Comparison of conventional pap smear versus liquid based cytology in a diagnostic centre of central Madhya Pradesh

Abstract

Introduction: Cervical cancer is the second leading cause of cancer related deaths, next only to breast cancer worldwide, but is easily preventable if detected early. However conventional paps smear technique has many limitations. To overcome these limitations liquid based cytology was introduced in the mid 1990 as a better tool for processing cervical samples the present study was undertaken to compare conventional paps smear with liquid based methods and to assess the diagnostic accuracy of LBC in our setting. Materials and Methods: The present study was a prospective study conducted on the first 300 patients visiting our diagnostic centre for pap smear tests from May to October 2015. The samples were collected with Rovers Cervex brush and a conventional slide was prepared and the brush head was detached and suspended in the preservative fluid. Split samples of CPS and LBC were analysed and reported using the Bethesda system 2001 and results were compared Results: While only 5 patients were found to have unsatisfactory smear in LBC (1.67%), 20 patients had unsatisfactory smear in conventional smear (6.67%). Endocervical cells were not seen in conventional pap smears while LBC showed presence of endocervical cells in all patients. Candida bodies were not evident in LBC smears while the CPS showed presence of candida bodies in 5 cases. ASCUS was reported in 10 (3.31%) patients by CPS while it was found to be present in only 6(2%) patients by LBC technique. Conclusion: The introduction of liquid based cytology technique has brought about a revolution in the field of cervical screening programmes because of its advantages like reduced rate of unsatisfactory smears, increased number of satisfactory smears with adequate endocervical cells, optimal preservation and staining of cellular material, small area on the slide for screening hence lesser time for reporting and non interference by blood, mucus and other cell debris, air drying artefacts which hampers the proper detection of cellular abnormalities by the conventional method and may replace the conventional smear slowly but steadily. Key words: LBC, CPS, Pap smear, Cervical cancer