Eco-Pap: The Ecological Modification of the Papanicolaou Stain for Sustainable Cervical Cancer Diagnosis

Abstract

Objectives: To validate the ecological modification of the Papanicolaou stain (Eco-Pap) for the diagnosis of cervical cancer. Study Design: A prospective study was performed at the Mother and Child “San Bartolomé” Hospital, Lima, Peru. Reagent handling strategies were divided into three phases: we used (1) Harris progressive hematoxylin (for nuclear staining), (2) a polychromatic solution (a mix of EA-36/Orange G-6 to suppress the use of several alcohol baths), and (3) direct mounting (with Entellan® solution). The cellular details were analyzed by the staining quality index, an external quality control, and the Bethesda System 2014. Results: We evaluated 72,901 cervical smears stained with the Eco-Pap. The validation of the Eco-Pap against the conventional Pap stain was optimal (κ = 0.89; 95% CI: 0.87–0.92), showing a sensibility and specificity of 88.3% (95% CI: 85.1–90.0) and 98.7% (95% CI: 98–99.2), respectively. The Eco-Pap dramatically reduced the environmental pollution caused by 72 L of xylene, hydrochloric acid, and ammonia (6 L each) and mercury oxide. Conclusion: The Eco-Pap is an innovative and efficient staining method reducing the use of toxic reagents with carcinogenic potential during cervical cancer screening by exfoliative cytology.

Cost and pollution by the use of xylene in cervical cytology in four Peruvian hospitals

“…In view of this, Eco-Pap (patent application pending) brings an alternative to ecological staining, which can reduce the number of reagents, staining time and cost without reducing test performance. 8,12 On the other hand, our estimated analysis model for three xylene baths shows that the cost of the Pap stain and the liters of xylene solvent are reduced. However, this assumption could not be further from reality, given that exfoliative cytology has a new stage.…”

“…5 These protocols, and several modifications 6,7 suggest the use of one or three xylene baths, causing high exposure to workers (as several hospitals do not have adequate protection barriers), bioaccumulation, and environmental pollution (due to the incorrect handling of these wastes). 8 Even though there are techniques for the biodegradation of xylene such as the use of iron and manganese from underground aquifers, the biofiltration of xylene by microorganisms adhered to a Nylon support, 9,10 and modifications of the Pap stain that avoid the use of xylene (and other pollutants), 8,11,12 laboratories in many countries continue using xylene as a cellular clarifier in two or three baths during the process. According to the standardized operating procedures of each cytology laboratory, these baths are replaced every thousand slides or once a week.…”

5R y Sustentabilidad hospitalaria: Nuestro aporte en la emergencia climática. Parte II. Repensar e investigar

“…Debido al impacto ambiental negativo causado por el uso diario masivo y la eliminación de reactivos para realizar el Papanicolau, el Hospital Materno Infantil San Bartolomé de Perú modificó los componentes de la tinción de Papanicolau por reactivos menos contaminantes mostrando una sensibilidad y especificidad similar a la técnica convencional [2].…”

Kalium Permanganat: Termodinamika Mengenai Transport Ionik dalam Air

“…Konduktivitas listrik (162)(163)(164)(165)(166) adalah ukuran kemampuan suatu larutan (167)(168)(169)(170)(171)(172)(173) untuk menghantarkan arus listrik .Arus listrik di dalam larutan dihantarkan oleh ion yang terkandung didalamnya.Ion memliki karakteristik tersendiri dalam menghantarkan arus listrik.Maka dari itu nilai konduktivitas listrik hanya menunjukan konsentrasi ion total dalam larutan.Banyaknnya ion di dalam larutan juga dipengaruhi oleh padatan terlarut didalamnya.Semakin besar jumlah padatan terlarut didalam larutan maka kemungkinan jumlah ion dalam larutan juga akan semakin besar, sehingga nilai konduktivitas listrik juga akan semakin besar.Dapat dilihat bahwa terdapat hubungan antara jumlah zat padat terlarut yang dinyatakan dengan TDS dengan nilai konduktivitas listrik.Eletrolit kuat (174)(175)(176)(177)(178)(179) adalah zat yang terionisasi sempurna dalam larutan dan meliputi padatan ion dan asam kuat.Sebagai hasil pengionan sempurna , konsentrasi ion dalam larutan sebanding dengan konsentrasi elektrolit yang ditambahkan .Berdasarkan data mengenai konduktivitas larutan KMnO 4 yang telah dilakukan yaitu :…”