CA2125650C - Pap smear collection device - Google Patents

Pap smear collection device

Info

Publication number
CA2125650C
CA2125650C CA002125650A CA2125650A CA2125650C CA 2125650 C CA2125650 C CA 2125650C CA 002125650 A CA002125650 A CA 002125650A CA 2125650 A CA2125650 A CA 2125650A CA 2125650 C CA2125650 C CA 2125650C
Authority
CA
Canada
Prior art keywords
bristles
handle
cells
forward end
cervical face
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Fee Related
Application number
CA002125650A
Other languages
French (fr)
Other versions
CA2125650A1 (en
Inventor
Richard D. Strickland
Geno Saccomanno
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Baal Medical Products Inc
Original Assignee
Baal Medical Products Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Baal Medical Products Inc filed Critical Baal Medical Products Inc
Publication of CA2125650A1 publication Critical patent/CA2125650A1/en
Application granted granted Critical
Publication of CA2125650C publication Critical patent/CA2125650C/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02Instruments for taking cell samples or for biopsy
    • A61B10/0291Instruments for taking cell samples or for biopsy for uterus
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02Instruments for taking cell samples or for biopsy
    • A61B2010/0216Sampling brushes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B2017/320004Surgical cutting instruments abrasive
    • A61B2017/320012Brushes

Abstract

A device (10) for simultaneous collection of cells from the endocervical canal and the cervical face of the uterus and methods of use. The device (10) has an elongated handle (12) having one cell-collecting member (30) projecting from the handle (12) at an axis perpendicular to the axis of the handle (12) for contacting with the cervical face of the uterus, and one cell-collecting member (20) projecting from the handle (12) along the same axis as the handle (12) for contact with the endocervical canal of the uterus. Along each member (20, 30) project sets of bristles (26, 32) which, because they are perpendicularly positioned on each member (20, 30), provide mild abrasive action to the endocervical canal and the cervical face when the device (10) is inserted into the uterus and rotated, so that cells from both regions are collected onto the bristles (26, 32).

Description

~;iO93/11708 2 1 2 ~ 6 ~ O PCT/US92/10234 PAP 8~BAR COLLECTION DEVIC~
e~
l. The Fiel~ of the Invention The p~ent invention relates generally to apparatus and methods for use in the collection of a Pap smear. More particularly, the p~-ent invention provides a novel design which permits simul~Are~us collection of cells from the cervical face and from the çnAocervical canal. The device also provides a method and means for securing a vaginal sample without reverting to a ~con~ sampling device.
- 2. T~e Ba~a~ou~d of th- Tnv~~t~
Over the last 40 years, the death rate from cervical cAncer has dropped dramatically due to the widespread use of the Papanicolaou ("Pap") test. This test involves the collection of cells from the cervical face, the e~Aocervical cAn-l and orcAcionally from the vaginal wall.
Th~e cells are then mi~ orically examined fo~ eviAenGe of precAnGerous or cancerous growth. The periodic use of this test permits early detection of mali~nGy so that palliative therapy can be initiated at a time when it will yield the highest possible ~CCeS5 rate.
For many years the s~AnA~rd method for collection of these cells has been a wooden or plastic spatula. A
variety of slightly different shapes have been used in an effort to allow the clinician to collect cells from the cervical face as well as the endocervical canal. In some c~es, the opposite end of the spatula was designed to collect a vaginal scraping.
For the most part, these designs have been able to retriev~_ cells from the surface of the cervix and the vaginal wall but have frequently failed to collect adequate cell samples from the enAocervical canal. This has been a serious problem because any sample which does not include endocervical cell8 iS deemed to be inadequate for proper WO 93tll708 ~5 o PCr/US92/tO234 interpretation and diagnosis. Further, many women who have had an inadequate sample taken are reluctant to have the procedure repeated and may be placed at risk for p~o~e_sion of their ~ e until their next periodic c~ck"r A delay in the diagnosis of cervical or uterine cancer can result in the need for far more radical treatment ~Loc~ e~ than would be need~ if the c~n~er were detected earlier. In the worst case, a delay in diagnosis could ~ tl t in the p~y~__sion from treatable c~er to a terminal c~n~er~
n~ modifications in collection p~o~ res have added a cotton swab to the tech~ique in an effort to 15 collect en~ocervical cells. The cotton swab is inserted into the cervical c~n~l and rotated. Although the cotton swab may somewhat improve the yield, it is not abrasive e--o~-J)- to scrape the e~AO~ ical ~ 1 and consistently retrieve an adequate sample.
Another modification made in an attempt to collect end~cervical cells is what is called a "cytology brush."
This cytology bru~h has on the end of a long h~n~l e a conically-tapering brush made of spiraling bristles. When the brush is rotated within the endocervical canal, cells 25 become entrapped by the brush. However, while the cytology brush can consistently obtain endocervical cells, the brush is too abrasive, and so its use increases the incidence of bleeding and discomfort and, in addition, adds considerable cost to a very pricc se~citive procedure.
If blee~ing occurs during collection, the red blood cells may obscure other cells on the cytology slide and make in~erpretation difficult or impossible. When this h~rpen~, the cell collection p~Gce~re must be repeated.
As many "Pap smears" are performed in public health clinics 35 and similar free or lo~ cos- environments, the device to be ~93/11708 2 1 2 3 6 ~ l3 PCT/US92/102 used must not substantially increase the material costs of the procedure.
Another disadvantage to the cytology ~rush has been 5 that entry of the brush into the endocervical canal is difficult to control. If the brush is extended too far inside the canal, injury to the endocervix may result. It is difficult for the user to determine proper penetration of the cytology brush.
R~cently, some ch-ng-o in the design of cytolo~y br~ c have been taking place, ai~ed primarily at decreasing the incidence of cervical blee~ing and improving the ease with which cells are extracted from the bristles.
These changes have been somewhat effective but have typically further incr~ the cost of the brushes.
One change has been to design a broom-like device to simultaneously collect cells from the ectocervix and enAorervix. This brush has bristles which extend forward from a c~ piece and looks very much like a broom. The central bristles are longer than the lateral bristles and are intenA~~ to enter the en~o~ervical canal while the lateral bristles ~ake contact with the ectocervix. The collection difficulties arise from the fact that the central bristles are parallel to the walls of the ~n~or~rvical canal and, thus, very little abrasive effect is generated, e-pecially if there is any dilation of the cAn~l. As a result, endocervical cells are not consistently collected.
Further A ~ vantages of the prior art devices are in transferring the cells for examination. After cells have been collected, they are usually transferred to a mi~ riC slide for later examination. This is accomplished by wiping the collecting apparatus, whether spatula, brush swab, or broom, directly against the surface of the slide. A fixative is then applied to avoid any deterioration of the cells before the cytology ~ec~nician W093/11708 565~ PCT/US92/10234 and/or pathologist can examine them. Unfortunately, many doctors lack time and patience to transfer every collected cell from the device with a mic~vsçopic slide and so valuable diagnostic material may be lost, resulting in risk of erroneous diagnosis. With the spiral brush, it is difficult to transfer all cells from the brush to the slide and excess time and care to do so is necessAry.
In some ca~~~, the presence of mucous or blood or the knowledge that the patient is at high risk, can make this type of slide preparation ~ 6~~te. A monocellular preparation may be requested. In this technique, the samples must be transferred from the collection device(s) into a container of fixative. The container is then centrifuged until all cellular components have collected at the bottom of the container as a "cell pellet." After the ecc fixative is pipetted off, the cell pellet can be spread evenly onto a slide. This provides a slide with very little cellular overlap. Mucous will have gone into solution and any red blood cells will be sufficiently spread so as to avoid obscuring other cells.

BRI15F 8~1ARY OF T~ INV~NTION
In view of the present state of the art, the present invention is directed to an apparatus and methods of use which permit cimultaneous contact and collection of cells from the ectocervix and endocervix. Accordingly, the device is provided with an elongated h~n~l e having a forward end and a rear end. The forward end narrows slightly into a flexible zone which is important in the removal of cells from the device onto a mic~~cope slide.
This zQne allows the hAnAle to flex and bring the collection areas into a position parallel to the slide, thereby facilitating the transfer of cellular material onto the micl.-coric slide by a direct smear technique.

!093/1l708 21 2:~ 6;j o PCT/US92/tO234 s A member longi~ in~lly extends from the flexible zone of the handle, along the same axis as the h~nAle. This member is sized for comfortable insertion into the enAocervical canal. Substantially perpendicularly projecting from the longitn~in~lly extenAing member is a first set of bristles. Due to their being substantially perpenAicular to the axis of the enAorervical canal and of sufficient combined length to span the diameter of the canal, these bristles allow mildly abrasive contact with the walls of the e"~ rvical canal even when the cAn~l is dilated. When the c~n~l is not dilated, these bristles are sufficiently supple to be easily comprc~~A when entering the non-dilated cervix so as to not cause t~nAl~ trauma to the enAooervical walls.
A second member laterally extends from the flexible zone of the h-nAle ~e.-rally on opposite sides of the flexible zone from the same point where the longi~ n~lly ex~e~in~ member extends from the flexible zone, and is positioned along an axis substantially perpendicular to the h~n~le of the device. Projecting forwardly from the laterally ex~e~in~ member is a ~?con~ set of bristles.
When the device is inserted into the uterus, the longitl~AinAlly extenAing member becomes inserted into the e~A~e~vical cAn~l and the f irst set of bristles makes contact with the ~nAorervical walls. Simultaneously, the laterally extenAing member is pressed against the cervical face with sufficient forward pressure to flex the second set of bristles slightly.
To reduce the potential for sampling trauma of the enAoce~vical c~n~l from excessive penetration of the longit~ Ally ex~en~i~g member, the laterally extending member will act as a mer~ica} barrier. The device can only penetrate up to the point where the laterally 3 extenAing member pr~e~~e against the cervical face. It will also provide a means for main~;nin~ an axial ~ r36'~3~ 6 relationship between,the device and the endocervical canal, thereby preventing unwanted damage to the walls of the canal by an off-axis insertion. The lat-erally exten~ing member may be curved so as to conform to the s~e of the cervical face.
Once the device is comfortably placed within the uterus, the device is then rotated 360 degrees.
~n~ocervical cellc and cells from the cervical face are simultanQously collected onto the bristles of the device.
Removal of the cells from the collection device of the pL~-ent iJ.~e..~ion may be accompli~he~ by two methods. The first method is by utilizing the flexible zone of the h~nAl e to smear the cells easily onto a mi~L&-~ope slide with a minimum of cellular material loss. Once a fixative is applied, the cells are ready to be analyzed.
The ~ecQnA method is by inserting the forward end of the device into a centrifuge tube filled with a fixative solution and spi nni ~ the device between the palms of two ~-nAe . The laterally extenAin~ member is designed such that when the device is man~ y rotated, an oscillating turbulence, similar to that found in a w~in~ machine, is created which effectively rel~A~e- the collected cells from the set of bristles and simultaneously Ai~F~lves any collected mucous into suspension. The solution is centrifuged ~nd a cell pellet i~ producad. When this pellet is spread onto a slide, a single layer of cells is available for analysis.
- In one emhoAiment of the device, at the rear end of the hAnAle, the hAnAle may flatten into an elliptically-shaped spatula which may be used to perform vaginal scrapings when nece~ y~.

BRI~F D~8CRIPTION OF TH~ DRA~INGB
In order that the manner in which the above-recited and other advantages and objects of the invention are obtAired, 'O 93/11708 PCI'/US92/10234 21256~

a more particular description of the invention briefly described above will be rendered by reference to specific embodiments thereof which are illustrated in the appended drawings. Unders~AnAing that these drawings depict only typical embodiments of the invention and are therefore not to be considered limiting of its rcor~, the invention in its pl~-ently understood best mode will be described with additional specificity and~detail through the use of the accompanying drawings in which:
Figure 1 is a peL~e--~ive view of one embodiment of the pl~,e~t invention.
Figure la is an end view of the embodiment of Figure 1 illustrating single plane positioning of bristles along lS axis line A-A.
Figure 2 i~ a cross-section taken along the line 2-2 of Figure 1, illustrating the ridged ~p~ of the h~nAle.
Figure 3 is a cross-sectional view of the device of the ~ nt i~ ion ~ein~ inserted into the enAo~~,~ical c~n~l of the uterus.
Figure 4 is a perspective view of cells being transferred from the device of the present invention onto a mic~ cQpe slide.
Figure 5 is a perspective view of cells being transferred from the device of the p~ nt invention into a centrifuge tube.
Figure 6 is a perspective view of a presently preferred embodiment of the present invention illustrating collection of cells from the vaginal wall.
Figure 7 is a cross-section taken along the line 7-7 of figure 6 illustratîng the scraping action of the device of the present invention.
Figure 8 is a perspective view of one alternate embodiment of the device of the present invention.
Figure 9 is a cross-section of an alternate emhoAiment ~e~ in the general area long the line 9-9 of Figure 8.

W093/11708~ 6~ PCT/US92/10234 In the drawing figures, like parts have been designated with like numerals throughout.

DETAI~n DE8CRIPTION OF T~ Pk~ EMBODIN~NT~
Reference is first made to Figures 1-3 which illustrate one p~-ently preferred embodiment of the invention and its use. The device for simultaneously contacting and collecting cells from the endocervical canal 6 and the cervical face 8 of the uterus 9 is generally designated at 10 and can be seen in use in Figure 3. The device 10 is comprised of an elongated h-nAle 12 and a ti~ ~ sampling means 11 for collecting cells. Although it can be a~e_iated that the ~~nAl e 12 could be of a variety of lengths, the p~-ently preferred length is about six inCh~ nAle 12 comprises longitl~Ain~lly ex~en~ing ridges 13 along the length of handle 12. The~e ridges 13 serve to provide better grip and ease of ~n~ling of the device 10. The ridges 13 provide more of a non-slip surface than would a smooth h~n~l e on the same device. A
c~-C-section of the b~n~le 12 illustrating the longi~Ain~lly extDnAing ridges 13 can be clearly seen in Figure 2.
u~nAle 12 further comprises a forward end 14 and a rear end 16. Forward end 14 narrows into a flexible zone 18 of the hAnAle 12. As will be seen later, flexible zone 18 is important in the A~rosit of cells onto mi~ rcspe slides for analysis.
Tissue sampling means 11 comprises a first bristle means and a rsconA bristle means. In the preferred embodiment within the scope of the present invention, the first _bristle means comprises a member 20 which longitl~A;n~lly extends from the flexible zone 18 along the same axis as the ax~s of the h~nAle 12. As can be ~een in Figure 3, when the device 10 is inserted into the uterus 9, the longi~ in~lly ex~en~in~ member 20 becomes inserted '093/11708 21 256~ ~ PCT/US92/102~

into the endocervical canal 6. (A clamp 21 is shown in Figure 3 to illustrate how the vagina 22 must be opened and held open for insertion of this or any device.) Thus, the longi~1~AinAlly extenAin~ member 20 must be short and slim so as not to cause trauma to the endocervical canal. In one preferred embodiment, the longi~l~Ain~lly eX~en~ing member 20 has a length of about l/2".
Projecting perpendicularly from longit1~inAlly 10ex~enA~nq member 20 are means for contacting and collecting cells within the ~nAo~ervical canal. In one p~ ~ -ently preferred embodiment of the PL ~~~nt invention, the means for contacting and collecting cells within the endocervical canal is a first set of bristles 26 projecting tSsubstantially perp~nAicularly from the longitudinally exten~ing member 20. In Figure l, the first set of b~1A~?s 26 can be seen projecting from opposing sides of the longit~in-lly ex~en~i~g member 20. As the first set of bristles 26 are perpendicular to the axis of the 20longit~in~lly ex~enAing member 20, they are also perpendicular to the axis of the endocervical canal 6 when the longit~in~lly extended member 20 is inserted, and so provide a mildly abrasive contact with the walls of the enAocervical cAn~l which allows sufficient collection of 25cells. In Figure 3, the first set of bristles 26 can be seen in contact with the cells of the endocervical canal.
The size of the first set of bristles 26 are preferably of a length sufficient for contacting and collecting cells within the en~ocervical canal even when the endocervical 30canal is dilated. The desired width of each bristle is such that the bristles are stiff enough to provide abrasive action ~Y obtain a succe~sful sample of cells in the endocervical cAnAl, but sufficiently supple to be somewhat easily compreeA~ when entering an undilated en~oc~rvical 35cAnAl, so as to prevent excess abrasion or damage to the walls.

W093/11708 ~ ~j65 PCT/US92/10234 The spacing between the first set of bristles 26 is preferably such that bristles 26 are spaced closely enough to each other so that collection of the cells from the ~nAocervical canal is possible, yet spaced widely enough from each other so that easy dislodgement of the cells from the first set of bristles 26, when desired, is accommodated. In the preferred embodiment within the scope of the invention, the preferred spacing i~ about l/64n.
The preferred second bristle means within the scope of the ~ ~ t invention compri~es a ~on~ member 30 which - extends laterally from the flexible 20ne 18, generally on opposite sides therefrom,i from the same point where the longit~in~1ly ex~e~Ain~ member 20. extends from the flexible zone 18. The laterally exten~ing member 30 is gently curved and is positioned on an axis substantially perpendicular to the axis of the h-~le 12. As can be seen in Figure 3, when the device lO is inserted into the uterus 9, the laterally ext~ g member 30 comes into contact with and rests against the cervical face 8 of the uterus.
In a ~ ently preferred embodiment of the present invention, the laterally ext~nAin~ member 30 is slightly C~L~d SO as to conform comfortably to the cervical face, thereby permitting comfortable and full contact between the laterally exten~ing member 30 and the cervical face 8 of the uterus 9. When the laterally exten~ing member 30 i5 pushed up against the cervical face, the slight curve allows more of the laterally extending member 30 to be in contact with and embrace the cervical face, thereby permitting a greater area of cell collection. It can be apprec~ that in older women whose cervices have ~Yp~n~ed, embodiments with less of a curve may be preferred.
The laterally ex*e~din~ member 3~ also acts as a me~ ical barrier ag~i~ct eY~ cive penetration of the ~93/11708 2 I 2 ~ 6 ~ ~ PCT/US92/10234 endocervical canal by the longitudinally extending member 20. When the laterally extending member 30 rests a~inct the cervical face 8, further penetration into the endocervical canal 6 by the longi~ in~lly extending member 20 is prohibited. The laterally exten~ing member 30 also provides a means for maintaining an axial relationship between the device lO and the enAocervical canal 6 by guiding placement of the device ag~inct the cervical face.
tO Without this axial stability, the longit~ Ally exten~ing member 20 could be inserted in a misaligned direction and damage to the walls of the ~nAr~ervical canal may ~e~ t.
Projecting from the laterally ex~enAin~ member 30 are a second set of bristles for contacting and collecting cells of the cervical face 8. In Figures l and 3, this ~?CQ~ set of bristles 32 can be seen as projecting forwardly from said laterally ex*enAing member 30. The ~onA set of bristles preferably has a length whereby they contact the cervical face 8 with enough abrasive action to collect ~ s, yet with enough softness so as not to cause damage. In one preferred embodiment, the length of each bristle of the ~econA set of bristles is 3/32n.
It is important to note that the spacing of the second set of bristles 32 is important in the same way as described above for the first set of bristles 26.
When the second set of bristles 32 are pushed up against the cervical face, they are preferably pushed with sufficient forward pressure to flex them slightly. At this point, the longit~in~lly extD~ing member 20 is within the en~oc~rvical canal. The device lO is then rotated 360 de~ee_. With this action, the first set of bristles 26 within ~the e-~1o~rvical canal 6 and the ~?cond set of bristles 8 ag~i~t the cervical face 8 rotate and collect cells on their leading edges. Collection of the e ~o~rvical rel1c and the cervical face cells is done simultaneously, and with a r~~ceseful yield of cells. This WO93/11708 ~ 6~ PCT/usg2/l02~

is an improvement over the prior art devices which could not consistently, safely, and s~1cc~ssfully simultaneously collect ~nAor~rvical and cervical face cells. As the p~s~ss itself tends to be embarrassing and somewhat uncomfortable, a high yield of cells from only one try is important, since patients may not be willing to come back to redo an ~ censful test.
It is another feature~ in the preferred embodiment of the device of the ~ ent invention to have the longi~ in~l1y ex~endin~ me~ber, the laterally ex~enAing member, the first and second 8QtS of bristles, and the h~n~l e of the device all positioned in the same plane.
This feature is best illustrated in Figure la, wherein the first and s~.conA set of bristles can be seen to lie in the same plane along axis line A-4. With this embodiment, the cost of manufa~ e is low due to the fact that molding can more easily be done with a single planed object than with an object with several other dimensions. This low cost of manufacture encourages widespread use of the invention.
Additionally, having the longit~dinA~ 20 and lateral 30 members in the same plane as the set of bristles 32, 26 enh~nces the removal of cells onto a flat surface. With all parts in one plane, one quick swipe of both sides of the device onto the slide (as pictured in Figure 4 and later ~iscllcs~) is all that is necessary.
Further, with all parts in one plane there is less chance of causing ey5~cS abrasion and damage to the cervix, while at the same time, there is still successful collection of cells from both the endocervical canal ~nd the cervical face.
It A an be appreciated that having the members, the h~n~l e, and the bristles in separate planes is also within the scope of the pL~-ent invention, but it is preferred that they all lie within the same plane.

093/1170X 21 2 S 6 ~ ~ PCT/US92/10234 Referring now to Figure 4, one method of removing the cells from the device 10 can be seen. When the device 10 is removed from the uterus, the device 10 contains S endocervical and cervical face cells on the leading edges of the sets of bristles. Because of the 360 degree rotation, the cervical cells have basically collected only on the l~ing edges.
One method of removing~the cells from the device 10 is to smear the cells onto a mi~L.-~ope slide 36, as can be seen in Figure 4. The longitu~i n- lly ex*enAing member 20 and the laterally ex~enAin~ member 30 are placed on the slide 36. The h-nAle 12 is then bent upwards at the flexible zone 18, so that an angle between the h~n~l e 12 and the members 20 and 32 is formed while the members 20 and 32 are held parallel to the slide. The user of the device can now easily wipe the cells off of the device onto the slide in a parallel motion. A first smear is made by wiping the device 10 onto the slide 36. The device 10 is then rotated 180 de~ e_s and wiped a seconA time onto the slide 36. By these two actions, the cells on the 1~A~ ing edges of each side of the bristles are wiped off the device and onto the slide. After a fixative is applied to the slide, the slide is ready for analysis.
It is important to note that without the flexible zone 18, it is awkward to remove the cells from the device onto a slide. There is less maneuverability because, without the flexible zone, the collecting portion cannot be smeared against the slide easily in a parallel motion, and so many of the cells are not transferred to the slide. In contrast, with the flexible zone 18, the longitudinally and laterall~ex~enAing members ~6 and 32 are allowed to be placed flat against the slide 36 and to be maneuvered along the slide by the handle from a position above the slide and pressing downwards, rathe than from an awkward position beside the slide, pressing with a sideways motion. Thus, WO93/tl708 ~rj6~ PCT/VSg2/102 the presence of the flexible zone 18 facilitates removal of cells from the device 10 with a minimum of cell material loss.
The above-mentioned removal method illustrated in Figure 4 may result in several layers of cells being stacked on the slide. As any malignant cells may be hidden at the bottom of the stack, this method may not always be sufficient. Thus, an alternative method may be used to create a monolayer preparation in which the cells are applied to the slide in a single layer. Such a method is also facilitated by the device of the p~-ç~t invention and is illu~lated in ~igure 5.
By this method, the longit~;nAlly and laterally exten~i~g members 26 and 32 are held in a fixative solution in a centrifuge tube 40. The ~nAle 12 is placed between the hAnAc 41 of the user and a rubbing action between the two h~n~c spins the device. Because of the design of the laterally extenAin~ member 30, i.e., because it is generally perpendicular to the hAnAle, an oscillating ~uL~ulence similar to that found in a wA~ing machine is created by the spinning action. This action rel~A~es the cells from the bristles of the device into the fixative solution. The action also dissolves any collected mucous into ~ r~cion.
The cells are then spun by a centrifuge into a cell pellet. When this cell pellet is spread onto a slide, a smooth layer, one cell deep, results. Additionally, the cells retrieved for analysis are from both the endocervical canal and the cervical face. As stated earlier, with the prior art devices, many times only one type of cell or the other c~n~be retrieved from the body and tested.
Another important advantage of the device of the p ~-çnt invention is the capability and means for scraping and collecting cells from the vagina 22 located on the same device that simul~Ar~Dusly collects both the endocervical 093/11708 21 2 S6S ~ PCT/US92/10234 and ectocervical cells. The present invention can also accomplish this as illustrated by the embodiment shown in Figures 6 and 7.
In this embodiment, the rear end 16 comprises a spatula-c~pe~ member 46 positioned along the same axis as the axis of the h~nAl e 12. The edges ~8 of the spatula-~re~ member 46 are perpendicular to the faces 50 of the spatula ~~pe~ member 46. This perrenAicular ~pe forms a scraping surface which enables successful yet non-abrasive scraping of the ~aginal wall 45 and collection of the vaginal cellc~ The scraping action of perrenAicular e~c_ 48 can be clearly seen in the cross-section of Figure 7.
Another embodiment of the device lO of the present invention which allows collection of vaginal cells is illustrated in Figure 8. In this embodiment, a triangular shaped spatula 54 is positioned off the axis of the ~-nAle 12. Ag~in~ as with the spatula -~ped member 46, the edges of triangula~ ped spatula S4 are perrenAicular.
By having the triangula~ ped spatula 54 off-axis, maneuverability of the device lO is incr~e~ and collection of vaginal cells is facilitated.
Yet another feature of an alternate embodiment of device lO can be seen in Figure 9. In Figure 9, a cross-section of the laterally extending member 60 is illustrated. In this emhoAiment~ the laterally extending member 60 is tapered to form a narrow forward edge 62 from which the second set of bristles 32 extends.
This particular embodiment facilitates transfer of rell~ from the laterally exten~ng member 60 to the examin-~;0n ~urface by allowing ea~ier acces6 to the recon~
set of bristles 32 at the area where the bristles extend from the laterally ex~Dn~ing member. Thus, when the device is wiped along an examination surface such as a slide in a WO g3/11708 ~ 6~ PCT/US92/1023~

parallel motion, more cells can be available for transfer from the device to the slide for analysis.
In the presently preferred embodiment of the device, the preferred materials from which the device is made are high density polyethylene materials. It will be appreciated that a variety of other materials may also be used. The advantages, however, of usinq high density polyethylene for manufacture of the present invention are many. ~irst, the h~ e may be made to be rigid, but when the diameter of the h~n~le is reduced, it ¢an be made to be relatively flexible, ~o as to bend in the way illustrated in Figure 4.
The properties of the bristles can also be controlled.
With polyethylene, the bristles can be made of a length and width which would be stiff enough to cause sufficient abrasion for collection of cells, yet supple eno~gh to not cause trauma to the cervix. High density polyethylene is also a material which can be molded into the tiny bristles that are used within the ~col~ of the present invention.
Additionally, high density polyethylene is relatively ineY~e~cive. Wire, as used in many art devices, can be about twice as ~ypçncive as polyethylene and so cA~t be used in such a widespread manner in low cost environments.
From the foregoing, it will be appreciated that a substantial adv~ntage of the device of the present invention is that cells from the endocervical canal of the uterus, cells from the cervical face, and cells from the vagina can be collected by the same device. More importantly, cells from the endocervical canal and from the cervical face can be collected simultaneously, without e~cessi~rasion to the uterus, and with successful sampling resùlts.
Additionally, because of the perpendicular configuration of the laterally extending member allowing placement of the member against the cervical face, trauma 093/11708 21 2 ~ 6 5 ~ PCT/US92/102~

to the endocervical canal by ~yc~ccive or misaligned entry by the device into the canal is prevented. Further, the device is axially stabilized. Further yet, the cost of manufacture and use of the device is very low, making the device desirable for widespread use.
The invention may be embodied in other specific forms without departing from its spirit or e~r~ntial characteristics. THe described embodiments are to be considered in all respects only as illustrative and not restrictive. The scope of the invention is, therefore, indicated by the app~n~e~ claims rather than by the foregoing description. All ~ g~s which come within the meAning and range of equivalency of the claims are to be embraced within their ~cor~.
Nhat is claimed is:

Claims (36)

1. A device for collection of tissue cells from a cervical face and endocervical canal of a uterus comprising:
(a) an elongated handle having a forward end and a rear end;
(b) tissue sampling means, located at the forward end of said handle, for simultaneously collecting tissue cells from the cervical face and endocervical canal, said sampling means comprising:
(i) first means providing a plurality of bristles oriented in a row and in a plane for contacting and collecting cells within the endocervical canal as said handle is rotated, said first means aligned with said handle and extending from said forward end thereof; and (ii) second means providing a plurality of bristles oriented in a row and in the same said plane for contacting and collecting cells from the cervical face as said handle is rotated, said second means extending from said forward end of said handle in a direction generally orthogonal to said first means; and (c) flexible means positioned at said forward end of said handle for bending said tissue sampling means at an acute angle with respect to the handle for assistance in dislodging the collected tissue cells from said first and second means onto an area for examination.
2. A device as defined in claim 1, wherein said first means comprises:
(a) a member longitudinally extending from said flexible means at said forward end of said handle; and (b) a first set of bristles extending substantially perpendicularly from said longitudinally extending member from opposing sides thereof.
3. A device as defined in claim 2, wherein the bristles of said first set of bristles have a length such that the overall length of said first set of bristles extending from the opposing sides of said longitudinally extending member is sufficient to contact the endocervical canal, even when the endocervical canal is dilated, and have a width such that said first set of bristles are stiff enough. to provide abrasive action yet supple enough to be easily compressed when entering an undilated endocervical canal.
4. A device as defined in claim 2, wherein said second means comprises:
(a) a member laterally extending from said flexible means generally on opposite sides of said flexible means, at a point where said first means extends from said flexible means, said laterally extending member positioned along an axis substantially perpendicular to the axis of said handle, and said laterally extending member having a forward edge which faces said forward end of said handle; and (b) a second set of bristles extending substantially perpendicularly from said laterally extending member along the forward edge thereof for contacting and collecting cells of the cervical face.
5. A device as defined in claim 4, wherein the bristles of said second set of bristles are formed from a material and have a length and width such that said bristles are soft enough to contact the cervical face without causing damage to the cervical face as the second set of bristles are pressed against the cervical face, yet stiff enough to cause enough abrasive action necessary to collect cells.
6. A device as defined in claim 1, wherein said rear end comprises a means for scraping and collecting cells from the vagina.
7. A device as defined in claim 6, wherein said means for scraping and collecting cells comprises a spatula-shaped member positioned along the same axis as the axis of said handle, said spatula-shaped member having perpendicular edges to enhance collection of cells from the vagina.
8. A device as defined in claim 6, wherein said means for scraping and collecting cells is positioned at an angle relative to the longitudinal axis of said handle.
9. A device as defined in claim 4, wherein said laterally extending member is curved so as generally to conform to the cervical face.
10. A device as defined in claim 1, wherein said handle is comprised of longitudinally extending ridges.
11. A device as defined in claim 4, wherein said forward edge of said laterally extending member is tapered to form a narrow forward edge from which said second set of bristles extends.
12. A device for collection of tissue cells from a cervical face and endocervical canal of a uterus comprising:

(a) an elongated handle having a forward end and rear end; and (b) tissue sampling means, located at the forward end of said handle, for simultaneously collecting tissue cells from the cervical face and endocervical canal, said sampling means comprising:
(i) first means providing a plurality of bristles oriented in a row and in a plane for contacting and collecting cells within the endocervical canal as said handle is rotated, said first means aligned with said handle and extending from said forward end thereof; and (ii) second means providing a plurality of bristles oriented in a row and in the same said plane for contacting and collecting cells from the cervical face as said handle is rotated, said second means extending from said forward end of said handle in a direction generally orthogonal to said first means, and said second means comprising means for conforming to said cervical face and maintaining said first means generally in alignment in said endocervical canal when said first means is inserted therein and when said handle is rotated.
13. A device as defined in claim 12, wherein said first means comprises:
(a) a member longitudinally extending from said forward end of said handle; and (b) a first set of bristles extending substantially perpendicularly from said longitudinally extending member on opposing sides thereof.
14. A device as defined in claim 13, wherein the bristles of said first set of bristles have a length such that the overall length of said first set of bristles extending from the opposing sides of said longitudinally extending member is sufficient to contact the endocervical canal, even when the endocervical canal is dilated, and have a width such that said first set of bristles are stiff enough to provide abrasive action yet supple enough to be easily compressed when entering an undilated endocervical canal.
15. A device as defined in claim 12, wherein said second means comprises:
(a) a member laterally extending from said forward end of said handle at a point where said first means extends from said forward end of said handle, and along an axis substantially perpendicular to the axis of said handle, said laterally extending member having a forward edge which faces said forward end of said handle; and (b) a second set of bristles extending substantially perpendicularly from said laterally extending member along the forward edge thereof.
16. A device as defined in claim 15, wherein the bristles of said second set of bristles are formed from a material and have a length and width such that said bristles will be soft enough to contact the cervical face without causing damage to the cervical face as the second set of bristles are pressed against the cervical face, yet stiff enough to cause enough abrasive action necessary to collect cells.
17. A device as defined in claim 12, wherein said rear end comprises a means for scraping and collecting cells from the vagina.
18. A device as defined in claim 17, wherein said means for scraping and collecting cells comprises an spatula-shaped member positioned along the same axis as the axis of said handle, said spatula-shaped member having perpendicular edges to enhance collection of cells from the vagina.
19. A device as defined in claim 18, wherein said means for scraping and collecting cells is positioned at an angle relative to the longitudinal axis of said handle.
20. A device as defined in claim 15, wherein said laterally extending member is curved so as generally to conform to the cervical face.
21. A device as defined in claim 12, wherein said handle is comprised of longitudinally extending-ridges.
22. A device as defined in claim 15, wherein said forward edge of said laterally extending member is tapered to form a narrow forward edge from which said second set of bristles extends.
23. A device as defined in claim 12, wherein said forward end of said handle narrows into a flexible zone.
24. A device for collection of tissue cells from a cervical face and endocervical canal of a uterus comprising:
(a) an elongated handle having a forward end and a rear end: and (b) tissue sampling means, located at the forward end of said handle, for simultaneously collecting tissue cells from the cervical face and endocervical canal, said sampling means comprising:
(i) first means providing a plurality of bristles oriented in a row and in a plane for contacting and collecting cells within the endocervical canal as said handle is rotated, said first means aligned with said handle and extending from said forward end thereof; and (ii) second means providing a plurality of bristles oriented in a row and in the same said plane for contacting and collecting cells from the cervical face as said handle is rotated, and said second means extending from said forward end of said handle in a direction generally orthogonal to said first means.
25. A device as defined in claim 24, wherein said first means comprises:
(a) a member longitudinally extending from said forward end of said handle; and (b) a first set of bristles extending substantially perpendicularly from said longitudinally extending member on opposing sides thereof.
26. A device as defined in claim 25, wherein the bristles of said first set of bristles have a length such that the overall length of said first set of bristles extending from the opposing sides of said longitudinally extending member is sufficient to contact the endocervical canal, even when the endocervical canal is dilated, and have a width such that said first set of bristles are stiff enough to provide abrasive action yet supple enough to be easily compressed when entering an undilated endocervical canal.
27. A device as defined in claim 24, wherein said second means comprises:
(a) a member laterally extending from said forward end of said handle at a point where said first means extends from said forward end of said handle, and along an axis substantially perpendicular to the axis of said handle, said laterally extending member having a forward edge which faces said forward end of said handle; and (b) a second set of bristles extending substantially perpendicularly from said laterally extending member along the forward edge thereof.
28. A device as defined in claim 27, wherein the bristles of said second set of bristles are formed from a material and have a length and width such that said bristles will be soft enough to contact the cervical face without causing damage to the cervical face as the second set of bristles are pressed against the cervical face, yet stiff enough to cause enough abrasive action necessary to collect cells.
29. A device as defined in claim 24, wherein said rear end comprises a means for scraping and collecting cells from the vagina.
30. A device as defined in claim 29, wherein said means for scraping and collecting cells comprises a spatula-shaped member positioned along the same axis as the axis of said handle, said spatula-shaped member having perpendicular edges to enhance collection of cells from the vagina.
31. A device as defined in claim 29, wherein said means for scraping and collecting cells is positioned at an angle from the axis of said handle.
32. A device as defined in claim 27, wherein said laterally extending member is curved so as generally to conform to the cervical face.
33. A device as defined in claim 27, wherein the diameter of said laterally extending member is greater than the diameter of said longitudinally extending member.
34. A device as defined in claim 27, wherein said forward edge of said laterally extending member is tapered to form a narrow forward edge from which said second set of bristles extends.
35. A device as defined in claim 24, wherein said forward end of said elongated handle narrows into a flexible zone.
36. A device for collection of tissue cells from a cervical face and endocervical canal of a uterus comprising:
(a) an elongated handle having a forward end and a rear end, said forward end narrowing into a flexible zone of said handle;
(b) a member longitudinally extending from said flexible zone along the same axis as said handle, said longitudinally extending member having a length for insertion into the endocervical canal:
(c) a first set of bristles for contacting and collecting cells within the endocervical canal, said first set of bristles projecting substantially perpendicularly from said longitudinally extending member and being oriented in a plane;
(d) a member laterally extending from said flexible zone generally on opposite sides of said handle, at the point where said longitudinally extending member extends from said flexible zone, said laterally extending member positioned along an axis generally orthogonal to the axis of said handle and having a forward edge which faces said forward end of said handle, said laterally extending member being curved so as to generally conform to the cervical face, and said laterally extending member comprising means for maintaining said longitudinally extending member generally in alignment in said endocervical canal when said longitudinally extending member is inserted therein and when said handle is rotated;
(e) a second set of bristles for contacting and collecting cells on the cervical face of the uterus, said second set of bristles projecting from said forward edge of said laterally extending member along the same plane as said first set of bristles, and said second set of bristles being formed of a material and having a length and width such that said second set of bristles are soft enough to contact the cervical face without causing damage to the cervical face as the second set of bristles are pressed against the cervical face, yet stiff enough to cause enough abrasive action necessary to collect cells.
CA002125650A 1991-12-12 1992-11-20 Pap smear collection device Expired - Fee Related CA2125650C (en)

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US5191899A (en) 1993-03-09
AU3149093A (en) 1993-07-19
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JPH07501733A (en) 1995-02-23
EP0616509A4 (en) 1995-04-19

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