Comparison between manual liquid based cytology and conventional Pap smear for evaluation of cervical lesions and it’s histopathological correlation in cases of epithelial abnormalities

Abstract

Introduction: Pap smear has been most widely used screening method for cervical cytology since last 50 years. Despite of it reducing morbidity and mortality from cervical cancer by detecting precancerous lesions, false negativity rate of Pap smear is very high. Manual liquid based cytology has been developed as an alternative to conventional Pap smear to overcome its drawbacks. Main advantages of MLBC over CPS are increased percentage of representative cells, better presentation on slide, increased detection of abnormal or dysplastic cell and overall reduced number of unsatisfactory smears. Aim: to compare the number satisfactory smears and sensitivity in detecting intraepithelial abnormalities with both the techniques. Materials and Methods: this was a prospective study done on 200 symptomatic women. The sample of each patient was collected into a preservative vial by a cytobrush for MLBC and with an Ayre spatula directly on a slide for CPS. The results were interpreted according to the Bethesda system. The cases of intraepithelial lesions on cytology were followed and confirmed by histopathology. Results: MLBC showed slightly higher number of satisfactory smears ie. 175 (87.5 %) as compared to CPS (171 ie. 85.5%). The sensitivity of MLBC was much higher ie. 81.8% as compared to CPS which was 36.3%. The p-value was calculated as 0.15 which was not significant. Conclusion: MLBS was better than CPS in specimen adequacy and lesser obscurance of morphology of representative cells. The number of intraepithelial lesions detected on MLBC was higher but its superiority over CPS is still debatable.