AutoCyte Prep (R) system vs. conventional cervical cytology - Comparison based on 2,156 cases

OBJECTIVE: To compare the AutoCyte Prep(R) system (Burlington, North Caroli na) with conventional cervical cytology in a university medical center labo ratory. STUDY DESIGN: Split-sample conventional and AutoCyte Preps(R) were examined for 2,156 cases. Same-patient conventional and Prep(R) slides were submitt ed to separate cytotechnologists blindly. The results were compared on revi ew by a cytopathologist. The Prep(R) slides were subsequently scanned on th e AutoCyte Screen(R) automated interactive system, with manual review of th e flagged cases. The results were compared with anatomic pathology follow-u p when available. RESULTS: Of the 158 squamous intraepithelial lesions (SILs) found by both m ethods, 78% were found by AutoCyte Prep(R), while 59% were found by convent ional smear (P < .01). Among the discordant cases, thin-layer slides reveal ed 88% more LSIL lesions (P < .05), a comparable number of high grade SIL l esions and a single case gf adenocarcinoma that was ambiguous on the conven tional slide. The addition of AutoCyte(R) assisted primary screening demons trated a net benefit, recovering additional cases referenced as atypical gl andular cells of undetermined significance and as high grade SIL. CONCLUSION: The AutoCyte Prep(R) system affords excellent cellular presenta tions and superior sensitivity for SILs when compared to the conventional t echnique. The use of AutoCyte Screen(R) for primary screening demonstrated performance equivalent to manual screening, with a significant improvement in sensitivity when measured against biopsy results.