A comparative analysis of conventional smear and sure path liquid-based cytology with cell block preparation
DOI:
https://doi.org/10.18203/2320-6012.ijrms20213422Keywords:
Conventional pap smear, Liquid based cytology, SurePath, Cervical cancerAbstract
Background: Cervical cancer is ranked as the most frequent cancer in women in India. Conventional papanicolaou smear has been the mainstay of cervical cancer screening since the 1960s. As an alternative liquid-based cytology (LBC) was introduced in the mid-1990s, which are found to increase cytologic detection of squamous intraepithelial lesions and a reduction in the number of unsatisfactory pap tests.
Present study aims at comparison of liquid-based cytology with conventional cytology in detecting uterine cervical intraepithelial lesions.
Methods: The present study was conducted in the department of pathology in collaboration with the department of obstetrics and gynecology, Pt. B.D. Sharma PGIMS Rohtak including 100 non-pregnant female patients coming in the outpatient department of obstetrics and gynecology. Both liquid based and conventional pap smears were examined under the microscope and reported according to the 2001 Bethesda system. Cell blocks were prepared sin all the cases from the residual material of LBC.
Results: Median age was 42 years. More inadequate smears were reported on CS (17%) as compared to LBC (11%). In both, maximum number of cases reported were inflammatory. Equal number of cases were reported as SCC (n=4) in both.
Conclusions: Liquid based cytology has been developed to address the sampling problems of conventional Pap smear. But because of the increased cost of LBC in terms of capital investment, operation and disposables, developing countries should carefully consider the potential benefits and drawbacks of LBC before adopting this new technology.
References
Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clins. 2005;55:74-108.
ICO/IARC Information Centre on HPV and Cancer India Human Papillomavirus and Related Cancers, Fact Sheet. 2018;2019.
Smith PA, Gray W. Cervical intraepithelial neoplasia and squamous cell carcinoma of the cervix. In: Gray W, Kocjan G, editors. Diagnostic Cytopathology. 3rd ed. China: Churchill Livingstone. 2010;609-44.
Monie A, Hung CF, Wu TC. Preventive and therapeutic HPV vaccines. Curr Opin Invest Drugs. 2007;8:1038-50.
Sattar HA. Female genital system and Breast. In: Kumar V, Abbas AK, Aster JC, editors. Robbins Basic Pathology. 9th ed. Philadelphia: Elsevier Saunders. 2013;681-714.
Kaarthigeyan K. Cervix cancer in India and HPV vaccination. Indian J Med Paediatr Oncol. 2012;33:7-12.
Misra JS, Srivastava S, Singh U, Srivastava AN. Risk factors and strategies for control of carcinoma cervix in India: Hospital based cytological screening experience of 35 years. Indian J Cancer. 2009;46:155-9.
Murthy NS, Chaudhary K, Saxena S. Trends in cervical cancer incidence-Indian Scenario. Eur J Cancer Prev. 2005;14:513-8.
Taylor S, Kuhn L, Dupree W, Denny L, DeSouza M, Wright TC. Direct comparison of liquid based and conventional cytology in a South African screening trial. Int J Cancer. 2006;118:957-62.
Fahey MT, Irwig L, Macaskill P. Meta-analysis of Pap test accuracy. Am J Epidemiol. 1995;141:680-9.
Arybn M, Bergeron C, Klinkhamer P, Martin-Hirsch P, Siebers A, Bulten J. Liquid compared with conventional cervical cytology- A systemic review and meta-analysis. Obstet Gynecol. 2008;111:167-77.
Zhao FH, Hu SY, Bian J, Liu B, Peck RB, Bao YP et al. Comparison of ThinPrep and SurePath liquid based cytology and subsequent human papilloma virus DNA Testing in China. Cancer Cytopathol. 2011;119:387-94.
Williams AR. Liquid-based cytology and conventional smears compared over two 12-month periods. Cytopathology. 2006;17:82-5.
Broadstock M. Effectiveness and cost effectiveness of automated and semi-automated cervical screening devices: a systematic review of the literature. N Z Med J. 2001;114:311.
Moseley RP, Paget S. Liquid-based cytology: is this the way forward for cervical screening? Cytopathology. 2002;13:71-82.
Khan S, Omar T, Michelow P. Effectiveness of the cell block technique in diagnostic cytopathology. J Cytol. 2012;29:177-82.
Kalof AN, Cooper K. p16INK4aimmunoexpression: Surrogate marker of high-risk HPV and high-grade cervical intraepithelial neoplasia. Adv Anat Pathol. 2006;13:190-4.
Bancroft JD, Layton C. The hematoxylins and eosin. In: Suvarna SK, Layton C, Bancroft JD, editors. Theory and Practice of Histological Techniques. 7th ed. New York: Churchill Livingstone. 2013;179-80.
Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ. Cancer statistics, 2007. CA Cancer J Clin. 2007;57:43-66.
Papanicolaou GN. Introduction of Pap smear in early detection of cervical malignancies. Am J Clin Path. 1940;19:301-8.
Davey DE, Barratt A, Irwig PL, Chan SF, Macaskill P, Mannes P et al. Effect of study design and quality on unsatisfactory rates, cytology classifications and accuracy in liquid based versus conventional cervical cytology: a systemic review. Lancet. 2006;367:122-32.
Zhu J, Norman I, Elfgren K, Gaberi V, Hagman B, Hjerpe A et al. A comparison of liquid-based cytology and Pap smear as a screening method for cervical cancer. Oncol Rep. 2007;18:157-60.
Afsan N, Akhtar K, Khan K, Rahman K, Sherwani RK, Zeba A. Conventional Pap smear and liquid based cytology for cervical cancer screening-a comparative study. J Cytol. 2007;24:167-72.
Sharma J, Toi PC, Siddaraju N, Sundareshan M, Habeebullah S. A comparative analysis of conventional and SurePath liquid based cytology: A study of 140 cases. J Cytol. 2016;33:80-4.
Fremont-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. Cancer Cytopathol. 2004;102:269-79.
Beerman H, Van Dorst EB, Kuenen-Boumeester V, Hogendoorn PC. Superior performance of liquid-based versus conventional cytology in a population-based cervical cancer screening program. Gynecol Oncol. 2009;112(3):572-6.
Wintraub J, Morabia A. Efficacy of a liquid based thin layer method of cervical cancer screening in a population with a low incidence of cervical cancer. Diagn Cytopathol. 2000;22:52-9.
Monsonego J, Autillo-Touati A, Bergeron C, Dachez R, Liaras J, Saurel J et al. Liquid-based cytology for primary cervical cancer screening: a multi-centre study. Br J Cancer. 2001;84(3):360-6.
Ronco G, Cuzick J, Pierotti P, Cariaggi MP, Palma PD, Naldoni C et al. Accuracy of liquid based versus conventional cytology: overall results of new technologies for cervical cancer screening: randomised controlled trial. BMJ. 2007;335:28.
Hiroshi N, Takashi I, Hidetaka N. Liquid-based cytology versus conventional cytology for detection of uterine cervical lesions: a prospective observational study. Japanese J Clin Oncol. 2018;48(6):522-8.
Atif AH, Samreen N, Omer A. Comparison of Liquid-Based Cytology and Conventional Papanicolaou Smear for Cervical Cancer Screening: An Experience from Pakistan. Cureus. 2020;12(12):e12293.
Kiyoshi I, Ryusei K, Hiroshi K. A comparison of liquid-based and conventional cytology using data for cervical cancer screening from the Japan Cancer Society. Japanese J Clin Oncol. 2020;50(2):138-44.
Austin RM. College of American Pathologists Conference XXX on quality and liability issues with the Papanicolaou smear: introduction. Arch Pathol Lab Med. 1997;121:227-8.
Liu H, Shi J, Wilkerson M, Huang Y, Meschter S, Dupree W et al. Immunohistochemical detection of p16INK4a in liquid-based cytology specimens on cell block sections. Cancer Cytopathol. 2007;111:74-82.
Keyhani-Rofagha S, Vesey-Shecket M. Diagnostic value, feasibility, and validity of preparing cell blocks from fluid-based gynecologic cytology specimens. Cancer Cytopathol. 2002;96:204-9.
Akpolat I, Smith DA, Ramzy I, Chirala M, Mody DR. The utility of p16INK4a and Ki-67 staining on cell blocks prepared from residual thin-layer cervicovaginal material. Cancer. 2004;102:142-9.
Shidham V, D'Amore K, Varsegi G. Objective and definitive subcategorization of LSIL with p16INK immunocytochemistry on cell block sections of cervical cytology specimens. Cancer Cytopathol. 2009;117:349-450.
Sakamoto H, Takenaka M, Ushimaru K, Tanaka T. Use of LBC and cell blocks from cell remnants for cytologic, immunohistochemical and immunocytochemical diagnosis of malignancy. Open J Pathol. 2012;2:58-65.
