Manual method for liquid-based cytology: A demonstration using 1,000 gynecological cytologies collected directly to vial and prepared by a smear-slide technique

We report on the formulation and use of an alcoholic-agar additive solution generally useful for rapid, inexpensive liquid-based cytology slide prepar ation. Gynecological cytology specimens were collected from 1,000 women. Tw o hundred fifty aliquots each of CytoRich, CytoRich Red (Tripath Imaging, I nc., Burlington, NC), Preservcyt (Cytyc Corp., Boxborough, MA), and DINA* T RANS (DINA*CYT Corp., Portland, OR) fixatives it-ere used for this study. F ixed cell suspensions from 1,000 women, seen consecutively by a general obs tetrics and gynecology practice, were vortex-mixed and transferred into a p remeasured amount of alcoholic-agar in test tubes. Test tubes were conventi onally centrifuged, cells were trapped in a spontaneously formed agar-gel, and the supernatant solutions were decanted. Vortex-mixing cell buttons cau sed a rapid gel-to-sol transition, affording viscous cell suspensions that were applied to slides, smeared, and stained using Papanicolaou stains. Sli des showed unclumped, monolayered, uniform, random cell-spreads. All of the fixatives afforded crisp presentation of normal and abnormal cells. There was an about 3-fold increase in HSIL+ (0.7-1.8%) and LSIL diagnoses (1.3-4. 4%), and a 45% reduction in ASCUS diagnoses (3.3-1.8%), as compared to our cytology laboratory's previous year's patients' statistics with a concurren t 0.2% unsatisfactory rate, due solely to inadequate sampling. This manual method makes liquid-based cytology inexpensive and does not require special ized preparative devices. Diagn. Cytopathol. 2001;25:334-338. (C) 2001 Wile y-Liss, Inc.