Rehydration Of Air-Dried Smears For Papanicolaou Staining

Abstract

Background: Wet fixed smears are commonly used for routine investigation in determining many precancerous and cancerous lesions.  Wet fixed smears are associated with few side effects which lead to diagnostic difficulties. Therefore the present study is used to determine the effects of rehydration on air dried smears by comparing cellular preservation and staining quality in rehydration smears and wet fixed smears.

Aim: To study the effect of rehydration on air dried smears and to compare it with wet fixed  smears.

Objectives were 1) To compare the cytomorphological features in conventional Pap Smears and rehydration air dried Papsmear.  2) To compare the staining quality in  rehydration smears and wet fixedsmears. 3) To find whether rehydration techniques can be adopted as an alternative method especially in high volume resource limitedsettings.

Methodology: Our study was a prospective analytical study conducted in Cytopathology section of Department of Pathology, DMMC, Nagpur in alliance with Pathology Department of JNMC, Sawangi, Wardha. 100 samples were examined during the studyperiod. Wet fixed smears were processed routinely. Air dried smears were rehydrated with normal saline for thirty seconds and immediately added to jar containing fixative 95% ethanol forthirty  minutes. The smears from both sets were then pooled, coded, and stained by standard Papanicolaou technique. Both the smears were screened, assessed and graded for various cytomorphological parameters. The cervical smears were reported as per the 2014 Bethesdasystem.

Observation: Study was carried out on hundred samples which includes FNACs, exfoliated fluids, Cervical smears. Out of these maximum samples belongs to cervical smears (44%). Among the FNACs, maximum samples were from thyroid (18%). Comparing both the rehydrated smears and conventional wet fixed smears, no difference was noticed in cellularity, nuclear borders and chromatin, quality of cytoplasmic staining, background clearing and cell borders. Rehydrated air dried smears shows prominent cytolysis as compared to wet fixed smears with p value of 0.028. Drying artifact was common with wet fixed smears when compared to rehydrated  smears (p= 0.039).

Conclusion: Rehydrated air dried technique can be used effectively for FNACs, Effusion fluids, Exfoliated cells.