Evaluation of cervical smears by Conventional and Liquid Based Cytology

Abstract

Background: Cervical cancer is the second most common cancer. Screening for cervical cancer is done by Pap [Papanicolaou] test by Conventional Pap Smear [CPS] or by newer technique Liquid Based Cytology [LBC]. The aim of the study was to learn and compare cervical lesions on both the techniques. Methods:This was a prospective study conducted over a 2 months period. Cervical smears were taken from 625 patients. On 25/625 patients both CPS and LBC were done. CPS and LBC were done on 300/625 patients each. The smears were processed and stained with Papanicolaou stain. Smears were studied for adequacy, cell types, inflammatory/ haemorrhagic background, organisms and reactive changes. The cervical lesions were categorised according to the Bethesda System of classification. The two techniques were compared based on certain defined parameters. Results:The techniques of CPS and LBC were learnt and cervical cells were appreciated on smears. Various epithelial abnormalities could be identified. Inflammation, bacterial vaginosis, candidiasis and reactive changes were noted. Out of 25 cases taken for comparison, 24 [96%] and 25 [100%] cases were satisfactory on CPS and LBC respectively.CPS showed more cases of severe inflammation and hemorrhagic background as compared to LBC. Conclusions:We conclude that both CPS and LBC are effective screening modalities for cervical lesions. Despite better performance of LBC in many aspects, it was felt that CPS is an equally effective tool in our settings due to the cost constraints.