Comparative study of manual liquid-based cytology (MLBC) technique and direct smear technique (conventional) on fine-needle cytology/fine-needle aspiration cytology samples

Abstract

Background:Liquid-based cytology technique enables cells to be suspended in a liquid medium and spread in a monolayer, making better morphological assessment. Automated techniques have been widely used, but limited due to cost and availability.Aim:The aim was to establish manual liquid-based cytology (MLBC) technique on fine-needle aspiration cytology (FNAC) material and compare its results with conventional technique.Materials and Methods:In this study, we examined cells trapped in needles hub used for the collection of FNAC samples. 50 cases were examined by the MLBC technique and compared with the conventional FNAC technique. By centrifugation, sediment was obtained and imprint was taken on defined area. Papanicolaou (Pap) and May-Grünwald Giemsa (MGG) staining was done. Direct smears and MLBC smears were compared for cellularity, background, cellular preservation, and nuclear preservation. Slides were diagnosed independently by two cytologists with more than 5 years’ experience. Standard error of proportion was used for statistical analysis.Results:Cellularity was low in MLBC as compared with conventional smears, which is expected as remnant material in the needle hub was used. Nuclei overlap to a lesser extent and hemorrhage and necrosis was reduced, so cell morphology can be better studied in the MLBC technique. P value obtained was <0.05.Conclusion:This MLBC technique gives results comparable to the conventional technique with better morphology. In a set up where aspirators are learners, this technique will ensure adequacy due to remnant in needle hub getting processed

Manual Liquid Based Cytology in Breast Fine Needle Aspiration – Comparison with the Conventional Smear

“…Thus the diagnostic accuracy of MLBC was similar to CS which was comparable with authors like Pawar PS et al 24 and Leung CS et al 18 MLBC and CS showed a sensitivity and specificity of 95.2% and 100% respectively whereas positive predictive value and negative predictive value of both methods were 100% and 96.9% respectively, which were comparable with other studies (Table 5). 16,18,21,24,25,26 …”

“…6,16,17 Thus Micheal CW et al, 17 Biscotti CV et al 21 and Feoli F et al 20 observed that in order to avoid diagnostic errors it is advisable to undergo prior training in LBC to understand the morphological changes produced by LBC. Most of the MLBC smears showed cells arranged in monolayered sheets that enabled us to study the cell morphology even better which was also observed by Pawar PS et al 24 In the present study that there was an apparent decrease in number of myoepithelial cells in MLBC smears as compared to CS which was also observed by other authors. 17,18,19 …”

“…The aforementioned findings were also observed by various other authors. 17,23,24 But the presence of small clusters and loss of cohesion may lead to an erroneous diagnosis of malignancy as observed by Gerhard R et al…”

Comparison of Conventional Cytology, Liquid-Based Cytology, and Cell Block in the Evaluation of Peritoneal Fluid in Gynecology Malignancies

“…Moreover, Sakamoto et al [15] showed that LBC with immunocytochemistry and cell block with IHC improved the quality of the specimen and diagnostic accuracy. Pawar et al [11], who compared a manual LBC technique with conventional smear, reported the same results using the two methods. Table 7 summarizes the different cytologic findings of LBC in comparison to CS in previous studies.…”

“…We observed a significant difference regarding the background between the LBC and CS ( p = 0.045). In the study by Pawar et al [11], by using a manual LBC technique, the hemorrhagic and necrotic background was reduced in comparison with the CS method ( p < 0.05), but myxoid stroma, colloid, and mucin were retained. Tripathy et al [12] emphasized the support of CS in some cases.…”