CERVICAL SMEARS PREPARED BY AN AUTOMATED DEVICE VERSUS THE CONVENTIONAL METHOD - A COMPARATIVE-ANALYSIS

An automated, fluid-based method for the preparation of cervical Papan icolaou smears/slides teas compared to the conventional Papanicolaou s mear (CPS) method used for the screening of neoplasia. We determined d iagnostic agreement and sources of error for diagnostic disagreement. For 665 patients, one cervical sample was collected to make one CPS. T he collection devices, a wooden Ayre spatula and endocervical brush, w ere rinsed into a vial with fluid medium to be processed in the automa ted device. All slides were distributed among five cytotech nologists in a blind fashion. Exact diagnostic agreement was 94.6%. The results were not statistically significant (P greater than or equal to 70, McN emar's test) but were clinically important, as evidenced by the defect ion of lour grade lesions (LGL), during initial screening, on three sl ides prepared by the automated device but not on their matched-pair CP Ss (0.5% of all specimens). After reevaluation, the three matched CPSs demonstrated LGL. Sources of diagnostic error on the CPSs were: air-d rying artifact, obscuring blood/inflammation, crowding/overlapping of cells and/or absence of diagnostic cells. The only source of error in the automated-method smears was absence of diagnostic cells.