PROGRAM AREA REPORTS

CYTOLOGY PROGRAM

The Cytology Program Area has continued to focus primarily on cytology automation during the present two-year period. This focus is primarily in response to the active and growing interest of cytopathologists in both the United States and Japan in automation of cancer cell screening, as well as the major research and development programs in cytology automation supported by both countries.
The two annual scientific meetings and the exchange of scientists served as equally important means of exchanging information. The two scientific meetings included presentations by U.S. and Japanese workers on all aspects of cytology automation. These presentations included detailed accounts of instrument design and performance, especially very important presentations on effectiveness of recent instrument modifications undertaken by both sides. The Japanese reported extensively on optical and sensor modifications in static instruments while U.S. scientists described new approaches to flow system design and hardware and software data processing. Techniques for sample preparation for instrument analysis with both heat and light were discussed by all participants. Extensive data from the U.S. on fluorescent stains and from Japan on absorption stains opened up an extensive collaborative and cooperative interest in the fundamental cytochemistry of premalignant and malignant cell change which is now being actively pursued. Reports of clinical and field trials from both sides were presented and compared. Newer applications of automated quantitative cytologic techniques in the broad fields of clinical and experimental oncology were presented.*
During this two-year period, seven Japanese and two American exchange visitors spent periods of from several days to three months in host laboratories. The purpose of the shorter visits was the export of specific techniques from the host laboratory to laboratories in the visitor’s home country. The longer visits focused on detailed assessment of techniques such as flow microfluorometry, moving solid support transport of cells and sputum and urine cytology. These techniques were reviewed for comparability with the guest’s techniques, and modifications and/or understanding of performance differences were easily achieved. Finally, because of differences in performance of automated systems in the U.S. and Japan, which appeared to be due to the differences in cytochemical stains used in the two countries, detailed staining protocols from all active laboratories in both countries were exchanged.
No area of the cytology automation programs of the U.S. and Japan has remained untouched by the exchanges of the cooperative program. At the inception of the U.S.-Japan exchange, the U.S. program was almost exclusively involved in fluidic systems and the Japanese program in static cell systems. During the past three years, several of the Japanese exchange visitors have had as a primary purpose the investigation of flow analysis and sorting systems. As a result of these visits, an extensive review of flow microfluorometry was published in Japanese in the Japanese Journal of Obstetrics and Gynecology. Subsequent Japanese language articles on applications of flow microfluorometry in fundamental and clinical oncology have appeared or are in preparation. As a result of these publications, several Japanese laboratories are now working with flow microfluormetric systems applied to cancer cell screening and analysis and basic oncology.
In the U.S. program, interest in static cell image processing systems was rekindled by American exchange visitors and the system operating reports from Japanese workers. In addition, the Japanese film transport system was demonstrated to have significant advantages for rapid automated cell analysis. As a result of these exchanges, three laboratories in the U.S. program are working actively in static image processing and film transport of cells in cooperation and collaboration with Japanese scientists.
The problem of specimen preparation was identified early as possibly the most important aspect of automated quantitative cell analysis by scientists from both Japan and the U.S. In the relatively brief period of two years, a common protocol for sample preparation based on work in both countries has emerged and received wide acceptance among scientists active in this field. This U.S.-Japanese protocol has also been adopted by scientists from other countries as the best, most practical sample preparation technique currently available.
The topic of stain cytochemistry is currently the area of most active interest and collaboration. The differences and similarities among numerous quantitative probes of chromatin structure and nucleic acid content and distribution form the basis for several exchange visits and exchanges of data and protocols. The prospect of understanding the phenomenology of these stains at the level of molecular interactions is a very real goal of the present efforts in the Cytology Program Area. This understanding will allow significant progress in collaborative and cooperative design of clinical and field trials of cytology screening systems while ensuring reproducibility of results with easily exportable techniques.
Future plans for the development of the Cytology Program Area involve continued collaboration through both the exchange of scientists and scientific meetings. The most pressing topic continues to be the cytochemistry of premalignant and malignant cellular changes. In addition, a continued growing together of instrument design and clinical and field trial protocols is inevitable in the natural course of the cooperative exchanges currently being pursued.


*For detailed information on automated cytology, refer to Appendix VIII, Scientific Session on Automated Cytology.