THE ACCURACY OF LIQUID BASE PAP SMEAR VS CONVENTIONAL PAP SMEAR CYTOLOGY
DOI:
https://doi.org/10.47672/ejhs.414Keywords:
Cervical cancer, cervical precancer, liquid base cytology and conventional smearAbstract
The main aim of the present study was to assess the diagnostic accuracy of Liquid base versus Conventional smears (CS). The specific objective was to evaluate and compare efficacy liquid base cytology with conventional cytology (CS) as a screening tool and to assess the quality of immunohistochemical stain in conventional smears. A prospective study including 100 cervical samples over a period of six month. Split sample was obtained using cervex-brush. CS was prepared from the brush and the brush head was suspended in the LBC vial and processed by thin prep 5000 machine. The smears were stained with Pap stain and extra five conventional and thin prep slides prepared and stained with immunomarker. Results showed that there were 4.0% unsatisfactory (U/S) cases in CS and 1.0% in LBC; the main cause was ranging between obscuring blood and inflammation in CS and low squamous cellularity in LBC. About 5% split samples had epithelial abnormalities both in CS and LBC (3% atypical squamous cells of undetermined significance (ASCUS), devided between LBS 2% while CS1%.Low grade squamous intraepithelial lesion (LSIL) 2%, devided between LBC 1% and CS 1%. Infections as Trichomonas vaginalis (TV) and spores of candida species, 1% and 2% respectively detected only in LBC smear and missed in CS preparations of the same samples, considering 2-3 minutes for LBC screening and 5-6 minutes for CS screening following the international standards. Conventional smears did not appear to confer a cytomorphological advantage and has a lower diagnostic accuracy using IHC. The sensitivity of Thin Prep was significantly higher than that of CS due to cellular clumps and presence of marked inflammatory cells and blood which compete other epithelial cellular elements in staining affinity in addition to the length of the smear which need large volume of stains to cover the whole area. While the confined area of thin prep smear and homogenous cellular distribution support the advantages of thin prep over the conventional smear when using IHC stain. The study concluded that LBC technique leads to significant reduction of U/S rate. LBC samples offered better clarity, uniform spread of smears, less time for screening and better handling of hemorrhagic and inflammatory samples. In addition to feasibility to do further special stains and HPV tests. LBC had equivalent sensitivity and specificity to CS.
Downloads
References
- WHO, World Health organization, (2018).
- Pap Smear: Medline plus Lab Test Information". Medlineplus.gov. (2018).
- Cervical Screening". NHS. (2018)-
- Moyer, VA; U.S. Preventive Services Task, Force. (2012). "Screening for cervical cancer: U.S. Preventive Services Task Force recommendation statement". Annals of Internal Medicine. .
- Jump up to: Saslow, D; et al. (2012). "American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology Screening Guidelines for the Prevention and Early Detection of Cervical Cancer"(PDF). Journal of Lower Genital-Tract Disease..
- American Cancer Society. (2011). Detailed Guide: Cervical Cancer. Can cervical cancer be prevented?
- The American College of Obstetricians and Gynecologists (2010). "ACOG Education Pamphlet AP085 – The Pap Test". Washington, DC.
- Shidham, VinodB; Mehrotra, Ravi; Varsegi, George; D′Amore, KristaL; Hunt, Bryan; Narayan, Raj (2011). "p16 INK4a immunocytochemistry on cell blocks as an adjunct to cervical cytology: Potential reflex testing on specially prepared cell blocks from residual liquid-based cytology specimens". CytoJournal. (1)
- Liquid Based Cytology (LBC), NHS cervical screening programme. (2014).
- Adams AL, Gidley J, Roberson J, Wang W, Eltoum I, Chhieng DC. (2005). Clinical significance unsatisfactory conventional pap smears owing to inadequate squamous cellularity defined by the Bethesda 2001 criterion. Am J Clin Pathol;123:738-43.
-
Longatto Filho A, Pereira SM, Di Loreto C, Utagawa ML, Makabe S, Sakamoto Maeda MY, et al. (2005). DCS liquid-based system is more effective than conventional smears to diagnosis of cervical lesions: Study in high-risk population with biopsy--based confirmation. Gynecol-Oncol-;97:497-500.
-.
-Halford JA, Batty T, Boost T, Duhig J, Hall J, Lee C, et al. (2010). Comparison of the sensitivity of conventional cytology and the ThinPrep Imaging System for 1,083 biopsy confirmed-high-grade-squamous-lesions-Diagn-Cytopathol-;38:318-26.
-
-Kirschner B, Simonsen K, Junge J. (2006). Comparison of conventional Papanicolaou smear and SurePath liquid-based cytology in the Copenhagen population screening programme for cervical cancer. Cytopathology;17:187-94.
-Utagawa ML, Pereira SM, Makabe S, Maeda MY, Marques JA, Santoro CL, (2004). Pap test in a high-risk population comparison of conventional and liquid-base cytology. Diagn Cytopathol-;31:169-72.
-
-Strander B, Andersson-Ellström A, Milsom I, Rådberg T, Ryd W. (2007). Liquid-based cytology versus conventional Papanicolaou smear in an organized screening program: A prospective randomized study. Cancer;111:285-91.
-
-Schledermann D, Ejersbo D, Hoelund B. (2006). Improvement of diagnostic accuracy and screening conditions with liquid-based cytology. Diagn Cytopathol;34:780-5.
-
-Hutchinson ML, Zahniser DJ, Sherman ME, Herrero R, Alfaro M, Bratti MC, (1999). Utility of liquid-based cytology for cervical carcinoma screening: Results of a population-based study conducted in a region of Costa Rica with a high incidence of cervical carcinoma. Cancer;87:48-55.
-Arbyn M, Bergeron C, Klinkhamer P, Martin-Hirsch P, Siebers AG, Bulten J. (2008). Liquid compared with conventional cervical cytology: A systematic review and meta-analysis. Obstet-Gynecol-;111:167-77.
-Confortini M, Bergeron C, Desai M, Negri G, Dalla Palma P, Montanari G, ( 2010). Accuracy of liquid-based cytology: Comparison of the results obtained within a randomized controlled trial (the New Technologies for Cervical Cancer Screening Study) and an external group-of-experts-Cancer-Cytopathol;118:203-8.
-Siebers AG, Klinkhamer PJ, Grefte JM, Massuger LF, Vedder JE, Beijers-Broos A. (2009). Comparison of liquid-based cytology with conventional cytology for detection of cervical cancer precursors: A randomized controlled trial. JAMA;302:1757-64.
-
Burnley C, Dudding N, Parker M, Parsons P, Whitaker CJ, Young W. (2011). Glandular neoplasia and borderline endocervical reporting rates before and after conversion to the SurePath(TM) liquid-based cytology (LBC) system. Diagn Cytopathol;39:869-74.
- Taylor S, Kuhn L, Dupree W, Denny L, De Souza M, Wright TC Jr. (2006). Direct comparison of liquid-based and conventional cytology in a South African screening trial. Int J Cancer;118:957-62.
Taoka H, Yamamoto Y, Sakurai N, Fukuda M, Asakawa Y, Kurasaki A. (2010). Comparison of conventional and liquid-based cytology, and human papillomavirus testing using SurePath preparation in Japan. Hum Cell;23:126-33.
-.Sigurdsson K. (2013). Is a liquid-based cytology more sensitive than a conventional Pap smear? Cytopathology;24:254-63.
-.Harrison WN, Teale AM, Jones SP, Mohammed MA. (2007). The impact of the introduction of liquid based cytology on the variation in the proportion of inadequate samples between GP practices. BMC Public Health;7:191.
Tench W. (2000). Preliminary assessment of the AutoCyte PREP. Direct-to-vial performance. J Reprod Med;45:912-6.
- National Institute for Clinical Excellence. (2003): NHS Technology Appraisal Guidance 69. Guidance on the Use of Liquid-Based Cytology for Cervical Screening. London: National Institute for Clinical Excellence;.
-Takei H, Ruiz B, Hicks J. (2006). Cervicovaginal flora. Comparison of conventional pap smears and a liquid-based thin-layer preparation. Am J Clin Pathol 125:855-9.
-
Aminisani N, Armstrong BK, Canfell K. (2013). Uptake of liquid-based cytology as an adjunct to conventional cytology for cervical screening in NSW, Australia: A cross-sectional and population-based cohort analysis. BMC Public Health 2;13:1196.
Downloads
Published
How to Cite
Issue
Section
License
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work’s authorship and initial publication in this journal.
