Objectives: We tested the ability of automated screening in processing conventional gynecological cytology smears and its efficacy in assessing sample adequacy and stratifying cases for risk of malignancy. Study Design: Cases were retrospectively selected, including unsatisfactory samples and slides with various sorts of artifacts. Automated screening was performed using the FocalPoint GS Imaging System (Becton Dickinson, Franklin Lakes, N.J., USA), with classification into five quintiles. For agreement purposes, cases were grouped into high risk for malignancy (quintiles 1 and 2) and low risk for malignancy (quintiles 3, 4 and 5). Results: A total of 120 cases (median age 37.5 years, range 18-85) were included in the study. Eighty-three cases (69.2%) could be successfully classified into quintiles. When divided by risk, 31 cases were placed in the high-risk and 52 in the low-risk group. The overall sensitivity and specificity of the automated analysis was 100 and 70.3%, respectively. Conclusions: Automated analysis could analyze the majority of conventional smears, including one case previously screened as unsatisfactory. All malignant and high-grade lesions were correctly classified into the high-risk group. Broad use of this automation system could potentially decrease screening time and augment the efficacy in detecting precursor neoplastic changes in cervical cytology smears.

Keywords:
Automation, Conventional smears, Gynecological cytology
1.
Anderson G, Macaulay C, Matisic J, Garner D, Palcic B: The use of an automated image cytometer for screening and quantitative assessment of cervical lesions in the British Columbia Cervical Smear Screening Programme. Cytopathology 1997;8:298-312.
2.
Linder J: Automation of the Papanicolaou smear: a technology assessment perspective. Arch Pathol Lab Med 1997;121:282-286.
3.
Syrjänen K, Derchain S, Roteli-Martins C, Longatto-Filho A, Hammes LS, Sarian L: Value of conventional Pap smear, liquid-based cytology, visual inspection and human papillomavirus testing as optional screening tools among Latin American women <35 and > or = 35 years of age: experience from the Latin American Screening Study. Acta Cytol 2008;52:641-653.
4.
Schledermann D, Hyldebrandt T, Ejersbo D, Hoelund B: Automated screening versus manual screening: a comparison of the ThinPrep imaging system and manual screening in a time study. Diagn Cytopathol 2007;35:348-352.
5.
Biscotti CV, Dawson AE, Dziura B, Galup L, Darragh T, Rahemtulla A, Wills-Frank L: Assisted primary screening using the automated ThinPrep imaging system. Am J Clin Pathol 2005;123:281-287.
6.
Colgan TJ, Bon N, Clipsham S, Gardiner G, Sumner J, Walley V, McLachlin CM: A validation study of the FocalPoint GS Imaging System for gynecologic cytology screening. Cancer Cytopathol 2013;121:189-196.
7.
Kitchener HC, Blanks R, Dunn G, Gunn L, Desai M, Albrow R, Mather J, Rana DN, Cubie H, Moore C, Legood R, Gray A, Moss S: Automation-assisted versus manual reading of cervical cytology (MAVARIC): a randomised controlled trial. Lancet Oncol 2011;12:56-64.
8.
Wilbur DC, Black-Schaffer WS, Luff RD, Abraham KP, Kemper C, Molina JT, Tench WD: The Becton Dickinson FocalPoint GS Imaging System: clinical trials demonstrate significantly improved sensitivity for the detection of important cervical lesions. Am J Clin Pathol 2009;132:767-775.
9.
Birdsong GG: Automated screening of cervical cytology specimens. Hum Pathol 1996;27:468-481.
10.
Bishop JW, Kaufman RH, Taylor DA: Multicenter comparison of manual and automated screening of autocyte gynecologic preparations. Acta Cytol 1999;43:34-38.
11.
Longatto-Filho A, Maeda MY, Erzen M, Branca M, Roteli-Martins C, Naud P, Derchain SF, Hammes L, Matos J, Gontijo R, Sarian LO, Lima TP, Tatti S, Syrjänen S, Syrjänen K: Conventional Pap smear and liquid-based cytology as screening tools in low-resource settings in Latin America: experience of the Latin American screening study. Acta Cytol 2005;49:500-506.
12.
Nayar R, Solomon D: The Bethesda System for Reporting Cervical Cytology, ed 2. New York, Springer, 2004.
13.
Nieminen P, Kotaniemi L, Hakama M, Tarkkanen J, Martikainen J, Toivonen T, Ikkala J, Luostarinen T, Anttila A: A randomised public-health trial on automation-assisted screening for cervical cancer in Finland: performance with 470,000 invitations. Int J Cancer 2005;115:307-311.
14.
Cuzick J, Szarewski A, Cubie H, Hulman G, Kitchener H, Luesley D, McGoogan E, Menon U, Terry G, Edwards R, Brooks C, Desai M, Gie C, Ho L, Jacobs I, Pickles C, Sasieni P: Management of women who test positive for high-risk types of human papillomavirus: the HART Study. Lancet 2003;362:1871-1876.
15.
Duggan MA: Papnet-assisted, primary screening of cervico-vaginal smears. Eur J Gynaecol Oncol 2000;21:35-42.
16.
Dziura B, Quinn S, Richard K: Performance of an imaging system vs manual screening in the detection of squamous intraepithelial lesions of the uterine cervix. Acta Cytol 2006;50:309-311.
17.
Chute DJ, Lim H, Kong CS: BD FocalPoint slide profiler performance with atypical glandular cells on SurePath Papanicolaou smears. Cancer Cytopathol 2010;118:68-74.
18.
Walts AE, Thomas P: Endometrial cells and the AutoPap System for primary screening of cervicovaginal Pap smears. Diagn Cytopathol 2002;27:232-237.
© 2014 S. Karger AG, Basel
2014
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.