CYTOSCRAPE CELL BLOCK IMPROVES CYTOLOGICAL EVALUATION OF FINE NEEDLE ASPIRATION SMEARS AT KENYATTA NATIONAL HOSPITAL (NAIROBI, KENYA): A CROSS- SECTIONAL STUDY

Abstract

Background: There are more than nine methods used to prepare cell-blocks. Cytoscrape cell-blocks have been found to be effective for haemorrhagic and overly thick smears. Our study utilized the direct formalin method for the preparation of cytoscrape cell-blocks.
Objective: to assess the utility of cytoscrape cell-blocks for evaluation of fine needle aspiration (FNA) smears at Kenyatta National Hospital, Nairobi, Kenya.
Methodology: This was a cross-sectional (laboratory-based) study involving 55 smears of breast and axillary lymph node aspirations reported as ‘suspicious’ or ‘malignant’. Scrapings from fine needle aspiration smears were processed as a micro-biopsy. The cytoscrape block findings were compared with smear findings, and cyto-histological correlation was made whenever available. Data were analyzed using Microsoft Excel 2019 and Cohen’s Kappa test for agreement. Categorical data were summarized, and Kappa was calculated at a 95% CI. P-values <0.05 were considered statistically significant.
Results: cellular material was successfully recovered in 85.2% (47 of 55) of smears. Architectural picture was improved in 58.5% (n=16) of cases, providing additional information. The overall agreement between the cytoscrape technique and conventional smears was 72.3% with a kappa score of 0.43 (95% CI; p<0.001). Cytohistological correlations were performed in 20 cases. The agreement between the cytoscrape technique and histology was 85%, with a Kappa score of 0.69 (95% CI; p = 0.006).
Conclusion: The cytoscrape technique could enhance the utility of cytology in diagnostic workflows. It is an essential tool for secondary analysis of conventional specimens when FNA slides are the only available specimens.