Improving the Cytobrush as an aid in the evaluation of the abnormal Papanicolaou test

In a series of 39 patients undergoing cervical conization, the Cytobrush was used to determine whether dysplasia involved the endocervical canal. To improve the specificity of the Cytobrush for this purpose, a sleeve was designed to guide the brush into the endocervical canal in order to minimize contamination from ectocervical lesions. Both the unsleeved and sleeved Cytobrush demonstrated good sensitivity for detecting dysplasia within the endocervical canal (89 and 95%, respectively). The sleeved Cytobrush demonstrated greater specificity than the unsleeved Cytobrush (90 versus 60%; P less than .05). Compared with endocervical curettage, the Cytobrush used in conjunction with the described "cytosleeve" offers an inexpensive, less painful, and accurate method of determining endocervical involvement of dysplasia.