"TelePAPology" vs Liquid-Based Thin-Layer Cervical Cytology: A Comparative Study Evaluating Specimen Adequacy and Non-Neoplastic Findings.
Ossama Tawfik, Marilyn Davis, Susan Dillon, Dennis Friesen, Maura O'Neil, Fang Fan, Rashna Madan. Kansas University Medical Center, Kansas
Background: To date, the impact of digital imaging on routine day to day cytology remains far from perfect. Cellblock (CB) preparations from discarded/residual conventional and liquid based GYN samples have been shown to be of diagnostic value. In a pilot study, we have demonstrated the feasibility of utilizing imaging technology to overcome current limitations by digitizing cytologic specimens from CB preparations. The study was undertaken to evaluate the accuracy of TelePAP virtual slides from CB preparations in the determination of specimen adequacy and in the detection of various organisms and other non-neoplastic findings.
Design: The Cellient system from Hologic (Marlborough, MA) was used to prepare CBs. 231 H&E stained CB slides prepared from residual TP samples were analyzed. TelePAP slides were obtained using the Aperio digital imaging system (Vista, CA). They were reviewed by 4 cytopathologists and 2 cytotechnologists. Test performance characteristics of TP and TelePAP samples were compared for specimen adequacy, presence of organisms including bacterial vaginosis (BV), fungal organisms, trichomonas vaginalis (TV) and Herpes simplex, and non-neoplastic findings including reactive changes such as inflammation, radiation, glandular cells status post hysterectomy and atrophy.
Results: TelePAP virtual slides contained optimal amount of material from the overwhelming majority of cases. 7 cases were unsatisfactory due to absence of squamous cells. 19 cases were of suboptimal quality due to decreased cellularity (10 cases) or obscuring blood and/or inflammation. BV was diagnosed in 33 TelePAP cases as compared to 36 TP cases. Clue cells and filmy background of coccobacilli were evident. Budding yeasts and/or pseudohypheal forms were noted in 18 TelePAP vs 19 TP cases. TV organisms (10 cases) and one herpes case were identified in equal numbers of TelePAP and TP cases. Additionally classic radiation, inflammatory changes with reactive/reparative changes and endocervical and endometrial cells were easily identified in similar proportions by the 2 methods.
Conclusions: TelePAPology is a feasible method for widespread adoption to achieve high quality specimen preparations. The presence of organisms was identified on TelePAP slides as accurate as TP slides. TelePAP is as sensitive as TP method for detection of non-neoplastic findings. The cytologic/histologic findings are identical supporting the concept that this method is suitable for routine cytology, in situ and immunohistochemistry testing for HPV and other prognostic markers.
Tuesday, March 1, 2011 9:30 AM
Poster Session III # 99, Tuesday Morning