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LIQUID BASED CYTOLOGY

LIQUID BASED CYTOLOGY. Irene M le Roux Programme Head / National Cytology coordinator NHLS. NHLS STUDIES. Two separate studies: 2006 at the Tygerberg laboratory 2008 at the Braamfontein laboratory . Reasons for investigating LBC:. New Technology Improvement in screening volumes

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LIQUID BASED CYTOLOGY

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  1. LIQUID BASED CYTOLOGY Irene M le Roux Programme Head / National Cytology coordinator NHLS

  2. NHLS STUDIES Two separate studies: • 2006 at the Tygerberg laboratory • 2008 at the Braamfontein laboratory

  3. Reasons for investigating LBC: • New Technology • Improvement in screening volumes • Improvement in diagnosis • Improvement in unsuitable rates • Improvement in adequacy rates • Improvement of TAT

  4. For the study: • Invited the 4 LBC companies in SA to participate • Collection of material was done according to an approved protocol • The CEVEX brush was used • The cervical (PAP) smear was made first • The remaining material rinsed in the preservative • The head of the brush was placed in the vial

  5. Preparation of the specimens • A national Cytology workshop was held • Presentations & practical demonstrations by each company • The PAP smears formed part of the routine work • The LBC prepared smears were screened “blind” • The results were compiled by an independent person • One company withdrew shortly before the workshop

  6. PREPARATION • Representatives from the companies prepared the collected samples as part of the demonstrations

  7. Results (1) • A total of 373 cases were included • LBC showed an improvement by: • lowering the ASCUS rates (4.3 vs 6.4%) • increasing the LSIL rates (13.4 vs 12.1%) • lowering the unsatisfactory rates (1.3 vs 1.9%)

  8. Results (2) • LBC and the PAP smears were equal on the: • HSIL (5.6% each) • The PAP smears had more Endo -cervical component present (85.7 vs 79.2 %)

  9. SECOND NHLS STUDY • The 2008 study was a collaboration between the Braamfontein laboratory & SurePath. • More than 1000 cases in study • Preliminary results: • Improvement of ±3% on LSIL cases • ±0.8% improvement on unsatisfactory cases

  10. CONCLUSION • The advantages of LBC in 2 studies: • Improvement in LSIL & unsatisfactory rates • Smaller surface to be screened • Monolayer preparations vs thick smears • Improved TAT • Less exudate and blood that obscure cells

  11. CONCLUSION (2) • The disadvantages: • Cost

  12. THANK YOU.

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