Liquid-Based Cytology Using $MonoPrep2^{TM}$ System in Cervicovaginal Cytology: Comparative Study with Conventional Pap Smear and Histology

고식적 직접 도말법과 $MonoPrep2^{TM}$ system 법에 의한 자궁경부질 세포검사 성적의 비교 검토

  • Jeon, Yoon-Kyung (Department of Pathology, Seoul National University College of Medicine) ;
  • Kim, Ok-Ran (Department of Pathology, Seoul National University College of Medicine) ;
  • Park, Ki-Wha (Department of Pathology, Seoul National University College of Medicine) ;
  • Kang, Soon-Beom (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Park, In-Ae (Department of Pathology, Seoul National University College of Medicine)
  • 전윤경 (서울대학교 의과대학 병리학교실) ;
  • 김옥란 (서울대학교 의과대학 병리학교실) ;
  • 박기화 (서울대학교 의과대학 병리학교실) ;
  • 강순범 (서울대학교 의과대학 산부인과학교실) ;
  • 박인애 (서울대학교 의과대학 병리학교실)
  • Published : 2004.05.30

Abstract

We compared the diagnostic accuracy of liquid-based cervicovaginal cytology using $MonoPrep2^{TM}$ system (Monogen, Herndon, Virginia, USA), a manual system based on membrane filtration method, with conventional Pap smear. Study population included 92 patients visiting the gynecologic department under the suspicion of uterine cervical disease. In thirty of them, surgical biopsy was performed. $MonoPrep2^{TM}$ system provided well-preserved monolayer specimen with good nuclear morphology. However, about 19% of specimens were inadequate to interpret due to low cellularity. The detection rate of abnormal cells more than ASCUS (atypical squamous cells of unknown significance) was 23.9% and higher than 19.4 % of conventional Pap smear. Diagnostic concordance rate with conventional Pap smear was 81%, and severe discordance rate influencing on the management of patient was 7.6 %. Among these seven cases, $MonoPrep2^{TM}$ system was more diagnostic only in four. In comparison with histology, the sensitivity of diagnosis of $MonoPrep2^{TM}$ system was 78.9% and slightly higher than 73.5% of conventional Pap smear. However, the specificity was 81.1% and lower than 90.9% of Pap smear. In conclusion, $MonoPrep2^{TM}$ system provided diagnostic accuracies similar to the conventional Pap smear. The inexpertness of slide preparation and the low cellularity were considered to endow a limitation in more accurate evaluation.

Keywords

References

  1. Lender J. Recent advances in thin-layer cytology. Diagn Cytopathol 1998;18:24-32 https://doi.org/10.1002/(SICI)1097-0339(199801)18:1<24::AID-DC5>3.0.CO;2-U
  2. Hutchinson ML, Zahniser DJ, Sherman ME, et al. Utility of liquid-based cytology for cervical carcinoma screening : results of a population-based study conducted in a region of Costa Rica with a high incidence of cervical carcinoma. Cancer 1999;87:48-55 https://doi.org/10.1002/(SICI)1097-0142(19990425)87:2<48::AID-CNCR2>3.0.CO;2-D
  3. Weintraub J, Morabia A. Efficacy of a liquid-based thin layer method for cervical cancer screening in a population with a low incidence of cervical cancer. Diagn Cytopathol 2000;22:52-9 https://doi.org/10.1002/(SICI)1097-0339(200001)22:1<52::AID-DC14>3.0.CO;2-#
  4. Baker JJ. Conventional and liquid-based cervicovaginal cytology : a camparison study with clinical and histologic follow-up. Diagn Cytopathol 2002;27:185-8 https://doi.org/10.1002/dc.10158
  5. Carpenter AB, Davey DD. ThinPrep$\circled{R}$ Pap $Test^{TM}$ : performance and biopsy follow-up in a university hospital. Cancer 1999;87:105-12 https://doi.org/10.1002/(SICI)1097-0142(19990625)87:3<105::AID-CNCR2>3.0.CO;2-Z
  6. Florentine BD, Wu NC, Waliany S, Carriere C, Hindle W, Raza A. Fine needle aspiration (FNA) biopsy of palpable breast masses : comparison of conventional smears with the Cyto-Tek MonoPrep system. Cancer 1999;87:278-85 https://doi.org/10.1002/(SICI)1097-0142(19991025)87:5<278::AID-CNCR7>3.0.CO;2-A
  7. Davey DD, Nielsen ML, Frable WJ, Rosenstock W, Lowell D, Kraemer BB. Improving accuracy in gynecologic cytology : results of the College of American Pathologists in-terlaboratory comparison program in cervical cytology. Arch Pathol Lab Med 1993;117:1193-8
  8. Maksem JA, Finnemore M, Belsheim BL, et al. Manual method for liquid-based cytology : a demonstration using 1,000 gynecological cytologies collected directly to vial andprepared by a smear-slide technique. Diagn Cytopathol 2001;25:334-8 https://doi.org/10.1002/dc.2166