance o f
the Papanicolaou test is substantially im proved using these m eth-
ods. The degree o f im p rovem ent w ill vary fro m one lab oratory
to another, as illustrated b y the hig h degree o f v a ria b ility in the
studies presented. The achieved im p rovem ent is closely tied to the
starting p o in t fo r each facility. In those laboratories having o p ti-
m ized conventional smear m ethods, im provem ents m ay be less
than the norm , fo r laboratories receiving conventional slides fro m
a w id e ly varied sam ple-taker p op ulation, in w hich conventional
specimen q u a lity is diverse, the resultant technical standardiza-
tio n o f m ethod and o p tim iza tio n o f results w ill be m axim ized.
Automated Screening Devices
There are tw o fund am ental approaches to autom ated screening.
The first approach is fo r a device to categorize an entire slide
as to the p ro b a b ility o f a b n o rm a lity being present anywhere on
the slide. This process allow s fo r the ra n k ordering o f a group o f
slides, w h ic h allow s m achine decisions o f "neg ative" based on
1028
previous page 1012 ComprehensiveCytopathology 1104p 2008 read online next page 1014 ComprehensiveCytopathology 1104p 2008 read online Home Toggle text on/off