Comparison of ThinPrep preparations to other preparation types in gastrointestinal cytology observations from the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic cytology

Amy C. Clayton, Joel S. Bentz, Patricia G. Wasserman, Mary R. Schwartz, Rhona J. Souers, Beth Anne Chmara, Rodolfo Laucirica, Karen M. Clary, Ann T. Moriarty

Research output: Contribution to journalArticle

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Abstract

Context: Differences in participant responses for Thin-Prep (TP) and non-ThinPrep (NTP) preparations for gastrointestinal cytology challenges, which circulated in the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytology (CAP NGC), may help to identify performance variations between preparation types. Objective: To compare the performance of TP-prepared slides of gastrointestinal exfoliative cytology specimens to that of NTP preparations in the CAP NGC program. Design: Participant responses between 2000 and 2007 were evaluated for esophageal wash/brush, gastric wash/brush, and biliary tract brush specimens with a reference diagnosis of adenocarcinoma, squamous cell carcinoma, carcinoid, or spindle cell neoplasm. ThinPrep challenges were compared with NTP preparations (conventional smears, cytospins) for discordant responses. Results: In all, 6023 pathologist responses and 3825 cytotechnologist responses were reviewed. Non-ThinPrep preparations comprised 93% (n = 11 588) of the challenges, while 7% (n = 912) were TP material. A match for a "positive/suspicious" diagnosis was seen in 88.5% of NTP and 95.9% of TP preparations (P <.001). These results were statistically significant when the specific reference diagnosis was adenocarcinoma (P <.001). Overall performance of cytotechnologists was not different from that of pathologists (89.2% versus 89.0%; P =.75). Cytotechnologists had better performance for detecting squamous cell carcinoma (96.3% versus 92.6%; P <.001), while pathologists had better performance for detecting spindle cell neoplasm (79.7% versus 42.9%; P <.001). Conclusions: ThinPrep preparations performed significantly better than NTP preparations in gastrointestinal cytology specimens circulated in an interlaboratory comparison program. Performance varied by reference interpretation, with the best performance for the interpretation of adenocarcinoma. Cytotechnologists and pathologists performed at the same level overall, but with differences for the diagnosis of spindle cell neoplasm and squamous carcinoma.

Original languageEnglish (US)
Pages (from-to)1116-1120
Number of pages5
JournalArchives of Pathology and Laboratory Medicine
Volume134
Issue number8
StatePublished - Aug 1 2010

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Cell Biology
Squamous Cell Carcinoma
Adenocarcinoma
Neoplasms
Carcinoid Tumor
Biliary Tract
Stomach
Pathologists
Carcinoma

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology

Cite this

Comparison of ThinPrep preparations to other preparation types in gastrointestinal cytology observations from the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic cytology. / Clayton, Amy C.; Bentz, Joel S.; Wasserman, Patricia G.; Schwartz, Mary R.; Souers, Rhona J.; Chmara, Beth Anne; Laucirica, Rodolfo; Clary, Karen M.; Moriarty, Ann T.

In: Archives of Pathology and Laboratory Medicine, Vol. 134, No. 8, 01.08.2010, p. 1116-1120.

Research output: Contribution to journalArticle

Clayton, Amy C. ; Bentz, Joel S. ; Wasserman, Patricia G. ; Schwartz, Mary R. ; Souers, Rhona J. ; Chmara, Beth Anne ; Laucirica, Rodolfo ; Clary, Karen M. ; Moriarty, Ann T. / Comparison of ThinPrep preparations to other preparation types in gastrointestinal cytology observations from the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic cytology. In: Archives of Pathology and Laboratory Medicine. 2010 ; Vol. 134, No. 8. pp. 1116-1120.
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AU - Clayton, Amy C.

AU - Bentz, Joel S.

AU - Wasserman, Patricia G.

AU - Schwartz, Mary R.

AU - Souers, Rhona J.

AU - Chmara, Beth Anne

AU - Laucirica, Rodolfo

AU - Clary, Karen M.

AU - Moriarty, Ann T.

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N2 - Context: Differences in participant responses for Thin-Prep (TP) and non-ThinPrep (NTP) preparations for gastrointestinal cytology challenges, which circulated in the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytology (CAP NGC), may help to identify performance variations between preparation types. Objective: To compare the performance of TP-prepared slides of gastrointestinal exfoliative cytology specimens to that of NTP preparations in the CAP NGC program. Design: Participant responses between 2000 and 2007 were evaluated for esophageal wash/brush, gastric wash/brush, and biliary tract brush specimens with a reference diagnosis of adenocarcinoma, squamous cell carcinoma, carcinoid, or spindle cell neoplasm. ThinPrep challenges were compared with NTP preparations (conventional smears, cytospins) for discordant responses. Results: In all, 6023 pathologist responses and 3825 cytotechnologist responses were reviewed. Non-ThinPrep preparations comprised 93% (n = 11 588) of the challenges, while 7% (n = 912) were TP material. A match for a "positive/suspicious" diagnosis was seen in 88.5% of NTP and 95.9% of TP preparations (P <.001). These results were statistically significant when the specific reference diagnosis was adenocarcinoma (P <.001). Overall performance of cytotechnologists was not different from that of pathologists (89.2% versus 89.0%; P =.75). Cytotechnologists had better performance for detecting squamous cell carcinoma (96.3% versus 92.6%; P <.001), while pathologists had better performance for detecting spindle cell neoplasm (79.7% versus 42.9%; P <.001). Conclusions: ThinPrep preparations performed significantly better than NTP preparations in gastrointestinal cytology specimens circulated in an interlaboratory comparison program. Performance varied by reference interpretation, with the best performance for the interpretation of adenocarcinoma. Cytotechnologists and pathologists performed at the same level overall, but with differences for the diagnosis of spindle cell neoplasm and squamous carcinoma.

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