Objective: To compare the quality and sensitivity of CytoRich slides with conventional cytologic smears and to evaluate the benefits of using this technology as an add-on procedure.
Study design: The study design consisted of non-randomized, paired cervical samples. The subjects were 2,125 Sydney women who were routine patients of 13 gynecologists and 8 general practitioners and had cytologic smears taken between January and June 1995. All smears were taken using the Cervex brush. After preparing the conventional cytologic smear slide, the head of the sampler was detached and placed in a vial of fluid fixative. Paired slides were then prepared in the laboratory from the cells in the fluid fixative, using the CytoRich processing machine. The CytoRich and conventional cytologic smear slides were compared for quality, ease of screening, presence of endocervical cells, recognition of infections, and detection of squamous and glandular abnormalities.
Results: CytoRich slides were of much better quality, were easier to screen, had substantially fewer unsatisfactory results (0.3% vs. 2.6%) but lacked endocervical cells more often (16.1% vs. 10.6%). As regards abnormalities, the CytoRich slides showed fewer abnormalities, particularly in the low grade category. However, as a result of screening the paired CytoRich slide, some additional abnormalities were detected and a number of abnormalities reported on the conventional slide were reclassified (some to higher grades but more to negative).
Conclusion: As an add-on technology, the CytoRich process has much to offer, in particular in the virtual elimination of unsatisfactory smears and in helping to resolve the difficult dichotomy between normal and low grade categories. Examining additional cellular material on a CytoRich slide enhances the sensitivity and accuracy of the combined results.