Conventional pap (papanicoloau) smear cytology in primary screening of cervical lesions & its comparison with manual liquid based cytology

Conventional pap smear (CPS) examination has been the mainstay for early detection of cervical cancer. However, its widespread use has not been possible due to the inherent limitations, like presence of obscuring blood and inflammation, reducing its sensitivity considerably.

The study was performed to compare the efficacy of Manual Liquid based Cytology (MLBC) with CPS and to find out whether MLBC can be established for routine use in our laboratory setup.

Cervical smears were collected by the gynaecologist using Ayre's spatula and cytobrush for the conventional Pap smear method and are suspended in a liquid medium for manual liquid based cytology technique. In this study, cervical screening was performed in 481 cases, all were married women of reproductive age group who visited Department of Obstetrics and Gynaecology over a period of one year from July 2014 to June 2015. Slides were examined for cytomorphological parameters. The details regarding cell size, cytoplasmic and nuclear details were studied for making the diagnosis.

The sensitivity of CPS in detecting cervical lesions is 95% and by MLBC is 50% while the specificity was 86% with CPS technique and 69% by MLBC technique.

The cellular features are better in MLBC as compared to CPS and also background is more clear in MLBC as there was no obscuration by RBCs or inflammatory cells while in CPS, the background is dirty due to the presence of RBCs, necrosis and inflammation.