BRUSH VS SPATULA FOR CERVICAL SMEARS - HISTOLOGIC CORRELATION WITH CONCURRENT BIOPSIES

In this study we compared the resuls of 1,293 brush smears obtained be tween April 23, 1990, and April 22, 1991, with those of 1,304 consecut ive spatula smears from 1989. As expected, 94.1% of brush smears revea led the presence of endocervical cells as compared to 63.04% of the sp atula smears (P<.001). The number of ''normal'' cases was significantl y (P<.001) lower in the brush smears (58.2% for the brush vs. 73.7% fo r the spatula). A significantly larger number (P<.001) of ''abnormal'' cases and low and high grade squamous intraepithelial lesions (modera te, severe, carcinoma in situ) were demonstrated in the brush smears. In the second part of the study the resuls of 547 brush smears wth acc ompanying cervical biopsies obtained during the same period were studi ed for concordance of interpretation and were compared with 421 biopsy -accompanied spatula smears. Of the brush cases, 17.6% cytologically r eported as high grade squamous intraepithelial lesions or reactive or normal histology. This discrepancy was significantly lower (P<.05) in spatula cases (8.9%). These findings suggest that in this series, alth ough brush sampling yielded a higher pickup, it led to a tendency towa rd overinterpretation by cytopathologists.