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Performance of liquid-based, thin-layer cervical cytology: correlation with reference diagnoses and human
M E Sherman1, M Mendoza, K R Lee
1Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Summary
The ThinPrep cervical cytology method detects more squamous intraepithelial lesions (SILs) than conventional smears. This improved detection of SILs using ThinPrep correlates with human papillomavirus (HPV) DNA testing results.
Area of Science:
- Gynecologic Pathology
- Cytopathology
- Molecular Diagnostics
Background:
- Cervical cancer screening relies on accurate detection of squamous intraepithelial lesions (SILs).
- Conventional smears have limitations in sensitivity and specificity.
- ThinPrep offers an alternative method for cervical cytology preparation.
Purpose of the Study:
- To compare the diagnostic performance of ThinPrep cervical cytology with conventional smears.
- To evaluate the correlation between ThinPrep diagnoses and human papillomavirus (HPV) DNA detection.
- To assess the detection rates of SILs by ThinPrep versus conventional smears.
Main Methods:
- A split-sample study involving 1780 women.
- Comparison of ThinPrep slides and conventional smears against independent pathologist review.
- Detection of cancer-associated HPV DNA in relation to cytological diagnoses.
Main Results:
- ThinPrep detected significantly more SILs than conventional smears in screening centers (70.3% vs. 47.4%, P < .001).
- In hospital labs, ThinPrep also showed higher SIL detection rates (86.3% vs. 79.3%, P = .011).
- While HPV DNA was slightly higher in smear-diagnosed SILs, ThinPrep yielded a greater overall number of HPV-associated SIL diagnoses.
Conclusions:
- The ThinPrep method demonstrates superior performance in detecting SILs compared to conventional smears.
- ThinPrep diagnoses of SILs are consistent with the presence of cancer-associated HPV types.
- ThinPrep enhances cervical cancer screening accuracy by improving SIL detection rates.