New Device Provides Better Biopsies for Cancer Testing

In a study comparing a new frictional fabric brush versus the currently used sharp scraper for endocervical curettage, the new device provided better tissue yield with less pain and discomfort.

When a woman has an abnormal pap smear she usually undergoes colposcopy to more thoroughly examine for signs of disease. Typically a metal scraping instrument is used to obtain a small sampling of cells inside the cervix – a procedure that is oftentimes painful for the patient and does not consistently give good results. It tends to be painful because the instrument is sharp, which may make the physician not scrape as hard and so may not get many tissue cells.

The study, led by Justin T. Diedrich, MD, at the School of Medicine at the University of California, Riverside (Riverside, CA, USA) in collaboration with two colleagues at Aurora Diagnostics Bernhardt Laboratories (Las Vegas, NV, USA), tested an alternative device manufactured by Histologics (Anaheim, CA, USA), a company that innovates different approaches to tissue sampling. Called fabric-based endocervical curettage, the new device uses a fabric hook, like that making up the rough side of Velcro, to do the sampling instead of the standard metal scraping device. The hook simultaneously biopsies, traps, and stores the tissue for transport to the lab.

“We found that the new fabric devices had significantly fewer ‘inadequate’ specimens – meaning patients did not need to return for repeat biopsies,” said Prof. Diedrich, “This new device means that patients will get better results, with fewer patients needing repeat biopsies.”

The researchers sampled a group of 81 physician and nurse colposcopists who switched from the old-school metal version of endocervical curettage (January 2010-July 2011) to the new fabric-based version (September 2011-October 2013). They looked at the pathology lab results both before and after the switch took place.

“Minimally-invasive office procedures for evaluating the outside of cervix have been around for at least 10 years, but this is the first product to evaluate the inside of the cervix with such ease,” said Prof. Diedric, “Because the biopsy gets more tissue, it is able to find more precancerous cells. This could be the difference between intervening early before someone develops cancer and waiting until it has grown larger.”

When applied to tissue with pressure, the fabric hook flexes downward exposing the hook tip to the tissue face when rotated or agitated on the tissue surface. A colposcopist clinician is not required to handle the specimen and clean biopsy devices, thus reducing the risk of contamination.

“Innovation can make medicine work better and more efficiently,” said Prof. Diedrich, “In this case, innovation is making colposcopy less painful, gets a larger biopsy, and improves the detection of abnormal cells.” If a patient has an abnormal pap smear and needs a colposcopy she should ask her doctor about this new device.

The study, by Diedrich JT et al, was published July 25, 2017, in the Journal of Lower Genital Tract Disease.

Related Links:
University of California, Riverside
Histologics