CERVEX-BRUSH VS SPATULA AND CYTOBRUSH - A CYTOHISTOLOGIC EVALUATION

OBJECTIVE: To compare the efficacy of two cervical smear instruments, Cervex-Brush and spatula plus Cytobrush. STUDY DESIGN: Cervical smears were taken before laser ring biopsies in 213 women, who were randomiz ed for the Cervex-Brush or spatula plus Cytobrush (S+C). The cytologic diagnosis was compared to the histologic diagnosis after laser ring b iopsy. RESULTS: The correlation between cytology and histology showed comparable concordance (54% and 42%) for the two devices. In 130 (74 w ith Cervex-Brush and 56 S+C) patients, histology revealed moderate dys plasia or move advanced lesions. Those cases were further analyzed for smear failures. Negative smears were found in 13 cases (10 in the Cer vex-Brush and 3 in the S+C group). This difference in favor of S+C was not, however, statistically significant. Significantly more false neg ative smears were found when endocervical cells were absent and in pat ients 30-39 years of age. CONCLUSION: Modem sampling devices, such as the Cervex-Brush and S+C, seem to be equally efficient in obtaining dy splastic squamous cells. Other factors of importance for nonrepresenta tive cervical smears should be studied in order to improve efficacy.