Accurate assessment of cell density in low cellular liquid-based cervical cytology.
Summary of "Accurate assessment of cell density in low cellular liquid-based cervical cytology."
A. G. Siebers, J. A. W. M. van der Laak, R. Huberts-Manders, J. E. M. Vedder and J. Bulten Accurate assessment of cell density in low cellular liquid-based cervical cytology Objective: Scant cellularity is the most important source of unsatisfactory liquid-based cytology. Although still being debated, low cellularity is thought to compromise the detection of squamous lesions. Thus, reliable assessment of cellularity is essential. The aim of the present study was to determine the cellularity range for ThinPrep(®) slides of low cellularity and to establish the most accurate cell-counting protocol. Methods: A series of 60 ThinPrep cases representing the full spectrum of adequate, 'satisfactory but limited by' (SBLB) and unsatisfactory reports were included. Two cell-counting protocols with three different magnifications, using ×10, ×20 and ×40 objectives, were evaluated and related to the true cellularity, together with a reassessment of the degree of adequacy originally reported. The cell-counting protocol that showed the highest correlation coefficient was considered the most accurate. Results: Based on seven (re)assessments a majority score for adequacy was established. There were 42 cases with a majority score 'unsatisfactory' or 'SBLB' (low cellularity) of which 41 contained fewer than 20 000 squamous cells; and 18 cases with a majority score 'satisfactory' of which one had fewer than 20 000 cells. The cell-counting protocol that showed the significantly highest correlation with the reference standard was the Stichting Kwaliteitsbewaking Medische Laboratoriumdiagnostiek (SKML) protocol with a ×10 objective. Conclusions: ThinPrep slides reported as unsatisfactory or SBLB were shown to contain fewer than 20 000 squamous cells. The most accurate protocol for estimating the cellularity of these slides was cell counting in five non-adjacent microscope fields along the horizontal axis and five along the vertical axis of the slide with a ×10 objective and applying a correction factor of 1.24× to correct for underestimation of the true cellularity.
Affiliation
Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
Journal Details
This article was published in the following journal.
Name: Cytopathology : official journal of the British Society for Clinical Cytology
ISSN: 1365-2303
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22708685
- DOI: http://dx.doi.org/10.1111/j.1365-2303.2012.00990.x
Medical and Biotech [MESH] Definitions
Cytapheresis
Separation of one or more kinds of cells from whole blood with the return of other blood cell constituents to the patient or donor. This is accomplished with an instrument that uses centrifugation to separate the cells into different layers based on the differences in cell density (displacement) or drag coefficients in a current (elutriation). The procedure is commonly used in adoptive transfer to isolate NK cells, lymphocytes, or monocytes.
Laser Scanning Cytometry
A scanning microscope-based, cytofluorimetry technique for making fluorescence measurements and topographic analysis on individual cells. Lasers are used to excite fluorochromes in labeled cellular specimens. Fluorescence is detected in multiple discrete wavelengths and the locational data is processed to quantitatively assess APOPTOSIS; PLOIDIES; cell proliferation; GENE EXPRESSION; PROTEIN TRANSPORT; and other cellular processes.
Centrifugation, Isopycnic
A technique used to separate particles according to their densities in a continuous density gradient. The sample is usually mixed with a solution of known gradient materials and subjected to centrifugation. Each particle sediments to the position at which the gradient density is equal to its own. The range of the density gradient is usually greater than that of the sample particles. It is used in purifying biological materials such as proteins, nucleic acids, organelles, and cell types.
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Reality Therapy
Method of psychotherapeutic treatment based on assumption of patients' personal responsibility for their own behavior. The therapist actively guides patients to accurate self-perception for fulfillment of needs of self-worth and respect for others. (From APA, Thesaurus of Psychological Index Terms, 8th ed.)
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