LIQUID BASED CYTOLOGY

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LIQUID BASED CYTOLOGY

• Irene M le Roux
• Programme Head / National Cytology coordinator
• NHLS

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NHLS STUDIES

• Two separate studies
• 2006 at the Tygerberg laboratory
• 2008 at the Braamfontein laboratory

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Reasons for investigating LBC

• New Technology
• Improvement in screening volumes
• Improvement in diagnosis
• Improvement in unsuitable rates
• Improvement in adequacy rates
• Improvement of TAT

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For the study

• Invited the 4 LBC companies in SA to participate
• Collection of material was done according to an
  approved protocol
• The CEVEX brush was used
• The cervical (PAP) smear was made first
• The remaining material rinsed in the preservative
• The head of the brush was placed in the vial

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Preparation of the specimens

• A national Cytology workshop was held
• Presentations practical demonstrations by each
  company
• The PAP smears formed part of the routine work
• The LBC prepared smears were screened blind
• The results were compiled by an independent
  person
• One company withdrew shortly before the workshop

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PREPARATION

• Representatives from the companies prepared the
  collected samples as part of the demonstrations

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Results (1)

• A total of 373 cases were included
• LBC showed an improvement by
• lowering the ASCUS rates
• (4.3 vs 6.4)
• increasing the LSIL rates
• (13.4 vs 12.1)
• lowering the unsatisfactory rates
• (1.3 vs 1.9)

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Results (2)

• LBC and the PAP smears were equal on the
• HSIL (5.6 each)
• The PAP smears had more Endo -cervical component
  present
• (85.7 vs 79.2 )

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SECOND NHLS STUDY

• The 2008 study was a collaboration between the
  Braamfontein laboratory SurePath.
• More than 1000 cases in study
• Preliminary results
• Improvement of 3 on LSIL cases
• 0.8 improvement on unsatisfactory cases

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CONCLUSION

• The advantages of LBC in 2 studies
• Improvement in LSIL unsatisfactory rates
• Smaller surface to be screened
• Monolayer preparations vs thick smears
• Improved TAT
• Less exudate and blood that obscure cells

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CONCLUSION (2)

• The disadvantages
• Cost

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THANK YOU.