Abstract

The current, conventional method used is quick, easy and reasonably cheap but the nature of bronchial specimens themselves creates the need for a better preparation technique. Bronchial specimens often present with many obscuring features, such as blood and mucus, which can affect definitive diagnosis. In the study, the bronchial specimens underwent routine conventional preparation and that remaining was used to prepare an LBC slide. Both LBC methods were separately evaluated alongside the conventional method where, of the 44 specimens used, half were prepared using the conventional and ThinPrep and half with the conventional and SurePath. Evaluation forms were completed by pathologists who assessed all preparations. The results showed both LBC methods produced superior preparations that were better fixed, more cellular and had improved nuclear detail. They also removed a high percentage of background debris, were more diagnostically accurate and reduced the inadequate rate by a third. The conventional slides prepared from the same specimen as the SurePath had a lower average than those prepared with the ThinPrep. This indicated that the specimens used to evaluate the SurePath method were in fact inferior to those used for ThinPrep, with the SurePath slides showing only a slight improvement in overall quality. Despite LBC preparations reducing pathologist screening and reporting time, both methods are more labour intensive and less cost effective. The majority of laboratories are not in the financial situation to trial new methods that require extra training and more staff hours, and as such this study has highlighted an important question ‘Do the benefits of better quality preparation and diagnostic accuracy offset an increase in time and cost’.

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