AutoCyte interactive screening system - Experience at a University Hospital Cytology Laboratory

OBJECTIVE: To evaluate the AutoCyte Interactive Screening System (AutoCyte- Screen) as a prescreener for the cytologic detection of cervicovaginal abno rmalities. STUDY DESIGN: Eight hundred fifty-six AutoCyte Preparation System from cerv icovaginal samples were evaluated by AutoCyte-Screen. AutoCyte-Screen displ ayed 120 cell images and 6 low-power images for review by the cytotechnolog ist. The cytotechnologist classified the case as WNL, abnormal or unsatisfa ctory. AutoCyte-Screen then reviewed its classification as either unsatisfa ctory, WNL, abnormal or undecided. These classifications were combined to f orm an interactive result that was compared to the diagnosis from previous manual review. RESULTS: Interactive results were as follows: 251 (29.3%) abnormal, 582 (67 .9%) WNL and 24 (2.8%) unsatisfactory. The abnormal interactive result cont ained 15 ASCUS/AGUS and 25 SILs; the WNL interactive result contained 5 ASC US/AGUS and 2 SILs. Mo ASCUS/AGUS or SILs were in the unsatisfactory intera ctive category. The false negative proportion was 10.5% for the interactive diagnostic method vs. 15.7% for manual review for LSIL. CONCLUSION: The interactive use of AutoCyte-Screen san effectively select t hose cases which are most likely to contain an epithelial abnormality and c ould therefore be used as a triage system to select cases for manual review . A case with an interactive result of unsatisfactory and abnormal should r eceive full manual review, while those classified as WNL may require a less extensive review for quality assurance purposes. This resultant decrease i n the manual screening load could increase laboratory efficiency.