Comparative study of conventional Pap smear and liquid based cytology as a screening method for cervical cancer
DOI:
https://doi.org/10.18203/2320-6012.ijrms20213096Keywords:
Conventional Pap smears, Comparative study, Epithelial cell abnormality, Liquid based cytologyAbstract
Background: Pap smear is the conventional screening procedure for cervical cancer. Liquid based cytology has been developed as a cost effective alternative as it has a short screening time, better morphology and clean background while also providing residual material to test for HPV DNA. Therefore this study is undertaken to know the role of Liquid-based cytology in evaluating pre-malignant and malignant lesions of cervix. Objectives of current study were to study the distribution of various cervical lesions on liquid-based cytology and compare them with conventional Pap smears. To know the role of liquid-based cytology in evaluating pre-malignant and malignant lesions of cervix
Methods: This study included 200 women attending to gynaecology OPD and the samples were taken for both conventional cytology and liquid based cytology. The smears were studied in detail and were interpreted as per The Bethesda system 2014 of reporting pap smears and results are recorded and compared.
Results: The commonest cervical lesions on pap smears by liquid-based cytology are NILM-reactive changes (N=92, 46%), NILM Candida infection is seen in 9 cases (4.5%) and trichomonas vaginalis infection in 5 cases (2.5%). Unsatisfactory smears on LBC is less when compared to conventional smears as the coefficient of correlation is significant with p value of 0.000422 (<0.05). The number of cases with a diagnosis of ASCUS is reported more in liquid-based cytology (9 cases) when compared to conventional Pap (8 cases). The number of cases with diagnosis of HSIL, SCC is reported more in liquid based cytology (7 cases) when compared to conventional Pap (4 cases). Epithelial cell abnormality were easily diagnosed on LBC smears with significant p value of 0.002414 (<0.05).
Conclusions: Liquid-based cytology has advantages of fewer unsatisfactory smears and better detection of epithelial cell abnormalities when compared to conventional Pap smears. LBC is better for the screening of premalignant and malignant lesions of cervix even though it is costly.
Metrics
References
Liptak P, Barnetson RJ. Liquid-based cervical cytology in the United Kingdom and South Africa. Cont Med Edu. 2012;30(2):45-8.
Gibb RK, Martens MG. The impact of liquid-based cytology in decreasing the incidence of cervical cancer. Rev Obstet Gynecol. 2011;4(1):S2-11.
Wilbur DC, Marluce B. Automation in cervical cytology. Comp Cytopathol. 2008;52:102-42.
Sigurdsson K. Is a liquid-based cytology more sensitive than a conventional Pap smear? Cytopathol. 2013;24(4):254-63.
Pankaj S, Nazneen S, Kumari S, Kumari A, Kumari A, Kumari J, et al. Comparison of conventional Pap smear and liquid-based cytology: A study of cervical cancer screening at a tertiary care center in Bihar. Indian J Cancer. 2018;55(1):80-3.
Singh VB, Gupta N, Nijhawan R, Srinivasan R, Suri V, Rajwanshi A, et al. Liquid-based cytology versus conventional cytology for evaluation of cervical pap smears: Experience from the first 1000 split samples. Indian J Pathol Microbiol. 2015;58(1):17-21.
Taylor S, Kuhn L, Dupree W, Denny L, De Souza M, Wright TC, et al. Direct comparison of liquid-based and conventional cytology in a South African screening trial. Int J Cancer. 2006;118(4):957-62.
Srivastava P, Arora R. Evaluation of cervical smears by conventional and liquid based cytology. Ann Pathol Lab Med. 2017;4(6):686-91.
Gupta N, Bhar VS, Rajwanshi A, Suri V. Unsatisfactory rate in liquid-based cervical samples as compared to conventional smears: A study from tertiary care hospital. Cytojournal. 2016;52:13.
Siebers AG, Klinkhamer PJ, Vedder JE, Arbyn M, Bulten J. Causes and relevance of unsatisfactory and satisfactory but limited smears of liquid-based compared with conventional cervical cytology. Arch Pathol Lab Med. 2012;136(1):76-83.
Sherwani RK, Khan T, Akhtar K, Zeba A, Siddiqui FA, Rahman K, et al. A comparative study of conventional pap smears and liquid based cytology. J Cytol. 2007;24(4):167-72.
Sharma J, Toi PCh, Siddaraju N, Sundareshan M, Habeebullah S. A comparative analysis of conventional and SurePath liquid-based cervicovaginal cytology: A study of 140 cases. J Cytol. 2016;33(2):80.
Obwegeser JH, Brack S. Does liquid-based technology really improve detection of cervical neoplasia? A prospective, randomized trial comparing the thin Prep Pap test with the conventional Pap test, including follow-up of HSIL cases. Acta Cytol. 2001;45(5):709-14.
Sykes PH, Harker DY, Miller A, Whitehead M, Neal H, Wells JE, et al. A randomized comparison of SurePath liquid-based cytology and conventional smear cytology in a colposcopy clinic setting. BJOG. 2008;115(11):1375-81.
Davey E, Barratt A, Irwig L, Chan SF, Macaskill P, Mannes P, Saville AM. Effect of study design and quality on unsatisfactory rates, cytology classifications, and accuracy in liquid-based versus conventional cervical cytology: a systematic review. Lancet. 2006;367(9505):122-32.
Sangeetha A, Subbulakshmi G, Arasi R. A comparative analysis of manual liquid based cytology versus conventional smear. Int J Sci Res. 2018;7(4):42-4.
Smith M, Marino J, Griffin B, Spencer L, Bolick D. Comparison of the Surepath™ liquid based Papanicolaou smear with the conventional Papanicolaou smear in a multisite direct‐to‐vial study. Int J Am Cancer Soc. 2004;102(5):269-79.
Zhu J, Norman I, Elfgren K, Gaberi V, Hagmar B, Hjerpe A, Andersson S. A comparison of liquid-based cytology and Pap smear as a screening method for cervical cancer. Oncol Rep. 2007;18(1):157-60.
Kavatkar AN, Nagwanshi CA, Dabak SM. Study of a manual method of liquid-based cervical cytology. Indian J Pathol Microbiol. 2008;51(2):190-4.