{
  "abstract": "Wet-fixed cytologic smears are inherently prone to cell detachment, which causes cross-contamination and reduces smear cellularity, potentially leading to false-positive diagnoses and diagnostic uncertainty. This study evaluated the effects of the intermediate alcohol step, fixation duration, and slide type on detachment to establish an evidence-based optimized protocol. We evaluated: (i) the necessity and optimal concentration of the intermediate alcohol step; (ii) fixation duration from 30 min to 24 h; and (iii) slide type (ordinary vs. positively charged). Detachment was scored semi-quantitatively using a streak-wiping method. Wilcoxon and Friedman tests were used for paired and block comparisons, respectively. The intermediate alcohol step significantly reduced detachment ( p < 0.05), with 50% ethanol superior to 75% ( p = 0.012). Prolonged fixation progressively decreased detachment ( p < 0.001), with no further statistically significant reduction beyond 3 h. Under optimized conditions, ordinary and positively charged slides performed comparably ( p = 0.811). An evidence-based strategy for laboratory quality improvement—extending fixation toward 3 h, including an intermediate alcohol step (preferably 50% ethanol) at each transition between water and 95% ethanol, and using ordinary slides—substantially reduces detachment. By preserving cellularity and helping to reduce the risk of cross-contamination, this protocol offers an implementable quality improvement tool for cytology laboratories, potentially enhancing diagnostic reliability and patient safety in wet-fixed cytologic preparations.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "name": "Yinying Zou"
    },
    {
      "name": "Xin Wang"
    },
    {
      "name": "Yan Chen"
    },
    {
      "name": "Zihan Wu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3tdj7w4qvvfkm.bib",
  "cited_by": 0,
  "doi": "10.1038/s41598-026-76374-3",
  "fulltext_url": null,
  "id": "3tdj7w4qvvfkm",
  "issns": [
    "2045-2322"
  ],
  "landing_url": "https://www.nature.com/articles/s41598-026-76374-3",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2737|Clinical Laboratory Practices and Quality Control"
    ]
  ],
  "openalex": "W7222836214",
  "pdf_url": "https://www.nature.com/articles/s41598-026-76374-3_reference.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-17",
  "publisher": "Springer Science and Business Media LLC",
  "ris": "https://research.draconitic.com/paper/3tdj7w4qvvfkm.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:30Z",
      "native_id": "10.1038/s41598-026-76374-3",
      "source": "crossref",
      "url": "https://www.nature.com/articles/s41598-026-76374-3"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2737|Clinical Laboratory Practices and Quality Control",
      "subfield": "physiology"
    }
  ],
  "title": "Optimizing fixation and staining to reduce cell detachment in wet-fixed direct smears, a quantitative evidence-based quality improvement study",
  "title_text": "Optimizing fixation and staining to reduce cell detachment in wet-fixed direct smears, a quantitative evidence-based quality improvement study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:30Z",
  "url": "https://research.draconitic.com/paper/3tdj7w4qvvfkm",
  "venue": "Scientific Reports",
  "versions": []
}