COMPARISON OF LIQUID-BASED CYTOLOGY AND CONVENTIONAL CYTOLOGY FOR EVALUATION OF CERVICAL PAP SMEARS

Abstract

INTRODUCTION: This high mortality rate from cervical cancer globally can be reduced by an approach that includes prevention, early diagnosis, effective screening and treatment programmes. There are currently vaccines that protect against common cancer-causing types of human papilloma virus and can significantly reduce the risk of cervical cancer. in low socioeconomic or developing countries where screening programmes are not available, diagnosing cervical cancer at an early stage and providing access to effective treatment can significantly improve the likelihood of survival. Liquid-based cytology (LBC) was introduced at around mid-1990s as an alternative technique to process the cervical samples. After that most of the developed countries has switched from conventional Pap smear to LBC. LBC has been proposed to be beneficial than Pap smear because of less number of unsatisfactory smears

MATERIAL AND METHODS: This study comprises of 287 cervical samples from women visiting the Department of Obstetrics and Gynaecology over a period of 1 year.  Samples were taken and divided into two parts by split-sample technique.  Material was taken from the fornix, portio, and endocervix from all women. Slides for conventional cytology and LBC were stained according to the Pap method. LBC was considered representative if the slide contained >5000 epithelial cells. Endocervical cells were considered present if the slide contained ?2 groups of glandular/metaplastic cells with ?5 cells each or if the slide contained ?10 dissociated glandular/metaplastic cells

RESULTS: 287 patients were included in the study. Epithelial cell abnormality was observed in 10 cases in conventional smear while in LBC it was 11. In conventional smear pap report of Unsatisfactory, normal, atrophic, altered flora and candida was in 21,193, 21, 46 and 10 cases respectively. In LBC pap report Unsatisfactory, normal, atrophic, altered flora and candida was in 15,214, 22, 44 and 13 cases respectively.

Epithelial cell abnormality was seen in 10 (3.5%) cases by both the methods. Of these 10 cases low grade squamous intraepithelial lesion was observed in 2 cases, High grade squamous intraepithelial lesion in one case, Squamous cell carcinoma in one case and atypical squamous cells of undetermined significance in 6 cases.

CONCLUSION: There was a similar detection rate of epithelial abnormalities and infections in both the methods. US rate of CPS was 7.3% and 5.2% for LBC. Thus LBC can be a superior test as compared to conventional papsmear but has to reconsidered in the low-resource setting