A comparative study of conventional pap smear with liquid based cytology for early diagnosis of cervical cancer

Abstract

Introduction: Cervical cancer is the third most common female malignancies worldwide with high mortality. Since the introduction of conventional PAP smear (CPS) mortality from cervical cancer has reduced considerably. Evidence shows that alternative method liquid based cytology (LBC) is more sensitive and accurate for the detection of both squamous and glandular lesions of the cervix. Objective: The main objective of this study is to compare conventional PAP smear and liquid based cytology and observe for morphologic features, sensitivity, specificity and positive predictive values. Materials and Methods: This was a prospective study conducted on 240 cases and samples were processed for CPS and LBC. Cytobrush was used for LBC which was suspended and detached in the preservative fluid and processed by manual method. Histopathological correlation was done in 32 cases and HPV DNA testing was done in 76 cases. Results: LBC showed higher specimen adequacy, cellularity, clean background and uniform distribution of cells than CPS. Overall sensitivity of LBC (83.33%) and negative predictive value was more in LBC (92.85%) as compared to CPS. Conclusion: In this study LBC showed improved specimen adequacy, better cytomorphological features and higher detection of epithelial cell abnormality. Thus LBC has higher detection rate of precancerous lesion than CPS. Keywords: Cervical cancer, Liquid based cytology, Conventional PAP smear.