Seems like just yesterday we've started the first of SIP and now we're left with one more week to go. YAY! =D
So now, i would like to share with all of you my experience of being posted into a Cytology Laboratory. The Cytology Laboratory in the Hospital that I am attached to makes use of Liquid-Based Cytology for the diagnosis of cervical cancer.
Collection of Specimen for Pap Smear Test
First, a broom-like device is inserted into teh endocervical canal of patient to allow the shorter bristles of the device to fully contact the ectocervix. teh device is gently pushes iand rotted in a clockwise direction5 times. then, the broom is rinsed into the PreserCyt® Solution by pushing the broom into the bottom of the vial for 10 times (Figure 1), at the same time forcing the bristles apart. Finally the broom is swirled vigorously to furthe release any material into the vial. The collection device is discarded and the vial is tightly capped, corrected, labeled with the sticky label and sent down together with the patient’s form, to the Cytology Laboratory.
Figure 1(Image taken from http://www.moondragon.org/obgyn/procedures/papsmear.html)
The Thin Prep Process
In the Cytology Laboratory, Pap Smears are prepared via Liquid-Based Cytology. Patients samples that comes in vials are processed using the ThinPrep 2000 Processor(Figure 2.).
Figure 2. (Image taken from websites.labx.com)
The process involves 3 steps:
1. Dispersion of cells in the vial.
2. Cell collection onto the filter.
3. Cell transfer from the filter onto a glass slide to produce thin layer of cells onto the glass slide. (shown in Figure 3)
Figure 3. (Image taken from http://www.moondragon.org/obgyn/procedures/papsmear.html)
After the Pap Smear is obtained on the glass slide, it is fixed in 70% alcohol for 20 minutes minimum and then stained using the Pap stain. Basically, the stains involved in the Pap stains are the Haematoxylin stain (used to stain nucleus of cells), Orange-G and EA-60 (cytoplasmic stains). after staining, teh slides are mounted with Depex, dried and then read by Cytologists.
Comparison of Conventional Method and Liquid Based Cytology
Originally, Pap Smears are prepared using the Conventional Method which had many disadvantages compared to Liquid Based Cytology. This is shown in the table below.
This is my last blog post for SIP and i hope all of you have benefitted from reading my blog posts =D.
byebye!
Raihana.
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13 comments:
HI Raihana
I am curious as to what is the constituents of the PreserCyt® Solution?
Xin Ni
TG02
Hey Raihana,
Can I know what will happen if the cells are not properly dispersed?
And, why there will be missing cells in the smear if conventional pap smear is used?
Thanks
Lyn
TG02
hey rai,
i am actually curious on how the cytologists will read the results based on the Pap smear. may i know how the results are inetrpreted. thank alot.
Liyanah Zaffre
0607718D
TG02
hey
you mention that the cells will be rinsed in the presercyt solution. i assume that the cells from the brush would dislodge into the presercyt solution? (just wanted to clarify that the end collection product is the cells in the presercyt solution and not the brush.)
how long before the smear is made? is there a shelf life or some sort? are there any known disadvantages using this method?
thank you
Gladys
answers to questions:
to xin ni:
the constituents of the Preservcyt Solution includes:
preservatives and the main constituent would be methanol, to help preserve the cells
to Lyn:
if the cells are not properly dispersed, cells may overlap each other on the prepared glass slide.
there'll be missing cells if conventional pap smear is used because the device containing sample would still contain alot of sample after smearing on teh glass slide and then thrown away.
to Liyanah:
the Cytologists are trained (which involves reading 7000 glass slides) before they are qualified to read glass slides. results are read as beningn or malignant and in cases where diagnosis is uncertain, cases will be read again by Pathologists.
to Gladys:
yes, rinsing the device in the vial would dislodge the sample into the presercyt solution.
smear is madeas soon as specimen has been processed. disadvantages of the Thin Prep includes being expensive and taking a longer time as compared to the conventional method.
Raihana~
Hi Raihana,
Under the comparison between conventional and thin prep test 2nd point, you mentioned that blood can be separated from the cells. How do you ensure that this is achieved? And will the presence of blood affect the results?
Thanks.
Ka Hang
TG02
Hi Raihana..
How is filtration able to disperse the cells? Why is there a need to ensure cells are randomized?
Thanks =D
Shihui
0607135A
hi ka hang
answer to your question:
For specimens which blood is clearly visible, a specific protocol is carried whereby the blood in teh sample is lysed. only after blood is lysed, the processing can be done.
if processing is done on sample that contains alot of blood, many RBCs can be seen in the smear and this affects smear.
Raihana
hi shi hui =)
here is the answer to your question.
filtration does not ensure that cells are dispersed. the filter is to remove water from the filter ''layer'' so that only cells are captured on the filter and can be trasferred onto the glass slide easily.
cells need to be randomized so as to capture any abnormal cells present =)
raihana~
hey rai, has there been cases whereby the broom-like device failed to collect sufficient cells from the endocervix? because when i was receiving pap smears slides in cyto lab, i realized that some slides had thicker layer of subtance than the others. thanks!
nurathirah
0606561I
have you seen the pap smear being performed? and putting a broom like thing inside the canal of the patient, it sounds like its really pain. Is it really pain? have you asked any patients bout it?
cornelyus
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