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Cell Block Preparation from Cytology Specimen with Predominance of Individually Scattered Cells
Published on: July 21, 2009
Using a quality control approach to define an 'adequately cellular' liquid-based cervical cytology specimen
Summary
Defining a minimum cellularity for liquid-based cervical cytology (LBC) is challenging. Studies show no single cellularity guarantees detection of abnormal cells, suggesting pragmatic program-based settings for repeat testing.
Area of Science:
- Cytopathology
- Cervical Cancer Screening
- Quality Control
Background:
- Liquid-based cytology (LBC) is a method for cervical cancer screening.
- Establishing quality control metrics for LBC is crucial for accurate diagnosis.
Purpose of the Study:
- To determine a minimum acceptable squamous cellularity for ThinPrep liquid-based cervical cytology (LBC) specimens.
- To evaluate the effectiveness of quality control techniques in LBC analysis.
Main Methods:
- Analyzed 200 LBC preparations with varying numbers of dyskaryotic squamous cells and total cellularities.
- Assessed the relationship between cellularity, abnormal cell counts, and detection rates by cytoscreeners.
Main Results:
- Preparations missed by cytoscreeners often had fewer than 16 abnormal objects or 87 dyskaryotic cells.
- A minimum dyskaryotic to total squamous cell ratio of 1:47 was calculated for a 0.98 probability of detecting 87 abnormal cells in 5000 total squamous cells.
- No feasible minimum cellularity could ensure detection of all abnormal specimens given observed proportions.
Conclusions:
- A universally applicable minimum cellularity for LBC is not feasible for guaranteeing detection of all abnormal cells.
- Screening programs should pragmatically set minimum acceptable cellularity for LBC specimens to manage repeat testing rates.
