Comparative study between liquid-based cytology and conventional cytology for assessment of cervical pap smears

Abstract

Background :The mortality rate of cervical cancer is very high globally. There is vast research, which is currently going on to decrease the high occurrence of cervical cancer. The scientists have found that the reduction in cervical cancer can be brought about by an approach that comprises of prevention, prompt diagnosis, successful and thorough screening, and various treatment measures. Currently, there are vaccines that protect against common cancer-causing types of human papillomavirus and can significantly reduce the risk of cervical cancer. In non-industrialized or developing countries where effective screening programs and prompt diagnostic measures are not available, diagnosing cervical cancer at an early stage with access to effective treatment can significantly improve the likeliness of survival. Liquid-based cytology (LBC) was invented and started at around the mid-1990s as an alternative technique to process the uterine cervical scrape smear samples. After that most of the industrialized nations have changed over from conventional or standard Pap smear to LBC. LBC has been suggested to be advantageous and favorable than Pap smear because of a smaller number of unsatisfactory smears. Methods  :This study comprises of 287 cervical scrape smear samples from women visiting the Department of Midwifery and Gynecology over a timeframe of 1 year. Samples were taken and divided into two parts by split-sample technique. The cervical scrape substance was taken from the vaginal fornix, portio vaginalis and endocervix from all women. Glass slides for conventional or standard cytology and LBC were stained according to the Papanicolaou stain method. LBC was considered representative if the slide contained >5000 epithelial cells. Endocervical cells were considered present if the slide contained equal to 2 groups of glandular/metaplastic cells with 25 cells each or if the slide contained 210 dissociated glandular/metaplastic cells. Results :The study included 287 patients. Epithelial cell abnormality was observed in 10 cases in conventional smear while in LBC it was 11. In standard cervicalscrape smear pap report of Unsatisfactory, normal, atrophic, altered flora and candida was in 22,192, 23, 44 and 9 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 each 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 methods. US rate of CPS was 7.6% and 5.2% for LBC. Thus, LBC can be a superior test as compared to conventional or standard pap smear but has to reconsidered in the deficient resource setting.