Comparative study between liquid-based cytology & conventional Pap smear for cytological follow up of treated patients of cancer cervix

Abstract

Background & objectives:Cancer cervix is one of the most common forms of genital malignancy among Indian women. Recurrence is seen in a significant number of cases. The conventional cervical smear technique has inherent problems and screening and interpretation errors. This study was undertaken to assess the efficacy of liquid-based cytology (LBC) as a method for cytological follow up and detection of recurrence in treated cases of cancer cervix and to compare it with conventional Pap smear technique to find the best screening method for detection of recurrence in these patients.Methods:This cross-sectional study was conducted over a period of one year. Patients attending Gynecology and Radiotherapy outpatient departments for follow up after treatment of cancer cervix were included. Pap smear and LBC were taken in all cases. Colposcopy and biopsy were done for those having epithelial cell abnormality in cytology report. Colposcopy and biopsy were taken as gold standard for diagnosis of cancer cervix recurrence.Results:Ninety four treated patients of carcinoma cervix were studied. The diagnostic accuracy for detection of recurrence of conventional Pap smear was 79.16 per cent, and that of LBC was 97.6 per cent. The difference between the two methods was significant (P<0.001).Interpretation & conclusions:Our findings showed that LBC performed better than the conventional method of cytology to detect recurrence of squamous cell carcinoma. Its sensitivity, specificity as well as accuracy were much higher than conventional method. LBC can be a better method of cytological follow up of post-treated patients of cancer cervix.

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

“…WDPV as a presenting complaint was also seen in studies done by Khamankar S et al, 13 Sharma J et al, 14 Sherwani RK et al 15 and Singh A et al 16 This study showed more satisfactory smears in LBC( 95% ) than in CPS (92%) similar to Hegde V et al 17 (PAP34% LBC67%), Sherwani R K et al 15 Cellular overlapping, architectural change and cellular morphological change in our study was more in CPS than LBC similar to Kavatkar et al, 23 Nandini N M et al 21 and Hegde et al 17 Strander et al 24 and Kirschner B et al 25 also showed more number of unsatisfactory smears in CPS than LBC. Cases diagnosed with NILM were more in LBC (55.4%) as compared to CPS (42.9%) in this study similar to Singh V B et al, 26 Singh U et al 27 and Dhananjaya C et al 18 However studies done by Stabile S et al 28 and Beerman H et al 29 reported more number of NILM cases in CPS as compared to LBC. LSIL cases were equal in PAP and LBC in the present study and study done by Sherwani et al 15 While studies done by Budak et al, 12 Beerman et al, 29 Stabile S et al, 28 Strander et al, 24 Longatto-Filho A et al 19 and Singh U et al 27 observed more cases of LSIL in LBC as compared to CPS.…”

Liquid Based Cytology versus Conventional Cytology for Evaluation of Cervical PAP Smear

“…The advantages of liquid-based cytology include improved sensitivity and specificity since fixation is better and nuclear details are well preserved. Singh et al (2018) proved that LBC performed much better by showing more sensitivity, specificity and accuracy than the conventional method of cytology to detect recurrence of squamous cell carcinoma [15]. Abnormal cells are not obscured or diluted by other epithelial or inflammatory cells.…”

Cervical screening: A complete and patient centred approach

“…The second technique is the preferred method in private practice. There is however a significant difference in results between the two methods, with the liquid-based cytology 7,8,9 being superior to the traditional method in terms of sensitivity.…”