Cytologic distinctions between clinical groups using curette-probe compared to cytology brush

Background: We had previously used curette-probe (Rhinoprobe; Arlington Sci entific, Springville, UT) to study nasal cytology in various types of patie nts. Because of the potential sampling ease of using a brush, we sought to compare cytological results obtained with a curette-probe with those obtain ed using a cytology brush (Cytobrush Plus; Medscand, Malmo, Sweden). Objective: To compare the ability of samples of nasal leukocytes obtained w ith a curette-probe versus a cytology brush to distinguish clinical categor ies of patients attending an allergy clinic. Methods: Adult allergy clinic patients were studied by both curette-probe a nd cytology brush sampling. Quantitation of eosinophils and total leukocyte s was performed on samples. Comparisons of cell quantities for each samplin g method were made in patients classified into clinical groups. Patients wi th rhinitis complaints and abnormalities of nasal mucosal appearance with o r without aeroallergy were compared with other patients. The adjustment of leukocyte quantities for the numbers of epithelial cells observed was also analyzed. Sampling methods were also compared for receiver operating charac teristics. Results: Curette-probe sample leukocyte quantities distinguished patients w ith symptoms of rhinitis (SR) with abnormal nasal appearance from other pat ients. This between-group distinction was more significant for leukocyte nu mbers normalized for the number of epithelial cells. SR patients with both abnormal nasal appearance and aeroallergy had significantly more eosinophil s and less goblet cells than other patients. Greater than five curette-prob e eosinophils were only observed in patients with SR. Brush samples did not show differences between patients stratified in these ways, and eosinophil s were observed in patients without SR. Receiver operating characteristics favored curette-probe samples in terms of leukocyte or eosinophil increases characterizing their respective symptomatic patient subgroups. Conclusions: Curette-probe-obtained nasal samples allow for leukocyte and e osinophil quantitations which characterize rhinitis patients better than br ush-obtained samples. Total leukocyte quantitations obtained by curette-pro be may represent a marker of inflammatory nasal disease in adults undergoin g allergy evaluation and treatment for rhinitis.