Recently I noticed some topics related liquid based cytology (LBC) and conventional Pap smears (CP) in this website. We know that the price of LBC is higher than CP.

Hope we can discuss the disadvantage and advantage of both methods.

What methods are used in your hospitals?

What method you think should be used in China now or future?

Also I will find some data to let you know the main methods used in other main countries. As of May 1, 2008, the United Nations has 192 members. In China we mention 国外, which include more than 190 contries.

Thanks

cz

 Dr. Zhao brought an excellent question for discussion. When I was doing my cytopathology fellowship, we had 50% smears and 50% ThinPrep. Now, in our practice, it is 99% ThinPrep. The major advantage of ThinPrep in term of clinical management is that you can do reflex HPV DNA test on patients with a ASCUS pap. You are not going to be able to do that on the conventional smear unless you co-collect some and put into liquid during the Pap. The reflex HPV DNA test for ASCUS is recommended by the American Society of Colposcopy and Cervical Pathology. Last year, I visited University of Calgary in Canada, the Canadian system is different from the US and they don't have the reflex HPV test for ASCUS. However, their Paps are 90% ThinPrep anyway.

 I have to admit that on morphology for glandular lesions on Pap, I would prefer conventional than ThinPrep, provided the clinicians know how to do the smear (not the air-dryed poor quality smears).

 To 法师 :

休息的时候没事做，也来信口开河说几句，就当作闲聊。

you have excellent  points. Your name also means that you are a powerful person. If you are more serious, you will have more excellent points. Kiding.

2、液基并不是人人都能享受的，液基的高价格注定不适合在农村地区推广，即使政府拨款，贫困地区也不可能，比如我们在农村宫颈癌筛查，拨款最多10-20元/人，谁还奢望做液基？不过 其实国产液基价格应该没那么高吧，最起码他的研发投入没国外的多，虚高定价在医药行业是一个死结，不能望奢某一方面来解决。

3、如果涂片制作都合格，传统制片和液基在筛查的敏感性和特异性方面应该没多少差别（没做统计，凭感觉说的）。

4、细胞学领域的乱，我觉得是中国的国情决定的，过去长期细胞学好像不受重视（主要是经济价值不高），中国是一个人口大国，如果政府现在重视宫颈癌的筛查，短期不可能培训出那么多合格的细胞学医生，好的专家都在城市，至少现在政府在作这个事了，那么规范也就不远了。

5、商家推广液基的最大贡献是让细胞学领域红火起来了。

休息的时候没事做，也来信口开河说几句，就当作闲聊。

 国内细胞学混乱的很。而且真的是越来越离谱。

北京搞两癌筛查，大家都去参加宫颈液基细胞学培训，考试过关，才能参加筛查。但是听说有的医院病理医生全军覆没，考试都不过关，依然也每天在发液基细胞学报告。多可怕！

最后听说，两癌筛查，政府拨款不够用，最后预计都要做成传统涂片，而且还听说要巴氏五级分类发报告！上星期一位经销商来找我，问我们能否接受两癌筛查的片子，我说：您还是饶了我吧，巴氏五级还用啊，打死我也不接，谁爱接收谁接收。

我想政府的想法是好的，但是真正执行下去就变了味道。

 As of May 1, 2008, the United Nations (联合国） has 192 members （成员国）. In China we mention 国外, which include more than 190 contries。

 I spent 5 minutes with my wife's help to type few Chinese words above. My teachers did not teach me the spelling well in the elementary schoos, or I forget the chinese spelling. Ha ha.

I mentioned that because we Chinese always say 国外.......

One hospital cannot represent one country. One country cannot represent 国外.

In term of Pap test at least 95% or more of the Pap test in the US are 液基. This does not mean  液基 is used in all 国外 hospitals.

It is the same that conventional Pap may be maily used in some 外国. It does not mean conventional Pap is used in all  国外.

The United States=America, a federal constitutional republic comprising fifty states and a federal district (50 states + washington DC). The state is similar to the provience (省), but the state has more power than 省 in China.

The United nations=联合国。 Nation=contry here.

试译一楼的内容，译得不当之处，请大家指正：

   最近我注意到本站一些主题关于液基细胞学与传统巴氏涂片，大家知道液基的价格高于传统巴氏。我们希望能讨论一下两种方法的优缺点。

   请问，你的科室使用哪种方法？你认为现在或将来哪种方法更适用于中国？

   我也愿意找到一些数据说明在其他的一些国家和地区使用的主流方法。

   截至2008年3月1日，联合国有192个成员国，而在中国我们所谓的国外，包括了190多个国家。（谢谢赵老师和夫人对197译文的帮助！）

  谢谢！