Preliminary study concerning the cytoscreen system importance (liquid based cytology) in gynecologic cytology

Our study aims to present the principal and the advantage of using the Liquid Based Cytology method by Cytoscreen system, as an alternative to the conventional Babes-Papanicolaou test, by reducing the false negative results frequency due to the poor quality of the smears and the epithelial cell screening by the blood elements, mucus or inflammatory exudates. A set of 1 054 female patients was available to be investigated during 2002-2004 both in the Clinical Gynaecology of The Clinical Hospital Filantropia and the Clinic of Oncology of the Clinical County Emergency Hospital of Craiova; the patients were from the rural and urban places as well; they underwent cytologic screening by Cytoscreen method. We simultaneously performed the cytologic exam by using both the Cytoscreen and the conventional Papanicolaou methods in 220 patients; the rest of them, namely 834 patients, were examined just by Cytoscreen method. The samples were processed in the Laboratory of Pathology and Cytology of the Clinical County Emergency Hospital of Craiova. The smears were fixed in the absolute ethanol for minimum five minutes than was performed the Papanicolaou stain. The diagnosis was according to Bethesda System 2001. Most of the patients (85.87%) were 21-50 aged. For the group of those tested by Cytoscreen, the rate of the "satisfactory smears" was significant increase (82.27% compared to 65.45% of the patients examined by using only the conventional method). The positive results were 5.44% compared to 2.27%. More accurate diagnosis of high degrees squamous intraepithelial lesions (1.36% compared to one case --0.45%), of low degree lesions (4 cases--1.81% compared to 2 cases--0.91%) and the atypical squamous cells with undetermined significance (1.36%Cytoscreen tested compared with 0.91%). Cytologic diagnosis was enforced by biopsy with histopathologic exam for 4 of 10 cases; the rest of the patients did not present for biopsy to be performed. In one case, HSIL diagnosis was false negative as the biopsy result was well-differentiated invasive squamous carcinoma. Both the diagnosis sensitivity and the smears feasibility were significantly improved by using Cytoscreen method.