Clinical utility of Liqui-PREP[TM] cytology system for primary cervical cancer screening in a large urban hospital setting in China

Abstract

Background:Liquid based cytology (LBC) has been reported to increase the sensitivity of cervical cytology, in comparison with conventional cytology Pap smear (CPS). Most LBC systems though require expensive automated devices.Aims:To evaluate the efficiency of a new and inexpensive LBC system - LPT cytology system.Materials and Methods:Cervical screening was performed on 31500 patients utilizing the LPT cytology system test from January 2006 to May 2007. A similar number (n = 31500) of CPS were performed from January 2004 to July 2006. All cytology positive patients underwent colposcopy and cervical biopsy with histopathology examination. Fifty cases positive both on cytology and biopsy were submitted to the high-risk human papillomavirus (HPV) L1 protein (HR-HPV L1) tests.Results:The LPT cytology system adequately preserved cellular structure for morphologic evaluation. There was a significant difference of the histology/cytology diagnosis concordant rate between that of the CPS and LPT systems [93.6 vs. 78.4%, p=0.001]. The significant higher concordant rate was also seen in the low grade intraepithelial lesion (LSIL) (95.4 vs. 78.9%, p=0.001) and in high grade intraepithelial lesion (HSIL) (90.2 vs. 76.1%, p=0.001) cytology diagnosis. There was no statistical difference in rate in atypical glandular cells (AGC) (61.5 vs. 60%) and glandular cell carcinoma (GCC) (83.3 vs. 80%). LPT resulted in a marked increased global detection over the CPS. Nuclear expression of HPV L1 was seen in 34% (17/50) of cases.Conclusions:LPT showed an increase in detection rate compared to CPS (P = 0.001) and a significantly higher histological versus cytological concordant referral rate.

Manual Liquid Based Cytology in Primary Screening for Cervical Cancer - a Cost Effective Preposition for Scarce Resource Settings

“…Similarly both the methods were sensitive to the same extent for inflammation while MLBC is more specific thus agreeing with the findings of (Berstein et al, 2001;Alves et al, 2004) Regarding increase detection rate, our study found high increased detection rate which was consistent with earlier reports (Austin & Ramzy, 1998;Bishop et al, 1998). There was significant difference in concordance rate between CPS & MLBC Thus LBC showed a significantly higher histologically versus cytological concordance referral rate, as also observed by (Deshou et al, 2009).…”

“…Despite its success as a preventive screening tool for cervical cancer, CPS has its limitations (Deshou et al, 2009). False negatives in CPS may be related to inadequate sampling, inadequate transfer of the sample onto the glass slide or deficiencies in the microscopic assessment of the slide (Maksem et al, 2001).…”

“…As with most screening tests, the CPS suffers from imperfect sensitivity and specificity. Although a clinician may have excellent collection and sampling technique, only approximately 20% of the cells collected are smeared on the glass slide in CPS (Sherwani et al, 2007;Deshou et al, 2009;Johnson et al, 2000). Many studies have shown that with proper training, MLBC results in a higher diagnostic yield than traditional cervical smears (Baandrup et al, 2000;Atkins et al, 2003;Sherwani et al, 2007).…”

“…Moreover, although Conventional Pap Smears (CPS) screening leads to reduction in the rate of invasive cancer of the uterine cervix, its sensitivity reduces to less than 50% when there is presence of obscuring blood, inflammation or thick areas of overlapping epithelial cells (Sherwani et al, 2007;Kavatkar et al, 2008). These problems with the CPS, gave rise to the advanced technologies, like, Thin Prep and Sure Path commonly used in the setup of developed countries, like UK and USA (Kavatkar et al, 2008;Deshou et al, 2009). Use of these technologies however are quite resource intensive and therefore not feasible in the setup of developing countries.…”

Evaluation of cervicovaginal smear results at postmenopausal period

“…The frequency of epithelial abnormalities in another study conducted in the United States was reported to be 5.5%, of which 3.3% was AS-CUS, 1.2% was LSIL, 0.3% was HSIL and 0.2% was AGC-NOS [12] . In a study conducted in China, the overall prevalence was 3.12%, on which 2.3% was AS-CUS, 0.41% was LSIL, 0.28% was HSIL, 0.06% was AGC-NOS and SCC was 0.02% [18] . In our study, we detected abnormal smear results to be 5.69%, in which 2.46% was ASC-US, 0.55% was ASC-H, 1.23% was LSIL, 0.78% was HSIL and 0.22% was AGC-NOS.…”