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Thin-layer preparations of dithiothreitol-treated bronchial washing specimens
Kirsti I Koivurinne1, Paul W Shield
1Cytology Department, Sullivan Nicolaides Pathology, School of Life Sciences, Queensland University of Technology, Brisbane QLD 4001, Australia. k.koivurinne@qut.edu.au
Objective:
To evaluate the combined effect of dithiothreitol (DTT) treatment and ThinPrep (TP) (Cytyc Corp, Boxborough, Massachusetts, U.S.A.) processing on bronchial washing specimens.
Study Design:
A total of 431 bronchial washing specimens were initially treated with 0.05% DTT in a 30% methanol solution. After centrifugation, 1 TP slide and 2-4 conventional cytospin or smear preparations (CPs) were prepared. The reports of both preparations were compared in all cases. All 48 abnormal cases and 52 consecutive negative cases were also compared for cellular composition, distribution of the cells, ease of interpretation and overall preparation quality. Screening time was recorded for 20 of the cases.
Results:
The diagnostic accuracy of one TP slide appeared comparable to that of 2-4 CPs. The TP slide was assessed to be equal or superior in overall quality to CP in 85% of 100 cases of paired specimens. The cleaner background and smaller cellular area of TP slides significantly reduced the screening time. Mucolysis and specimen homogenization were not always optimal, occasionally resulting in uneven subsampling and poorly cellular TPs. However, in general, TP slides were considered superior to CPs in overall quality.
Conclusion:
Improvement in specimen quality and reduced screening time have to be balanced against the high cost of consumables with the TP technique.