Reprocessing Unsatisfactory ThinPrep Papanicolaou Smears: A Tool for Reducing Unsatisfactory Rate and Enhancing Disease Detection
Andra Kovalovsky, Cindy Steele, Kamal K Khurana. SUNY Upstate Medical University, Syracuse, NY
Background: Longitudinal studies have shown that cervical cytology specimens classified as unsatisfactory have an increased risk of being associated with disease, including carcinoma. We conducted this study to assess the effect of reprocessing ThinPrep slides on the unsatisfactory rate and subsequent detection of epithelial cell abnormality over a 3-year period at our institution.
Design: All unsatisfactory ThinPrep samples submitted between January 2008 and March 2011 were reprocessed using a glacial acetic acid wash.
Results: A total volume of 24345 ThinPrep samples were evaluated over a three year period. The unsatisfactory rate prior to reprocessing was 2.3 % (627 of 24345). After reprocessing all the unsatisfactory smears, the reprocessing rate was reduced to 0.07% (17 of 24345). Of the 627 samples that were reprocessed, 97.3% (610 of 627 TP samples) were changed from unsatisfactory to satisfactory. Of these 610 satisfactory reprocessed paps 81% (495) were negative for intraepithelial lesion or malignancy, 8.6% (53) were atypical squamous cells of undetermined significance, 0.81% (5) were atypical glandular cells of undetermined significance, 4.4% (27) were low-grade squamous intraepithelial lesions, 1.5% (9) were high-grade squamous intraepithelial lesions, 0.67% (4) were carcinoma and 2.8% (17) were 'other' category.
Conclusions: Reprocessing unsatisfactory ThinPrep Papanicolaou smears with glacial acetic acid serves as a useful tool for reducing unsatisfactory rate and enhancing cervical disease detection.
Category: Quality Assurance
Monday, March 19, 2012 2:45 PM
Platform Session: Section G, Monday Afternoon