INCREASED DETECTION OF EPITHELIAL-CELL ABNORMALITIES BY LIQUID-BASED GYNECOLOGIC CYTOLOGY PREPARATIONS - A REVIEW OF ACCUMULATED DATA

OBJECTIVE: To review published and other available data comparing the effectiveness of liquid-based cytology preparations in detecting epith elial cell abnormalities in cervicovaginal (gynecologic) cytology as c ompared to the conventional Papanicolaou test. STUDY DESIGN: Available split-sample data comparing liquid-based gynecologic cytology prepara tions with the conventional cervical cytologic test were collated from published studies, unpublished studies reported on at professional me etings or in the press, and from Food and Drug Administration Premarke t Clinical Trials on ThinPrep and AutoCyte PREP. Data were stratified with regard to use of newer preparatory instrument models, use of vary ing collection devices and different split-sample protocols. RESULTS: Available data from split-sample studies of liquid-based methods showe d overall increased detection of epithelial cell abnormalities. Result s have varied considerably from study to study and appear to be influe nced by collection protocol methods and probably by collection devices ' different delivery of cellular material in split-sample studies, fir st to the conventional smear and second to the liquid-based medium. Ne wer preparatory instrument models may also enhance detection. CONCLUSI ON: Liquid-based gynecologic cytology preparations increase detection of epithelial cell abnormalities, as compared to the conventional, sin gle-slide cervical cytologic smear, based on available data from split -sample studies. The true potential impact of these methods in enhanci ng detection of epithelial cell abnormalities awaits accumulation of d ata from direct-to-vial studies, especially data on detection of biops y-confirmed high grade squamous intraepithelial lesions from a wide va riety of clinical practice settings.