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The unsatisfactory ThinPrep Pap Test: missed opportunity for disease detection?
Joel S Bentz1, Leslie R Rowe, Evelyn V Gopez
1Department of Pathology, University of Utah School of Medicine, Salt Lake City 84132, USA.
American Journal of Clinical Pathology
|March 13, 2002
Summary
Reprocessing unsatisfactory ThinPrep Pap tests with a glacial acetic acid wash significantly reduces the rate of unsatisfactory specimens. This laboratory procedure also successfully identified previously undetected epithelial abnormalities, improving diagnostic yield.
Area of Science:
- Cytopathology
- Gynecologic Oncology
- Laboratory Medicine
Background:
- Unsatisfactory cervical cytology specimens pose a risk for undetected disease.
- The ThinPrep Pap Test is a common method for cervical cancer screening.
Purpose of the Study:
- To evaluate the effectiveness of a laboratory reprocessing procedure for unsatisfactory ThinPrep Pap tests.
- To determine the impact of reprocessing on the unsatisfactory specimen rate and diagnostic yield.
Main Methods:
- A prospective study was conducted on ThinPrep Pap test samples initially classified as unsatisfactory.
- Reprocessing involved a glacial acetic acid wash of residual material.
- The study compared the unsatisfactory rate before and after implementing the reprocessing procedure.
Main Results:
- The initial unsatisfactory rate was 1.3%. After reprocessing, 55.8% of unsatisfactory samples had residual material.
- Reprocessing reclassified 67.3% of these samples as satisfactory, reducing the final unsatisfactory rate to 0.8% (a 62% decrease).
- Epithelial abnormalities were detected in 6.4% of reprocessed slides, including squamous cell carcinoma.
Conclusions:
- Reprocessing unsatisfactory ThinPrep slides is a beneficial laboratory procedure.
- This method effectively increases the diagnostic yield of cervical cytology by detecting abnormalities that would otherwise be missed.