Evaluation of efficacy of an eco friendly enviropap and REAP stain in cervical cytology at resource limited area
Keywords:Cytological technique, Cancer screening, Enviro pap, Pap smear
Background: Cervical cancer is integral to any cancer control program in India because of the disease burden. Quick diagnosis plays a crucial role in limited resource areas. Hence, cost-effective and eco-friendly staining procedures with less time consumption help screening for cervical cancer cytodiagnosis. Thus, we wanted to assess the superiority of staining of smears by REAP (Rapid Economical Acetic acid Papanicolaou) technique and the newer EnviroPap (Environmental Papanicolaou) technique compared to conventional Pap technique on cervical smears.
Methods: From each patient, three smears were prepared, one with routine conventional method, one with REAP stain, and another with EnviroPap stain and quality parameters were noted. The chi-square test assessed differences in categorical variables between stains; a p value of <0.05 was considered significant. Statistical analysis used was the Chi-square test, and p value of <0.05 using a two-tailed test was taken as being significant for all statistical tests.
Results: REAP and Enviropap stained smears showed excellent nuclear and cytoplasmic details compared to conventional Pap staining protocol.
Conclusions: REAP and EnviroPap staining protocols for those two techniques were simpler, easier, and cost-effective, which took minimal turnaround time for assessing pap smears at a large scale.
Karunakaran U, Thekkandathil N, Divakaran B, Joseph MM, Kannankai S, Kumaran JA. Cervical cancer screening program- a camp based cross sectional study among rural women in North Kerala. Sci J Publ Health. 2017;5:215-23.
Izhar S, Kaur R, Masih K. Efficacy of rapid, economical, acetic acid, Papanicolaou stain in cervical smears as an alternative to conventional Papanicolaou stain. J Cytol. 2014;31(3):154-7.
Papanicolaou GN, Traut HF. The diagnostic value of vaginal smears in carcinoma of the uterus. Am J Obstet Gynecol. 1941;42:193-205.
Asthana A, Singh AK. Comparison of the routine Papanicolaou staining technique with the rapid, economic, acetic acid, Papanicolaou (REAP) technique. IJMDS. 2014;3:484-9.
Vani T, Yohesh. The merits of rapid, economic acetic acid, Papanicolaou stain (REAP) over Papanicolaou stain (PAP) technique in cervical cytology. Int J Res Med Sci .2017;5(8):3334-9.
Thakur M, Guttikonda VR. Modified ultrafast Papanicolaou staining technique: A comparative study. J Cytol. 2017;34(3):149-53.
Gill GW. Enviro-Pap: an environmentally friendly, economical and effective Pap stain. Laboratory Medi. 2006;37(2):105-8.
Moya-Salazar J, Rojas-Zumaran V. Eco-Pap: the ecological modification of the papanicolaou stain for sustainable cervical cancer diagnosis. Acta Cytolog. 2019;63(1):35-43.
Naylor B. The century for cytopathology. Acta Cytol. 2000;44(5):709-25.
Raju K. Evolution of Pap stain. Biomed Res Ther. 2016;3:490-500.
Rojas-Zumaran VA, Moya-Salazar JJ. From the Cytocolor towards ecological Pap test: origins. Patol Rev Latinoam. 2016;54(3):66-75.
Moya-Salazar J, Rojas-Zumaran V. Environmental Performance of xylene, hydrochloric acid and ammonia solution during Pap stain for diagnosing cervical cancer. J Health Pollution. 2016;6(11):58-65.
Gill GW. Using xylene forever: Molecular sieves and daily filtration. Acta Cytol. 2000;44(5):925.
Gupta S, Chachra KL, Bhadola P, Sodhani P. Modified Papanicolaou staining protocol with minimum alcohol use: a cost‐cutting measure for resource‐limited settings. Cytopathol. 2010;21(4):229-33.
Chantziantoniou N, Donnelly AD, Mukherjee M, Boon ME, Austin RM. Inception and development of the papanicolaou stain method. Acta Cytolog. 2017;61(4):266-80.
Biswas RR, Paral CC, Dey R, Biswas SC. Rapid Economic acetic acid papanicolaou stain (REAP) - Is it suitable alternative to standard PAP stain? Al Ameen J Med Sci. 2008;1(2):99-103.
Dighe SB, Dulhan A, Saleem P, Chinay R. Papanicalaou stain, is it economical to switch to rapid, economical, acetic acid, papanicolaou Stain? Acta Cytologica. 2006;50(6):643-6.
Gachie RN, Muchiri LW, Ndungu JR. A Comparison of modified and standard Papanicolaou staining methods in the assessment of cervical smears at Kenyatta National Hospital. East African Med J. 2011;88(7):244-50.
Gill GW. Bismar[c]k brown and Papanicolaou EA stains. The Scanner. 1975;14:2.
Gill GW. What is the Papanicolaou stain anyway? SCAN. 1999;10:18-19.