Liquid-based cytology versus conventional cytology for evaluation of cervical Pap smears: Experience from the first 1000 split samples.
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Date
2015-01
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Abstract
Context and Aim: Screening programs using conventional cytology conventional
Pap smear (CPS) have successfully reduced cervical cancer, but newer tests like
liquid-based cytology (LBC) and human papillomavirus testing might enhance
screening. The main aim of the present study was to assess the diagnostic
accuracy of LBC versus CPS using “split samples.” Materials and Methods: This
was a prospective study comprising of 1000 consecutive cervical “split samples”
over a period of 1 year. Split sample was obtained using cervex-brush. CPS was
prepared from the brush and the brush head was suspended in the LBC vial and
processed by SurePath™ LBC. Results: There were 4.3% unsatisfactory (U/S)
cases in CPS and 1.7% in LBC; the main cause is insuffi cient cells, and excess of
blood in CPS. About 25/100 (2.5%) split samples had epithelial abnormalities both
in CPS and LBC (1.2%-atypical squamous cells of undetermined signifi cance;
0.4%-low grade squamous intraepithelial lesion; 0.2%-high grade squamous
intraepithelial lesion; 0.5%-squamous cell carcinoma; 0.1%-atypical glandular
cells favouring neoplasia; 0.2%-adenocarcinoma). Infl ammatory organisms
were almost equally identifi ed in both techniques but were better seen in LBC
samples. Conclusions: LBC technique leads to signifi cant reduction of U/S
rate. LBC samples offered better clarity, uniform spread of smears, less time
for screening and better handling of hemorrhagic and infl ammatory samples.
LBC had equivalent sensitivity and specifi city to CPS.
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Keywords
Cervical cancer, cervical precancer, human papillomavirus, liquid-based cytology
Citation
Singh Vikrant Bhar, Gupta Nalini, Nijhawan Raje, Srinivasan Radhika, Suri Vanita, Rajwanshi Arvind. Liquid-based cytology versus conventional cytology for evaluation of cervical Pap smears: Experience from the first 1000 split samples. Indian journal of pathology& Microbiology 2015 Jan-Mar 58: (1) 17-21.