Cancer Cytopathology

Rapid prescreening is an underutilized strategy for gynecologic cytology. The study by Tavares et al published in the current issue of Cancer Cytopathology adds strong data to the growing body of evidence that rapid prescreening is an excellent internal quality assurance method for improving the performance of gynecologic cytology.

This commentary focuses on the use of rapid onsite evaluation in computed tomography-guided and endobronchial ultrasound-guided transbronchial needle aspiration procedures. The authors describe their process for triaging and handling hilar and mediastinal lymph node aspirates to maximize cell recovery to meet the current demand for the use of multiple ancillary techniques and molecular analyses in thoracic oncology.

Rapid prescreening performed better than 100% rapid review of negative smears as a method of internal quality control of cervical cytology exams. This method permits constant evaluation of the sensitivity of prescreeners and routine reviewers and provides assurance that the rate of false-negative results in cytology remains within minimum acceptable levels.

The incidence of cervical intraepithelial neoplasia (CIN) 2/3+ follow-up was significantly higher with human papillomavirus (HPV)-positive high-grade squamous intraepithelial lesion (HSIL) than with HPV-negative HSIL. Some HPV-negative HSIL cases may have represented HSIL cytologic mimics.

In this comparison of ThinPrep and SurePath liquid-based cytology (LBC), both methods yielded similar validity in detecting significant cervical lesions. However, SurePath samples yielded higher rates of satisfactory LBC slides and sufficient residual volume for Hybrid Capture 2.

Fluorescence in situ hybridization (FISH) analysis with the UroVysion assay demonstrated a high sensitivity and specificity in the monitoring of non–muscle-invasive bladder tumors, similar to cystoscopy and higher than cytology. Given these results, the authors propose that FISH could be a useful monitoring tool in the surveillance of patients with a previous history of bladder cancer.

The high frequency of chromosomal polysomies in reactive urothelial cells is a potential source of false-positive fluorescence in situ hybridization results. Cells with a polyploid chromosomal pattern are of limited diagnostic value and should be interpreted in synopsis with the morphology and patient's medical history because they are common in reactive conditions.

Fine-needle aspiration material is suitable for diagnosis and genomic techniques in patients with neuroblastoma. It also may be used for cytology prognostic scoring.