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Cervex-Brush vs. spatula and Cytobrush. A cytohistologic evaluation
B Risberg1, A Andersson, C Zetterberg
1Department of Gynaecology, Medical Centre Hospital, Orebro, Sweden.
Objective:
To compare the efficacy of two cervical smear instruments, Cervex-Brush and spatula plus Cytobrush.
Study Design:
Cervical smears were taken before laser ring biopsies in 213 women, who were randomized for the Cervex-Brush or spatula plus Cytobrush (S+C). The cytologic diagnosis was compared to the histologic diagnosis after laser ring biopsy.
Results:
The correlation between cytology and histology showed comparable concordance (54% and 42%) for the two devices. In 130 (74 with Cervex-Brush and 56 S+C) patients, histology revealed moderate dysplasia or more advanced lesions. Those cases were further analyzed for smear failures. Negative smears were found in 13 cases (10 in the Cervex-Brush and 3 in the S+C group). This difference in favor of S+C was not, however, statistically significant. Significantly more false negative smears were found when endocervical cells were absent and in patients 30-39 years of age.
Conclusion:
Modern sampling devices, such as the Cervex-Brush and S+C, seem to be equally efficient in obtaining dysplastic squamous cells. Other factors of importance for nonrepresentative cervical smears should be studied in order to improve efficacy.