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doi: https://doi.org/10.4132/jptm.2017.03.17    [Epub ahead of print]
Comparison of Unsatisfactory Samples from Conventional Smear versus Liquid-Based Cytology in Uterine Cervical Cancer Screening Test
Hoiseon Jeong1, Sung Ran Hong2, Seoung-Wan Chae3, So-Young Jin4, Hye Kyoung Yoon5, Juhie Lee6, Eun Kyung Kim7, Sook Tai Ha8, Sung Nam Kim9, Eun-Jung Park10, Jong Jae Jung10, Sun Hee Sung11, Sung-chul Lim12
1Department of Pathology, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Korea
2Department of Pathology, Cheil General Hospital and Women’s Health Care Center, Dankook University College of Medicine, Seoul, Korea
3Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
4Department of Pathology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
5Department of Pathology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
6Department of Pathology, Kyung Hee University School of Medicine, Seoul, Korea
7Department of Pathology, Eulji General Hospital, Seoul, Korea
8T&C Diagnostic Pathology Clinic, Seoul, Korea
9Samkwang Medical Laboratories, Seoul, Korea
10Foryou Pathology Laboratories, Gwangju, Korea
11Department of Pathology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
12Department of Pathology, Chosun University School of Medicine, Gwangju, Korea
Corresponding Author: Sung-chul Lim ,Tel: +82-62-230-6343, Fax: +82-62-226-5860, Email: sclim@chosun.ac.kr
Received: December 22, 2016;  Revised: March 9, 2017  Accepted: March 14, 2017.  Published online: April 17, 2017.
Cervical cytology for uterine cervical cancer screening has transitioned from conventional smear (CS) to liquid-based cytology (LBC), which has many advantages. The aim of this study was to compare the proportion of unsatisfactory specimens from CS versus LBC at multiple institutions including general hospitals and commercial laboratories.
Each participating institution provided a minimum of 500 Papanicolaou (Pap) test results for analysis. Pap tests were classified according to the participating institution (commercial laboratory or general hospital) and the processing method (CS, ThinPrep, SurePath, or CellPrep). The causes of unsatisfactory results were classified as technical problems, scant cellularity, or complete obscuring factors.
A total of 38,956 Pap test results from 8 general hospitals and three commercial laboratories were analyzed. The mean unsatisfactory rate of LBC was significantly lower than that of CS (1.26% and 3.31%, p=0.018). In the LBC method, samples from general hospitals had lower unsatisfactory rates than those from commercial laboratories (0.65% vs 2.89%, p=0.006). The reasons for unsatisfactory results were heterogeneous in CS. On the other hand, 66.2% of unsatisfactory results in LBC were due to the scant cellularity.
Unsatisfactory rate of cervical cancer screening test results varies according to the institution and the processing method. LBC has a significantly lower unsatisfactory rate than CS.
Key Words: Papanicolaou test; Cervical cytology; Unsatisfactory; Liquid-based cytology; Conventional smear