Spiral Brush in PapSure Test for Cervical Cancer Screening

Song, Eun Ho; Kim, Eo Jin; Myong, Na Hye; Park, Choong Hak

Abstract

OBJECTIVE
The purpose of this study was to investigate the clinical efficacy of a new stiff bristled spiral shaped brush (SpiraBrush Cx(R)) in PapSure Test for cervical cancer screening, by comparing SpiraBrush Cx(R) cytologic diagnoses with conventional Papanicolaou cytologic diagnoses and final histologic diagnoses.
METHODS
This study was performed in Gynecologic Oncology Clinic of Department of Obstetrics and Gynecology at Dankook University Medical Center from December 1, 2001 to June 30, 2002. Thirty three cases who underwent PapSure Test (Pap cytology+Speculoscopy) were analyzed. SpiraBrush Cx(R) Papanicolaou cytologic diagnoses were compared with conventional Papanicolaou cytologic diagnoses and histologic diagnoses as a reference standard.
RESULTS
Followings are the results summarized. 1. Age distribution was between 21 and 70. The mean age was 45.7 years. 2. The mean gravidity was 3.6 and the mean parity was 2.0. 3. There were 19 (57.6%) conventional Papanicolaou cytologic diagnoses of Negative, and 14 (42.4%) of Positive including ASC. There were 13 (39.4%) Speculoscopy diagnoses of Negative, and 20 (60.6%) of Positive including Suspicious. There were 8 (24.2%) SpiraBrush Cx(R) cytologic diagnoses of Negative and 25 (75.8%) of Positive including ASC. 4. There were 12 (52.2%) histologic diagnoses of Negative, 2 (8.7%) of LSIL, 3 (13.0%) of HSIL, and 6 (26.1%) of SCC, according to the criteria of TBS, 2001. 5. For detecting LSIL or worse lesions, conventional Papanicolaou cytologic test yielded sensitivity of 63.6% and specificity of 66.7%. On the other hand, SpiraBrush Cx(R) cytologic test yielded sensitivity of 90.9% and specificity of 33.3%.
CONCLUSION
SpiraBrush Cx(R) cytologic diagnosis does not seem to have clinical efficacy replacing the histologic diagnosis by punch biopsy in cervical cancer screening in this study. But further studies using ThinPrep Pap Test or Cellblock techniques with large data will be required and anticipated.