Manual Liquid-Based Cytology A Pilot Study

INTRODUCTION: Automated liquid-based cytology methods for cervical cancer screening require processing systems that may not be affordable in low-resource settings. The purpose of this study was to assess the use of the manual liquid-based cytology product VitroPrep Gyn/Cytology Processing Kit. METHODS: This is a descriptive pilot study. Women underwent cervical sampling to be processed by the Thin Prep liquid-based cytology system. This was followed by cervical sampling for the VitroPrep system. All samples were evaluated by a single blinded gynecologic pathologist. Results were scored as follows: 1=unsatisfactory, 2=borderline, 3=acceptable, 4=good, 5=excellent. The following criteria were assessed: monolayer cell adhesion, overall cellularity, background clarity, preservation of cellular morphology, red cell lysis, and elimination of mucus or debris. Specimens were evaluated for adequacy based on Bethesda criteria and diagnosis was compared with results from Thin Prep. Additional women were sampled before conization procedures. RESULTS: Forty-seven women underwent dual cytologic sampling. Five manual samples were unsatisfactory as a result of low cellularity and excluded. All scores were 3–5 with greater than 90% graded 4–5. The VitroPrep diagnosis correlated with the Thin Prep diagnosis in 90% (38/42). All VitroPrep specimens obtained from 15 additional women before conization were satisfactory and correlated abnormal cytologic findings with cervical intraepithelial neoplasia 1–3 pathology. CONCLUSIONS: Despite the disadvantage of obtaining samples after an initial cytologic or biopsy sample, VitroPrep was able to provide adequate specimens for evaluation and diagnosis. This low-cost processing method may provide a useful alternative in settings where automated liquid-based cytology systems may not be feasible.