Test ID: 9230
Maturation Smear
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Assessing hormonal status in a variety of conditions including:
-Assessment of ovarian function after hysterectomy, during menstrual disorders, or in premature menses (childhood)
-Before, during, and after a pregnancy (eg, fertility studies, threatened abortion, retained placenta, hydatidiform mole)
-Investigation of functioning (hormone-producing) tumors
-Evaluation of various endocrine disorders
-Guidance for hormonal therapy
Special Instructions and Forms Describes specimen collection and preparation information, test algorithms, and other information pertinent to test. Also includes pertinent information and consent forms to be used when requesting a particular test
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
MASM
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Specimen should be taken from the lateral vaginal wall (not cervix).
-An acceptable cytology request form must accompany specimen containers and include the following: Patient's name, medical record number, date of birth, sex, source (exact location and procedure used), date specimen was taken, name of ordering physician and pager number.
-Submit any pertinent history or clinical information
-For optimal results specimen should be collected at middle of menstrual cycle
-Maturation Index will not be determined if endocervical cells or inflammatory cells are present.
Submit only 1 of the following specimens:
Specimen Type: Smear
Container/Tube: Plastic slide container
Specimen Volume: Slide
Collection Instructions:
1. Label every slide with a minimum of 2 unique identifiers (eg, patient name and clinic number).
2. Immediately fix specimen in 95% ethanol or spray with a commercially available fixative.
Specimen Type: Broom collection device
Container/Tube: ThinPrep vial
Specimen Volume: Adequate specimen
Collection Instructions:
1. Label vial with a minimum of 2 unique identifiers (eg, patient name and clinic number).
2. Collect specimen from lateral vaginal wall.
3. Rinse broom in PreservCyt solution vial by pushing broom into bottom of vial 10 times forcing bristles apart.
4. As final step, swirl broom vigorously to further release material. Discard device.
5. Tighten cap on vial.
Specimen Type: Brush/spatula collection device
Container/Tube: ThinPrep vial
Specimen Volume: Adequate specimen
Collection Instructions:
1. Label vial with a minimum of 2 unique identifiers (eg, patient name and clinic number).
2. Collect specimen from lateral vaginal wall.
3. Rinse spatula in PreservCyt solution by swirling spatula vigorously into vial 10 times. Discard spatula.
4. Rinse brush in PreservCyt vial by rotating brush 10 times while pushing against side of vial.
5. Swirl brush vigorously as final step to further release material. Discard brush.
6. Tighten cap on vial.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | NA |
| Lipemia | NA |
| Icterus | NA |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Varies | Ambient | |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Maturation of the vaginal squamous epithelium is hormone dependent; estrogen stimulates proliferation and progesterone inhibits it. The maturation index, performed on squamous cells exfoliated from the intact top layer of the surface of the vagina epithelium, is expressed as a percentile relationship of parabasal cells to intermediate cells to superficial cells.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Descriptive report
Interpretation Provides information to assist in interpretation of the test results
In the preovulatory phase of the normal menstrual cycle (peak estrogen activity), superficial cells predominate and contain glycogen.
In the postovulatory phase (peak progesterone activity), intermediate cells predominate.
Before puberty and after menopause, parabasal and intermediate cells are seen.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
An accurate assessment cannot be made on any specimen other than a lateral vaginal wall.
Certain conditions can affect the hormonal status of the epithelium and should be avoided when making a hormonal assessment. These include:
-Inflammation and/or infection
-Vaginal erosion
-Current pregnancy
-Cytolysis
-Faulty fixation
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Naib ZM: Exfoliative cytology. Boston/Toronto, Little, Brown and Company, 1985, pp 56-58
2. Koss LG: Diagnostic Cytology and it’s Histopathologic Bases. Philadelphia, JB Lippincott Company, 1992, pp 300-301
Method Description Describes how the test is performed and provides a method-specific reference
Slide:
A sample is obtained from the lateral vaginal wall by the clinician using the usual methodology (spatula and/or brush) and smeared on a glass slide which is immediately fixed with a commercial spray fixative or dropped into 95% ethanol. The smear is then stained with the Papanicolaou stain, coverslipped, and given to the cytology staff for microscopic interpretation.(Unpublished Mayo method)
ThinPrep Vial:
The ThinPrep pap specimen is processed on a T2000 or T3000 processor, producing a slide that is stained with a Papanicolaou stain. The stained slides are examined microscopically.(Operator’s manual: ThinPrep 2000 System, Cytyc, Marlboro, MA: ThinPrep 3000 Processor, Cytyc, Marlboro, MA)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Friday; Varies 8 a.m.-5 p.m.
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
88155
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| 18703 | Accession Number | N/A |
| 18704 | Final Diagnosis: | 34574-4 |
| 18585 | Comment: | 48767-8 |
| 18705 | Revision Description: | In Process |
| 18706 | Signing Pathologist: | 19139-5 |
| 19188 | Specimen Description: | 33511-7 |
| 18707 | Special Procedures: | N/A |
| 18708 | SP Signing Pathologist: | N/A |
| 18709 | *Previous Report Follows* | N/A |
| 18710 | Addendum: | 35265-8 |
| 19191 | Addendum Comment: | 22638-1 |
| 18711 | Addendum Pathologist: | 19139-5 |
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