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Brush vs. spatula for cervical smears. Histologic correlation with concurrent biopsies
S Chakrabarti1, F B Guijon, M Paraskevas
1Department of Pathology, University of Manitoba, Winnipeg, Canada.
Acta Cytologica
|May 1, 1994
Summary
Cervical brush smears yield more endocervical cells but may lead to overinterpretation compared to spatula smears. While brush sampling increases abnormal case detection, it shows lower concordance with biopsy results.
Area of Science:
- Gynecologic Cytopathology
- Cervical Cancer Screening
Background:
- Cervical cancer screening relies on cytological evaluation of cervical cells.
- Specimen collection methods, such as brush versus spatula, can influence sample adequacy and interpretation.
Purpose of the Study:
- To compare the performance of cervical brush smears versus spatula smears in detecting endocervical cells and abnormal squamous lesions.
- To assess the concordance between cytological findings and histological results for both brush and spatula samples.
Main Methods:
- Retrospective analysis of 1,293 brush smears and 1,304 spatula smears.
- Comparison of cytological interpretation for 547 brush smears with biopsies and 421 spatula smears with biopsies.
Main Results:
- Brush smears showed significantly higher rates of endocervical cell presence (94.1% vs. 63.04%).
- Brush smears detected significantly more abnormal cases, including low and high-grade squamous intraepithelial lesions (LSIL/HSIL).
- Brush smears exhibited a higher discrepancy rate (17.6%) between cytological high-grade lesions and histological findings compared to spatula smears (8.9%).
Conclusions:
- Cervical brush sampling improves sample adequacy and detection of abnormalities.
- However, brush sampling may lead to cytopathological overinterpretation, indicated by lower concordance with biopsy results.
- The findings suggest a need for careful interpretation of brush smear results to minimize diagnostic discrepancies.