UPGRADING UNSATISFACTORY CERVICAL SMEARS WITH THE MIB-1 METHOD

When an unsatisfactory smear (thick inflammatory infiltrate or blood i nfluencing the staining characteristics of the epithelial cells) is re stained for MiB-1, the diagnostic proliferating cells are visualized, and the MiB-1-positive smears can be thus upgraded as borderline, grad e I, II, and III, corresponding with the cytologic diagnoses of, respe ctively, ASCUS, CIN I, II, and greater than or equal to III. In a peri od of 18 months, 2,068 unsatisfactory smears out of a material of 84,8 17 smears were restained for MiB-1. In the unsatisfactory group, signi ficantly more abnormal smears were detected than in the satisfactory g roup. Seventy-five of the unsatisfactory group were biopsied because o f the MiB-1 findings: Three women proved to have severe dysplasia, fou r had carcinoma in situ, and three had invasive carcinoma. The permill age for invasive cervical carcinoma was ten times larger in the unsati sfactory group than in the satisfactory group; thus the MiB-1 method h as further enhanced our diagnostic acumen in this difficult type of sm ears. (C) 1996 Wiley-Liss, Inc.