Areas of smear are to be examined and sometimes multiple smears are prepared. Examination is time consuming and tiring which may lead to missing of abnormal cells due to fatigue. Liquid-based cytology has the advantages of reduction in the smear screening time, uniform spread of cells (Fig. 16.6), with reported increase in detection of HSIL in LBC smears as compared to conventional Pap smears, and the facility of conducting ancillary studies on the same sample. However, some pathologists feel there may be interpretation errors due to alteration in cellular cytology caused by suspension of cells in the liquid medium; absence of intercellular relationship and absence of mucus deprives the screener with vital clues for interpretation. Moreover, it is expensive as compared to conventional Pap smear and preparation of smears is more time consuming.
The glass slide/specimen vial must be labeled with patient’s name and identification no. and packaged carefully to prevent breakage or leakage and transported to the laboratory for processing. All specimens should be submitted to the laboratory accompanied with completed laboratory requisition forms. Laboratory requisition form should include the following clinical details written clearly or typed
•Patient’s Name, Age, Address, Identification No., Telephone No.
•Date of procedure, referring Doctor with contact details
•Source and site of origin of specimen with identifying symbols
•Method of collection
•Clinical symptoms and signs
•Date of Last Menstrual Period
•Special situations-pregnancy, postmenopausal, oral contraceptive/ other hormonal use
•Provisional clinical diagnosis
•Prior abnormal cytology/histology report
•Prior treatment if any.
Causes for rejection of specimen or limited reports:
•Incomplete and/ or improper labeling
•Insufficient pertinent clinical history
•Specimen not fixed on slide immediately
•Obscuring inflammation, debris, or excessive air drying
•A broken slide will be rejected and discarded as a biohazard.
SCHEDULE FOR REPEAT SMEARS
In general, all repeats should not be performed within 6-8 weeks. It is because the scraped surface may not have re-epithelialized and the chance of a false negative result is increased. If colposcopic investigation is performed within this period upon a report of possible or definite abnormality, a concurrent cytology sample is not recommended.