Search

Objective To explore and validate the application value of a deep learning model based on the Huawei Cloud ModelArts platform in the diagnosis of atypical cervical cells in liquid-based cytology(LBC)and to evaluate its assistive effect for pathologists with different diagnostic experiences. Methods We retrospectively analyzed 1 044 cervical cytology specimens from Dongguan People's Hospital in 2020. The artifical intelligence(AI)-assisted diagnostic system developed on the Huawei Cloud ModelArts platform was compared with junior, intermediate, and senior pathologists for diagnosis. Sensitivity, specificity, precision, recall, and area under the receiver operating characteristic curve(AUC)were calculated to assess the diagnostic performance of the AI system and its assistive effect for pathologists with different levels of experience. The McNemar test was used to compare the differences between the AI system and manual diagnosis. P<0.05 was considered statistically significant. Results For the 1 044 cervical exfoliated cytology specimens, the sensitivity and specificity of the AI system in detecting atypical cells was 98.96% and 89.15%, both of which were higher than those of junior doctors(81.95% and 91.81%, respectively). The overall diagnostic accuracy of the AI system was 93.68%, which was significantly higher than that of junior doctors(87.26%, P<0.001). AI assistance could significantly improve junior doctors' ability to detect atypical cells, with the sensitivity and specificity increasing from 80.1% to 96.5% and from 85.6% to 92.3%, respectively. Conclusion The AI-assisted cervical cytology diagnostic system developed in this study demonstrated superior performance, particularly in significantly improving the diagnostic level of junior pathologists, showing promising clinical application prospects. [ABSTRACT FROM AUTHOR]

Abstract Background Primary cervical cancer screening and treating precancerous lesions are effective ways to prevent cervical cancer. However, the coverage rates of human papillomavirus (HPV) vaccines and routine screening are low in most developing countries and even some developed countries. This study aimed to explore the benefit of an artificial intelligence-assisted cytology (AI) system in a screening program for a cervical cancer high-risk population in China. Methods A total of 1231 liquid-based cytology (LBC) slides from women who underwent colposcopy at the Chinese PLA General Hospital from 2018 to 2020 were collected. All women had received a histological diagnosis based on the results of colposcopy and biopsy. The sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), false-positive rate (FPR), false-negative rate (FNR), overall accuracy (OA), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and Youden index (YI) of the AI, LBC, HPV, LBC + HPV, AI + LBC, AI + HPV and HPV Seq LBC screening strategies at low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL) thresholds were calculated to assess their effectiveness. Receiver operating characteristic (ROC) curve analysis was conducted to assess the diagnostic values of the different screening strategies. Results The Se and Sp of the primary AI-alone strategy at the LSIL and HSIL thresholds were superior to those of the LBC + HPV cotesting strategy. Among the screening strategies, the YIs of the AI strategy at the LSIL + threshold and HSIL + threshold were the highest. At the HSIL + threshold, the AI strategy achieved the best result, with an AUC value of 0.621 (95% CI, 0.587–0.654), whereas HPV testing achieved the worst result, with an AUC value of 0.521 (95% CI, 0.484–0.559). Similarly, at the LSIL + threshold, the LBC-based strategy achieved the best result, with an AUC of 0.637 (95% CI, 0.606–0.668), whereas HPV testing achieved the worst result, with an AUC of 0.524 (95% CI, 0.491–0.557). Moreover, the AUCs of the AI and LBC strategies at this threshold were similar (0.631 and 0.637, respectively). Conclusions These results confirmed that AI-only screening was the most authoritative method for diagnosing HSILs and LSILs, improving the accuracy of colposcopy diagnosis, and was more beneficial for patients than traditional LBC + HPV cotesting.

Background: FNAC is a simple, safe and cost-effective method and is one of the triple diagnostic triads along with clinical breast examination and radiology methods (mammography/ ultrasonography).Cytological diagnosis is very beneficial for the preoperative assessment of various breast lesions. The application of LBC technique along with conventional smear can strengthen the efficacy of diagnosing various breast lesions on FNAC. Aim: Comparison of liquid-based cytology versus conventional smears in fine needle aspiration cytology of breast lesions. Materials and Methods: A prospective study of 50 cases conducted over a period of 16 months included all female patients referred to the cytology department for FNAC. Two different passes were given, the first pass was used to prepare conventional smears and second pass was used for LBC smears. Results: Among 50 cases, 38 (76%) were benign and 12 (24%) were malignant. The commonest benign lesion was fibroadenoma and malignant lesion was Infiltrating Ductal Carcinoma. The difference between LBC and conventional smears was statistically significant pertaining to background blood debris (p < 0.00001), informative background (p = 0.0004) and cellular architecture (p = 0.0075) while it was not statistically significant for cellularity, mono layering, nuclear and cytoplasmic details The sensitivity, specificity, PPV, NPV and diagnostic accuracy of FNAC in both LBC and conventional smears were similar, being 80%, 100%, 100%, 95.23% and 96% respectively. Conclusion: LBC cannot replace conventional cytology but can be used as a supplement with the conventional method to minimize false negative cytology rate and to increase the diagnostic accuracy of breast lesions. [ABSTRACT FROM AUTHOR]

Background: Primary cervical cancer screening and treating precancerous lesions are effective ways to prevent cervical cancer. However, the coverage rates of human papillomavirus (HPV) vaccines and routine screening are low in most developing countries and even some developed countries. This study aimed to explore the benefit of an artificial intelligence-assisted cytology (AI) system in a screening program for a cervical cancer high-risk population in China. Methods: A total of 1231 liquid-based cytology (LBC) slides from women who underwent colposcopy at the Chinese PLA General Hospital from 2018 to 2020 were collected. All women had received a histological diagnosis based on the results of colposcopy and biopsy. The sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), false-positive rate (FPR), false-negative rate (FNR), overall accuracy (OA), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and Youden index (YI) of the AI, LBC, HPV, LBC + HPV, AI + LBC, AI + HPV and HPV Seq LBC screening strategies at low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL) thresholds were calculated to assess their effectiveness. Receiver operating characteristic (ROC) curve analysis was conducted to assess the diagnostic values of the different screening strategies. Results: The Se and Sp of the primary AI-alone strategy at the LSIL and HSIL thresholds were superior to those of the LBC + HPV cotesting strategy. Among the screening strategies, the YIs of the AI strategy at the LSIL + threshold and HSIL + threshold were the highest. At the HSIL + threshold, the AI strategy achieved the best result, with an AUC value of 0.621 (95% CI, 0.587–0.654), whereas HPV testing achieved the worst result, with an AUC value of 0.521 (95% CI, 0.484–0.559). Similarly, at the LSIL + threshold, the LBC-based strategy achieved the best result, with an AUC of 0.637 (95% CI, 0.606–0.668), whereas HPV testing achieved the worst result, with an AUC of 0.524 (95% CI, 0.491–0.557). Moreover, the AUCs of the AI and LBC strategies at this threshold were similar (0.631 and 0.637, respectively). Conclusions: These results confirmed that AI-only screening was the most authoritative method for diagnosing HSILs and LSILs, improving the accuracy of colposcopy diagnosis, and was more beneficial for patients than traditional LBC + HPV cotesting. [ABSTRACT FROM AUTHOR]

The technique of liquid-based cytology (LBC) is of increasing diagnostic value in non-gynecological cytology. The purpose of the present study was to validate modifications to stages of the LBC process and to assess the diagnostic usefulness of the LBC technique. Between May 2021 and January 2022, a total of 484 samples were prepared from routine cytology tests carried out in the Department of Tumor Pathology of The Greater Poland Cancer Center. The material was obtained from fine-needle aspiration biopsies and fluid samples. One hundred cases were selected for the research described in the article. The slides were prepared using the Becton Dickinson Totalys SlidePrep device. Based on the research, it was concluded that predominantly the LBC technique gives better results than a conventional smear because the background, which would otherwise make it difficult to assess preparations, was eliminated. Additionally, in LBC preparations the cellularity was increased, and the cells were arranged in a monolayer system, which improves the image quality. The introduction of modifications to the LBC method facilitated the process of sample preparation, without adversely affecting the quality of the obtained material.

The technique of liquid-based cytology (LBC) is of increasing diagnostic value in non-gynecological cytology. The purpose of the present study was to validate modifications to stages of the LBC process and to assess the diagnostic usefulness of the LBC technique. Between May 2021 and January 2022, a total of 484 samples were prepared from routine cytology tests carried out in the Department of Tumor Pathology of The Greater Poland Cancer Center. The material was obtained from fine-needle aspiration biopsies and fluid samples. One hundred cases were selected for the research described in the article. The slides were prepared using the Becton Dickinson Totalys SlidePrep device. Based on the research, it was concluded that predominantly the LBC technique gives better results than a conventional smear because the background, which would otherwise make it difficult to assess preparations, was eliminated. Additionally, in LBC preparations the cellularity was increased, and the cells were arranged in a monolayer system, which improves the image quality. The introduction of modifications to the LBC method facilitated the process of sample preparation, without adversely affecting the quality of the obtained material. [ABSTRACT FROM AUTHOR]

Purpose of the study. Was to assess diagnostic informative value of liquid-based cytology optimized with genetic methods for the differential diagnosis of precancerous and malignant diseases of the cervix.Materials and methods. The study included 381 patients. Cervical pathologies were diagnosed with liquid-based cytology only and liquid-based cytology optimized with genetic methods of assessing the expression of miRNA‑20a, miRNA‑375, miRNA‑21 and –23b. Results of liquid-based cytology and genetic methods were verified by histological examination of the material. Statistical analysis was performed using descriptive statistics methods with the calculation of the mean and standard error of the mean. The mean values were compared with the help of the Mann-Whitney test.Results. Diagnostic results of liquid-based cytology were consistent with histological results in 107 (73.8 %) of 145 cervical cancer (CC) patients, in 52 (57.1 %) of 91 patients with high-grade squamous intraepithelial lesions (HSIL), and in 30 (65.2 %) of 46 patients with low-grade squamous intraepithelial lesions (LSIL). Optimization of liquid-based cytology by assessing the expression of miRNA‑21 and miRNA‑23b in the cervical epithelium improved the diagnostic sensitivity of the method from 73.8 % to 80 %, and its specificity from 94.1 % to 97.9 %. The diagnostic sensitivity and specificity of liquid-based cytology for differential diagnosis of CC and HSIL was 87 % and 78.8 %, respectively. Optimization of liquidbased cytology by assessing the expression of miRNA‑20a and miRNA‑375 in the cervical epithelium for the differential diagnosis of CC and HSIL improved the diagnostic sensitivity of the method from 87 % to 95.1 %, and its specificity from 78.8 % to 93.9 %.Conclusions. We revealed the most informative pairs of miRNAs in the cervical epithelium, as an analysis of their expression expanded the possibilities of liquid-based cytology both as a method for diagnosing CC and as a method for the differential diagnosis between CC and HSIL.

Liquid-based cytology (LBC) is used primarily for cervical cytology, although it is also used for analyzing liquid samples such as urine and ascites specimens, as well as fine needle aspiration material, such as those obtained from breast and thyroid. The usefulness of the LBC method for endoscopic ultrasound-guided tissue acquisition (EUS-TA) of solid pancreatic masses was recently reported. The LBC method can produce multiple pathological slides and can be applied to immunocytochemistry and genetic analyses. In this article, we review the usefulness of LBC for EUS-TA of solid pancreatic masses.

Background: The role of Papanicolaou (Pap) test in cervical cancer screening need not be overemphasized. While most Western countries have adopted the liquid-based cytology (LBC), which is considered superior, many developing countries are still using the conventional Pap smear (CPS) technique. Objective: To compare the staining and cytomorphological features on conventional versus liquid-based cervicovaginal smears. Materials and Methods: One hundred and forty cervicovaginal smears prepared by the standard conventional and LBC techniques were interpreted as per the Bethesda system of reporting cervicovaginal smears. Twelve parameters were studied, compared, and statistically analyzed. A P value

Background: In this paper, we have compared the cytomorphologic characteristics of liquid-based preparation (LBP) [SurePath (SP)] cytology and conventional smear (CP) preparations on fine-needle aspiration (FNAC) material by a semi-quantitative scoring system for cases of lymphadenopathy. Materials and Methods: In this prospective study, a total of 52 consecutive cases of FNAC of lymphadenopathy were included. The first pass was used for CP followed by LBP with the help of SP technique. The smears were independently compared and assessed by two observers (PS and PD). Results: The semiquantitative grading was compared in two groups by Wilcoxon signed-rank test. The background information, cell architecture, pleomorphism, nuclear and cytoplasmic details, and three-dimensional structures were significantly different in LBP and CP smears. Conclusions: Liquid-based cytology (LBC) is a relatively simple technique, which exhibits good nuclear and cytoplasmic details with the absence of obscuring background material. Even the number of slides and area per slide to be screened were less than the conventional preparation but caution must be applied to interpret the slides and secure a diagnosis, especially if LBC is the first and only method applied for diagnosis.

Background: Conventional cytology (CC) is a well-established and effective methodology for the evaluation of pediatric tumors. Liquid-based cytology (LBC) is a better technique of smear preparation and is at present the standard protocol in cervical cytology samples. Aims: In the present study, we analyzed both smear preparatory techniques in fine-needle aspiration (FNA) samples from solid pediatric neoplasms in terms of adequacy and efficacy with objectives to study the changes in background and morphology of tumor cells in LBC smears. Materials and Methods: This was a prospective observational study conducted in a tertiary care teaching hospital, which included 52 pediatric patients with clinical diagnosis of malignancy and an assessable lump. Both conventional aspiration cytology and LBC smears were prepared as per standard protocols (SurePath BDTM) from FNA samples of cases and examined. Results and Conclusion: On comparing the diagnostic efficacy of cytology smears prepared by both techniques, LBC alone was diagnostic in 80.8% of the cases and conventional smear (CS) alone was diagnostic in 71.2% of the cases (agreement was 83.7%, P = 0.3). Cellular morphology was better preserved in LBC and interpretation was easier. There was a lower inadequacy rate in LBC and none of the samples was inadequate due to poor morphology in LBC smears (P = 0.0003). LBC showed an overall 40% improvement in inadequate cases by CS. LBC has been recommended as a complement to CC in nongynecological samples. Improved morphology and lower inadequacy rate make LBC a finer technique compared to CS in pediatric tumors as well.

Background: Liquid-based cytology (LBC) preparation is a way to improve and refine the fine-needle aspiration (FNA) samples. There are a few studies comparing LBC with conventional smear (CS). Aim: The present study was undertaken to evaluate the utility of manual LBC (MLBC) and CS preparations in various FNA samples. Materials and Methods: In this cross-sectional study, a total of 100 FNA samples from various anatomical sites were evaluated using MLBC and CS preparations. Cellularity, blood, informative background, monolayers, cell architecture, cytoplasmic, and nuclear preservation were compared with MLBC and CS preparations by Wilcoxon signed rank test. P < 0.05 is considered statistically significant. Results: MLBC preparations were superior to CS preparations in view of absence of blood and debris (P = 0.001), presence of monolayers (P < 0.001), and preservation of cytoplasmic (P = 0.001) and nuclear details (P = 0.001). However, no statistically significant differences were found between MLBC and CS preparations with regard to cellularity (P = 0.157), informative background (P = 0.083), and architecture (P = 0.739). Conclusion: MLBC preparations in FNAC are a safe, easy, and less time-consuming procedure, and it may have promising diagnostic value in the evaluation of FNA samples from various anatomical sites. However, the use of both MLBC and CS preparations is recommended to achieve optimal diagnostic yield.

Background: Liquid-based cytology (LBC) is fast becoming a useful method in evaluating both gynecological and non-gynecological preparations, including fine needle aspiration (FNA) cytology. Even distribution of cells, decreasing obscuring background elements like blood and mucus, well preserved nuclear and cytoplasmic details and rapid fixation helps in better visualization of cells. Aim: This study was conducted to asses the diagnostic accuracy of liquid-based cytology versus conventional smears in fine needle aspiration samples. Study Design: In this prospective study, we had 110 cases, including 30 cases of breast, 40 of lymph node, 10 of salivary glands, 18 of thyroid and 12 of bone and soft tissue. In each case, two passes were performed. The first pass was for conventional preparation (CP) and the second pass yielded material for thin-prep (TP) preparation. Both CP and TP smears were compared for cellularity, background blood and necrotic cell debris, cell architecture, informative background, presence of a monolayer of cells and nuclear and cytoplasmic details by a semiquantitative scoring system. Wilcoxon′s signed rank test on an SPSS program was used for statistical analysis. Results: Diagnostic accuracy was better in LBC smears compared with CP smears due to lack of background debris and better cell morphology, which was performed according to Wilcoxon′s signed rank test, yielding a P-value of

Background: Renal mass biopsy (RMB) has regained clinical interest in recent years due to the pursuit of individualized and precision medicine. Renal mass core needle biopsy (RMCNB) for histopathology (HP), with or without liquid-based cytology (LBC), has been used increasingly in our hospital. This study investigated factors influencing the HP diagnostic yield of RMCNB, and compared the diagnostic rate between HP alone and HP plus LBC., Methods: In this retrospective cross-sectional study, a total of 134 patients who underwent ultrasound-guided percutaneous RMCNB in the National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College between January 2015 and May 2022 were enrolled. All biopsies were performed using an 18-gauge core needle biopsy gun, and the sampling tissues and exfoliative cells of 18-gauge core needle groove were delivered for HP and LBC diagnosis, respectively. The patient demographics, clinical indications, tumor characteristics, number of biopsies, final pathological diagnosis, and follow-up data were reviewed. Univariate and multivariate logistic regression analyses were performed to evaluate the association between variables and HP diagnostic yield of RMCNB. The diagnostic rate between HP and HP plus LBC was compared using McNemar's test and agreement was evaluated using the Kappa score., Results: The most common indication of RMCNB was renal masses with a radiological diagnosis of locally advanced disease or distant metastasis (86.6%). The HP diagnostic yield was established in 88.1% (118/134) of cases, and the diagnostic rate of HP plus LBC was 94.0% (126/134). Logistic regression analyses revealed that non-enhanced area exceeding 50% [odds ratio (OR): 0.021, 95% confidence interval (CI): 0.003-0.134, P<0.001] and number of core biopsies (OR: 9.479, 95% CI: 1.528-58.794, P=0.016) were associated with the HP diagnostic yield of RMCNB. The diagnostic rate of HP plus LBC was significantly higher than that of HP alone (94.0% vs. 88.1%, P=0.008), and they showed substantial agreement (Kappa =0.638, P<0.001). Meanwhile, in the non-enhanced area ≥50% subgroup, the diagnostic rate between HP plus LBC and HP alone was significantly different (86.7% vs. 60%, P=0.008), and the agreement was fair (Kappa =0.375, P=0.009)., Conclusions: RMCNB has a high diagnostic yield with a minimum of two high-quality core biopsies, LBC can improve the diagnostic yield of HP alone, especially in masses with large non-enhanced area., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-22-972/coif). YW serves as an unpaid editorial board member of Quantitative Imaging in Medicine and Surgery. The other authors have no conflicts of interest to declare., (2023 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

Purpose: Cervical cancer is the fourth most common cancer in women worldwide with very high incidence in India. Liquid-based cytology (LBC) provides the use of ancillary techniques in addition to a good morphology and detection of cytologic abnormalities. The current study was designed to assess the diagnostics of P16INK4a immunoexpression, p16 promoter hypermethylation, human papilloma virus (HPV), and DNA ploidy in LBC samples with cervical precancer and cancer.Methods: A series of LBC samples categorised by Bethesda system including 22 atypical squamous cells of undetermined significance (ASC-US), 21 low-grade squamous intraepithelial lesion (LSIL), 41 high-grade squamous intraepithelial lesion (HSIL), 54 squamous cell carcinoma (SCC), and 26 controls with normal cytology were included. Ancillary techniques evaluated included P16INK4a immunoexpression, p16 promoter methylation DNA ploidy by flow cytometry, and HPV was detected using PGMY09/PGMY11 primers.Results: The test positivity rate of p16 expression in women with ASC-US, LSIL, HSIL, and SCC was 21.1, 39.0, 67.7, and 85.4%. For the p16 methylation the corresponding test positivity rate was 36.4, 76.2, 92.7, and 92.6%. The test positive rate of HPV in women with ASC-US, LSIL, HSIL, and SCC was 45.5, 76.2, 87.8, and 92.6%. Diploid G1 and diploid S values significantly (p < 0.05 or p < 0.01) discriminate LSIL versus HSIL and LSIL versus. SCC.Conclusions: P16 gene promoter methylation and HPV seem more sensitive in detection of ASC-US and LSIL cytology with higher specificity. Diploid G1 and diploid S phase study provides progressive change in parameters with progression from LSIL to HSIL and SCC. [ABSTRACT FROM AUTHOR]

Liquid-based cytology (LBC), now used globally for the head and neck region, has been used at our hospital since 2011. This study was designed to analyze the efficacy of LBC with immunocytochemical staining on preoperative diagnosis of salivary gland tumors. This retrospective analysis of fine-needle aspiration (FNA) performance for salivary gland tumors was conducted at Fukui University Hospital. Salivary gland tumor operations conducted during April 2006 – December 2010 (84 cases) were classified as the Conventional Smear (CS) group, which were diagnosed morphologically by Papanicolaou and Giemsa staining. Those done during January 2012 – April 2017 (112 cases) were classified as the LBC group, which were diagnosed using LBC samples with immunocytochemical staining. The FNA results and pathological diagnosis of both groups were analyzed to calculate the FNA performance. Compared to the CS group, cases of inadequate and indeterminate FNA sample were not reduced significantly by LBC with immunocytochemical staining. As for FNA performance, the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CS group were, respectively, 88.7%, 53.3%, 100%, 100%, and 87.0%. Those of LBC group were all 100%, representing significant improvement over the CS group. Analysis results indicated the usefulness of LBC with immunocytochemical staining for preoperative diagnosis of salivary gland tumors. [ABSTRACT FROM AUTHOR]

Background: Conventional cytology (CC) is a well-established and effective methodology for the evaluation of pediatric tumors. Liquid-based cytology (LBC) is a better technique of smear preparation and is at present the standard protocol in cervical cytology samples. Aims: In the present study, we analyzed both smear preparatory techniques in fine-needle aspiration (FNA) samples from solid pediatric neoplasms in terms of adequacy and efficacy with objectives to study the changes in background and morphology of tumor cells in LBC smears. Materials and Methods: This was a prospective observational study conducted in a tertiary care teaching hospital, which included 52 pediatric patients with clinical diagnosis of malignancy and an assessable lump. Both conventional aspiration cytology and LBC smears were prepared as per standard protocols (SurePath BD™) from FNA samples of cases and examined. Results and Conclusion: On comparing the diagnostic efficacy of cytology smears prepared by both techniques, LBC alone was diagnostic in 80.8% of the cases and conventional smear (CS) alone was diagnostic in 71.2% of the cases (agreement was 83.7%, P= 0.3). Cellular morphology was better preserved in LBC and interpretation was easier. There was a lower inadequacy rate in LBC and none of the samples was inadequate due to poor morphology in LBC smears (P = 0.0003). LBC showed an overall 40% improvement in inadequate cases by CS. LBC has been recommended as a complement to CC in nongynecological samples. Improved morphology and lower inadequacy rate make LBC a finer technique compared to CS in pediatric tumors as well. [ABSTRACT FROM AUTHOR]

Background: In this paper, we have compared the cytomorphologic characteristics of liquid-based preparation (LBP) [SurePath (SP)] cytology and conventional smear (CP) preparations on fine-needle aspiration (FNAC) material by a semi-quantitative scoring system for cases of lymphadenopathy. Materials and Methods: In this prospective study, a total of 52 consecutive cases of FNAC of lymphadenopathy were included. The first pass was used for CP followed by LBP with the help of SP technique. The smears were independently compared and assessed by two observers (PS and PD). Results: The semiquantitative grading was compared in two groups by Wilcoxon signed-rank test. The background information, cell architecture, pleomorphism, nuclear and cytoplasmic details, and three-dimensional structures were significantly different in LBP and CP smears. Conclusions: Liquid-based cytology (LBC) is a relatively simple technique, which exhibits good nuclear and cytoplasmic details with the absence of obscuring background material. Even the number of slides and area per slide to be screened were less than the conventional preparation but caution must be applied to interpret the slides and secure a diagnosis, especially if LBC is the first and only method applied for diagnosis. [ABSTRACT FROM AUTHOR]

Background: Liquid-based cytology (LBC) preparation is a way to improve and refine the fine-needle aspiration (FNA) samples. There are a few studies comparing LBC with conventional smear (CS). Aim: The present study was undertaken to evaluate the utility of manual LBC (MLBC) and CS preparations in various FNA samples. Materials and Methods: In this cross-sectional study, a total of 100 FNA samples from various anatomical sites were evaluated using MLBC and CS preparations. Cellularity, blood, informative background, monolayers, cell architecture, cytoplasmic, and nuclear preservation were compared with MLBC and CS preparations by Wilcoxon signed rank test. P < 0.05 is considered statistically significant. Results: MLBC preparations were superior to CS preparations in view of absence of blood and debris (P= 0.001), presence of monolayers (P< 0.001), and preservation of cytoplasmic (P= 0.001) and nuclear details (P= 0.001). However, no statistically significant differences were found between MLBC and CS preparations with regard to cellularity (P= 0.157), informative background (P= 0.083), and architecture (P= 0.739). Conclusion: MLBC preparations in FNAC are a safe, easy, and less time-consuming procedure, and it may have promising diagnostic value in the evaluation of FNA samples from various anatomical sites. However, the use of both MLBC and CS preparations is recommended to achieve optimal diagnostic yield. [ABSTRACT FROM AUTHOR]

Background: The role of Papanicolaou (Pap) test in cervical cancer screening need not be overemphasized. While most Western countries have adopted the liquid-based cytology (LBC), which is considered superior, many developing countries are still using the conventional Pap smear (CPS) technique. Objective: To compare the staining and cytomorphological features on conventional versus liquid-based cervicovaginal smears. Materials and Methods: One hundred and forty cervicovaginal smears prepared by the standard conventional and LBC techniques were interpreted as per the Bethesda system of reporting cervicovaginal smears. Twelve parameters were studied, compared, and statistically analyzed. A P value <0.05 was considered to be statistically significant. Results: 129/140 (92%) of CPSs and 130/140 (93%) LBC smears were satisfactory. LBC had a significantly shorter screening time (2.0 ± 0.08 vs 4.0 ± 0.65) and better representative material than that of CPS (50% vs 42%). Neutrophils were significantly more in CPS than LBC (96% vs 92%) with a P value <0.05 while hemorrhagic background and red blood cells (RBCs) were more prominent in CPS. LBC showed significant artifactual changes in squamous epithelial cells. Epithelial abnormalities ranging from atypical squamous cells of undetermined significance (ASCUS) to high grade squamous intraepithelial lesion (HSIL) were seen in 3% (4) and 2% (2) of CPSs and LBCs, respectively. Organisms were better picked up in CPS (99% in CPS vs 73% LBC) with a value of P = 0.0001. Conclusion: Although a shorter screening time and cleaner background are the major advantages of LBC, CPS is not inferior to LBC. Considering the high cost, rather than the advantages associated with LBC, we feel that CPS is a better option for developing countries. [ABSTRACT FROM AUTHOR]

The technique of liquid-based cytology (LBC) is of increasing diagnostic value in non-gynecological cytology. The purpose of the present study was to validate modifications to stages of the LBC process and to assess the diagnostic usefulness of the LBC technique. Between May 2021 and January 2022, a total of 484 samples were prepared from routine cytology tests carried out in the Department of Tumor Pathology of The Greater Poland Cancer Center. The material was obtained from fine-needle aspiration biopsies and fluid samples. One hundred cases were selected for the research described in the article. The slides were prepared using the Becton Dickinson Totalys SlidePrep device. Based on the research, it was concluded that predominantly the LBC technique gives better results than a conventional smear because the background, which would otherwise make it difficult to assess preparations, was eliminated. Additionally, in LBC preparations the cellularity was increased, and the cells were arranged in a monolayer system, which improves the image quality. The introduction of modifications to the LBC method facilitated the process of sample preparation, without adversely affecting the quality of the obtained material.

Background: Liquid-based cytology (LBC) is fast becoming a useful method in evaluating both gynecological and non-gynecological preparations, including fine needle aspiration (FNA) cytology. Even distribution of cells, decreasing obscuring background elements like blood and mucus, well preserved nuclear and cytoplasmic details and rapid fixation helps in better visualization of cells. Aim: This study was conducted to asses the diagnostic accuracy of liquid--based cytology versus conventional smears in fine needle aspiration samples. Study Design: In this prospective study, we had 110 cases, including 30 cases of breast, 40 of lymph node, 10 of salivary glands, 18 of thyroid and 12 of bone and soft tissue. In each case, two passes were performed. The first pass was for conventional preparation (CP) and the second pass yielded material for thin-prep (TP) preparation. Both CP and TP smears were compared for cellularity, background blood and necrotic cell debris, cell architecture, informative background, presence of a monolayer of cells and nuclear and cytoplasmic details by a semiquantitative scoring system. Wilcoxon's signed rank test on an SPSS program was used for statistical analysis. Results: Diagnostic accuracy was better in LBC smears compared with CP smears due to lack of background debris and better cell morphology, which was performed according to Wilcoxon's signed rank test, yielding a P-value of <0.001. However, in some cases, because of a decrease in cell size, clustering and altered background in LBC, a support of CP was essential. Conclusion: LBC performed on FNA samples can be a simple and valuable technique. Only in few selected cases, where background factor is an essential diagnostic clue, a combination of both CP and TP is necessary. [ABSTRACT FROM AUTHOR]

Liquid-based cytology (LBC) is used primarily for cervical cytology, although it is also used for analyzing liquid samples such as urine and ascites specimens, as well as fine needle aspiration material, such as those obtained from breast and thyroid. The usefulness of the LBC method for endoscopic ultrasound-guided tissue acquisition (EUS-TA) of solid pancreatic masses was recently reported. The LBC method can produce multiple pathological slides and can be applied to immunocytochemistry and genetic analyses. In this article, we review the usefulness of LBC for EUS-TA of solid pancreatic masses., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Itonaga, Ashida and Kitano.)

Abstract: Background: The AMPLICOR HPV Test has been validated for use with cervical cells collected in liquid-based preservative fluids, such as BD SurePath. It is currently recommended, however, that residual BD SurePath samples be stored at 4°C prior to testing. Objectives: The aim of this study was to demonstrate that DNA isolated from SurePath cervical cytology specimens and stored at ambient temperature was also compatible with the AMPLICOR HPV Test. Study design: DNA was extracted using the AmpliLute Media Sample Preparation Kit. Amplification and detection of HPV was performed both as directed by the manufacturer and with minor protocol modifications. Results: Cervical specimens collected in SurePath preservative fluid remained stable for testing with the AMPLICOR HPV Test for at least 21 days. The performance of DNA extracted from specimens stored at room temperature was equivalent to DNA extracted from specimens stored at 4°C. The β-globin internal control was detected in all of the 146 residual SurePath cervical cytology specimens tested using the AMPLICOR HPV Test, and high-risk HPV was detected in 46.2% (18/39) of ASCUS cases, in 63.3% (19/30) of LSIL cytology specimens, and 92.3% (24/26) of HSIL cases. Concordance of AMPLICOR HPV Test results with Hybrid Capture II was 83.9%. Conclusions: The AMPLICOR HPV Test can be successfully and reproducibly performed from DNA isolated from residual SurePath cervical cytology specimens stored at ambient temperature for at least 21 days. This provides clinical laboratories flexible storage conditions for residual SurePath cytology specimens. [Copyright &y& Elsevier]

Background: To define the spectrum of human papillomavirus (HPV) types and establish an age limit for triage HPV testing in atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LSIL).Materials and Methods: 343 liquid-based cytological samples from the population-based screening programme with minor abnormalities were subjected to HPV genotyping (Linear Array, Roche, Basel, Switzerland).Results: High-risk human papillomavirus (HR-HPV) was found in 71% of LSIL and 49% of ASCUS cases (P<0.001). High-risk human papillomavirus prevalence was age-dependent in LSIL (P=0.01), with decreasing prevalence until the age of 50 years, followed by a slight increase. Human papillomavirus type 16 was the most common HR-HPV, found in 23% of HPV-positive women. Human papillomavirus type 18 was the sixth most common, found in 9.9% (P<0.001). An age-dependent quadratic trend was observed for multiple infections (P=0.01) with a trough at about 42 years. The most common HR-HPV types to show a coinfection with HPV16 (clade 9) were HPV39 (28%), 45 (38%), and 59 (46%), belonging to HPV18 clade 7. The frequency of low-risk (LR) vs probable HR and HR-HPV also followed an age-dependent quadratic trend.Conclusions: After the age of 25 years, HR-HPV prevalence is similar in LSIL and ASCUS cases, motivating a low age limit for triage HPV testing. Multiple infections and LR/HR-HPV dominance are age-dependent. Genotyping in longitudinal design is needed to elucidate the importance of multiple infections in cancer progression and in cross-protection from vaccination. [ABSTRACT FROM AUTHOR]

Primary fallopian tube carcinoma (PFTC) is a rare malignant carcinoma among all genital tract malignancies. It occurs most commonly in postmenopausal women and is similar to ovarian malignancy historically and clinically. Because of its insidious onset and silent course, the diagnosis is made usually postoperatively. Liquid-based cytology (LBC) is a type of method for cervical cancer screening, but sometimes it may aid in making PFTC diagnosis. We report a 47-year-old woman with PFTC, whose diagnosis was made with the aid of LBC. [ABSTRACT FROM AUTHOR]

The aim was to evaluate human papillomavirus (HPV) 'reflex genotyping' in cases of minor cytological abnormalities detected in the gynaecological screening programme in Stockholm, Sweden. Liquid-based cytology samples showing minor cytological abnormalities were analysed using HPV genotyping (Linear Array, Roche diagnostics). Colposcopically directed cervical biopsies were obtained and the HPV test results were correlated with the histological results. In all, 63% (70/112) of the samples were high-risk (HR) HPV (HR-HPV) positive. A statistically significant correlation was found between high-grade cervical lesions and HR-HPV (P=0.019), among which HPV 16, 18, and 31 were the most important. The negative predictive value of HR-HPV detection for histologically confirmed high-grade lesions was 100%. An age limit for HPV reflex testing may be motivated in cases of low-grade squamous intraepithelial neoplasia (LSIL), because of high HR-HPV prevalence among younger women. By using HPV reflex genotyping, additional extensive workup can safely be avoided in about 50% of all cases of atypical squamous cells of undetermined significance (ASCUS) and LSIL among women 30 years. This screening strategy could potentially reduce the total abnormal cytology-reporting rate in the Swedish screening programme by about 1% and provide more accurately directed follow-up, guided by cytological appearance and HPV test results. [ABSTRACT FROM AUTHOR]

Background: HPV L1 capsid protein is expressed together with the production of infectious viral particles, but its expression and relation to p16 expression, which has been a surrogate marker for human papilloma virus (HPV) infection in cervix, are little studied in cytology samples. The authors aimed to elucidate the relation between L1 capsid protein and p16 protein expressions in liquid-based samples from uterine cervical lesions.Methods: Immunochemical analyses using antibodies against L1 capsid protein and p16 protein were carried out on cytological materials obtained from uterine cervical lesions of low-grade squamous intraepithelial lesions (LSILs), high-grade squamous intraepithelial lesions (HSILs), and squamous cell carcinomas (SCCs).Results: L1 capsid protein was positive in 30% of LSILs and 12% of HSILs, but in 0% of SCCs. In contrast, p16 protein was positive in 55% of LSILs, 100% of HSILs, and 100% of SCCs. L1-positive cells were only observed in the superficial layer, whereas p16-positive cells were seen throughout the full thickness of the epithelium. The relation between L1 capsid protein and p16 protein, p16(-)/L1(+) cases represented 44% of LSILs, but 0% of HSILs, and 0% of SCCs, whereas p16(+)/L1(-) cases represented 82% of LSILs, 88% of HSILs, and 100% of SCCs.Conclusions: Expression of L1 capsid protein decreased with lesion progression from LSILs to HSILs and SCCs, whereas p16 protein was positive in all HSILs and SCCs. The correlation between L1 and p16 expressions suggests that L1(-)/p16(+) cases have the potential for progression, whereas L1(+)/p16(-) and L1(-)/p16(-) cases may be nonprogressive lesions or potentially in remission. [ABSTRACT FROM AUTHOR]

Abstract: Organised, cytology-based cervical screening has led to a reduction in deaths associated with cervical cancer. Human papillomavirus (HPV) is necessary for the development of cervical cancer and associated pre-cursor cervical intraepithelial neoplasia and accumulated evidence suggests that incorporation of HPV testing could further refine screening programmes. HPV testing is discussed in the context of primary screening, for triage, and as a test of cure of treatment and possible value in developing countries. The high negative predictive value of a “double negative” cytology and HPV result could allow considerable changes in policy such as increased intervals between screening rounds, adjustment of age ranges for testing and schedule for return to routine screening post treatment. HPV testing for the triage of women to colposcopy with borderline or atypical squamous cells of undetermined significance (ASCUS) cytology could be clinically effective, but may be limited in women with low-grade squamous intraepithelial lesions (LSIL) or mild dyskaryosis by high HPV prevalence. Markers of HPV persistence harbour enormous potential to identify women at greatest risk of disease progression. Due to the diversity of existing cytology-based screening programmes, full cost-effectiveness analyses of HPV testing should be performed and assessed within local contexts. [Copyright &y& Elsevier]

Background: Fine needle aspiration cytology (FNAC) is the first diagnostic step in patient with cervical lymphadenopathy because of its simplicity, safety and early availability of the results. Liquid-based cytology (LBC) is an alternative processing method which is used for both gynecological and nongynecological samples. Literature reviewed show few studies comparing LBC with conventional preparation (CP)., Aim: The present study was undertaken to evaluate the efficacy of LBC and comparison of LBC and CP in cervical lymphadenopathy., Materials and Methods: In this prospective study, a total of 75 cases of FNAC with cervical lymphadenopathy were included. The first pass was used for CP followed by LBC with the use of SurePath (SP) technique. Both the smears were compared for cellularity, background containing blood, cell debris, lymphoglandular bodies, stromal fragments, cytoarchitectural pattern, etc., by semiquantitative scoring system., Results: There was no statistical difference in the cellularity, cell architecture, and monolayer cells (P > .05). On the basis of background containing blood, cell debris, lympho-glandular bodies, stromal fragments (P < .001), nuclear, and cytoplasmic details (P < .05), LBC was found to be superior to CP., Conclusion: LBC is a relatively simple technique and superior to CP in respect of better nuclear and cytoplasmic details with loss of background blood and debris. It has a diagnostic accuracy equivalent to that of CP. However, use of both LBC and CP can result in better diagnostic accuracy., (© 2020 Wiley Periodicals LLC.)

Objectives: To evaluate the diagnostic values of urine liquid-based cytology (LBC), fluorescence in situ hybridization (FISH), and p16/Ki-67 dual immunostaining in the detection of upper tract urothelial carcinomas (UTUCs)., Methods: Sixty-one patients with UTUCs were retrospectively analyzed. All patients were diagnosed both by urine cytology and by FISH, and histologically confirmed as UTUCs. Thirty-two patients had been stained with p16/Ki-67 dual labeling., Results: The sensitivities for low-grade UTUCs (LGUTUCs) and high-grade UTUCs (HGUTUCs) were 33.3% and 67.4% by LBC, 60% and 69.6% by FISH, and 12.5% and 66.7% by p16/Ki-67 dual labeling, respectively., Conclusions: Our results indicated that LBC was more suitable to identify HGUTUCs, FISH was highly valuable for predicting LGUTUCs, and p16/Ki-67 dual labeling was useful for distinguishing HGUTUCs from LGUTUCs. The combined application of these methods may improve the sensitivity or accuracy in the detection or diagnosis of UTUCs., (© 2017 Wiley Periodicals, Inc.)

Blood-rich gynecologic specimens can be problematic in the processing of liquid-based cytology. However, little is known about the influence of erythrocytes and protein on urine specimens. In addition, the SurePath™ system has two preservatives for non-gynecologic specimens. In this study, we compared the epithelial cell counts and cytomorphology obtained from CytoRich™ (CR) Red and CR Blue. A total of 98 voided urine samples were processed using both CR Red and CR Blue. We made an assessment of the epithelial cell counts, fixation, and staining quality, and backgrounds of both slides. Urine protein and urine erythrocyte counts were analyzed, and those data were compared with the epithelial cell counts in CR Red and CR Blue slides. Overall, epithelial cell counts were equivalent for both CR Red and CR Blue slides. However, in high-level proteinuria cases, the CR Red slides showed higher epithelial cell counts than the CR Blue slides. On the other hand, in microscopic hematuria cases, the CR Blue slides showed higher epithelial cell counts than the CR Red slides. We have found both CR Red and CR Blue to be available for urine cytology. However, it is important to note that CR Blue is inferior to CR Red in epithelial cell recovery rates in cases of high-level proteinuria., (Copyright © 2013 Wiley Periodicals, Inc.)