Thin-layer cytology

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The cytology also Flüssigkeitszytologie or liquid-based cytology called, is a specific method for taking swabs and smear preparation, especially in the early detection of cervical cancer .

The method is a technical development of the previous Pap test , in which the cell smear is smeared directly onto a small glass plate. In thin-layer cytology, the smears are shaken out into a small vessel with liquid, thus producing a cell solution. This removes impurities such as blood , mucus and inflammatory cells and only then removes the cells in a thin layer on a slidedistributed. This procedure results in a smear preparation that can be easily assessed by the examiner and that can be evaluated manually, but also with computer assistance. This is intended to reduce the proportion of preparations that cannot be assessed or that cannot be assessed with difficulty, as well as unclear or incorrect findings. However, the superiority could not be confirmed in all studies.

In many countries, thin-layer cytology is now the method of choice when screening for cervical cancer . In the USA , after approval by the Food and Drug Administration and the payers, more than 70 percent of all smears are made with the help of thin-layer cytology. Thin-layer cytology has also become widespread in England , Scotland , Ireland and Switzerland .

So far, this procedure has not yet been part of the statutory early detection program in Germany and is therefore only available as a so-called Individual Health Service (IGeL), since the Federal Joint Committee rejected the introduction of thin-layer cytology at the expense of the statutory health insurance funds due to insufficient evidence of its superiority. The IGeL monitor of the MDS (Medical Service of the Central Association of Health Insurance Funds) rates thin-layer cytology for early detection of cervical cancer as “unclear” compared to the conventional Pap test. A systematic literature search did not reveal any evidence of benefit, but neither did any evidence of harm. It was compared whether thin-layer cytology missed fewer cancer cells than the Pap test and triggered a false alarm less often. As a result, the studies showed no difference between the two methods. According to the IGeL-Monitor, no studies were found that examined whether thin-layer cytology can actually help prevent deaths.

Individual evidence

  1. ^ AG Siebers, PJ Klinkhamer, M. Arbyn, AO Raifu, LF Massuger, J. Bulten: Cytologic detection of cervical abnormalities using liquid-based compared with conventional cytology: a randomized controlled trial. In: Obstet Gynecol. 112, 2008, pp. 1327-1334. PMID 19037043
  2. Jump up ↑ E. Davey, A. Barratt, L. Irwig, SF Chan, P. Macaskill, P. Mannes, A. Marion Saville: Effect of study design and quality on unsatisfactory rates, cytology classifications, and accuracy in liquid-based versus conventional cervical cytology: a systematic review. In: Lancet. 367, 2006, pp. 122-132 doi: 10.1016 / S0140-6736 (06) 67961-0
  3. ^ Albertus G. Siebers, Paul JJM Klinkhamer, Johanna MM Grefte, Leon FAG Massuger, Judith EM Vedder, Angelique Beijers-Broos, Johan Bulten: Comparison of Liquid-Based Cytology With Conventional Cytology for Detection of Cervical Cancer Precursors. A Randomized Controlled Trial. In: JAMA. 302, 2009, pp. 1757-1764.
  4. ↑ Federal Joint Committee: Early detection of cervical cancer. 2007. (PDF; 4.5 MB)
  5. ↑ IGeL-Monitor, evaluation of thin-layer cytology for the early detection of cervical cancer . Retrieved October 31, 2018.

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