COMPARISON OF CONVENTIONAL PAP SMEAR AND LIQUID-BASED CYTOLOGY IN DETECTING CERVICAL ABNORMALITIES
Abstract
Cervical cancer represents one of the most common types of cancer in women, requiring early diagnosis to reduce prevalence and mortality rates. The Pap smear plays a crucial role in the early diagnosis of precancerous lesions. While the conventional Pap smear has been the standard method for lesion detection, liquid-based cytology (LBC) is emerging as an alternative with potential advantages.
Research comparing the conventional Pap smear to LBC has shown that LBC yields a higher percentage of satisfactory samples and demonstrates greater sensitivity and specificity in identifying various cervical abnormalities. Similar findings have been reported in Japanese research. However, some studies have shown conflicting results, emphasizing the specificity of the conventional method. While some studies suggest that the conventional Pap smear is better at detecting ASC-US, others show similar or favorable results for the LBC method.
The LBC method stands out for its higher diagnostic sensitivity, especially in detecting various types of cervical abnormalities, while the conventional Pap smear method maintains its specificity, particularly in diagnosing LSIL. The LBC method has the advantage of better sample representativeness and fewer unsatisfactory samples.
References
Pajtler M, Milojković M. Cytology and colposcopy as a screening test for preinvasive and early invasive lesions of cervix uteri. Medicinski vjesnik. 2006;38((1-4)):43-50. [Article in Croatian].
Derya A, Derya KS, Esra U, Cansa A. The relationship between gynecologic cancer and reproductive health awareness and obesity awareness in women: a cross-sectional study. Sanamed. 2023; 18(2): 91-103. doi: 10.5937/sanamed0-44692.
Butorac D, Nemeth Blažić T, Potkonjak AM, Bokulić A, Stojanović I. Kolposkopija u dijagnostici premalignih i malignih promjena vrata maternice. Liječ Vjesn. 2021;143(11-12):463–9. [Article in Croatian].doi: 10.26800/LV-143-11-12-7.
Berbić-Fazlagić J, Jurić N. Metode u citodijagnostici: univerzitetski udžbenik. 1. izd. Sarajevo: Fakultet zdravstvenih studija, 2015.
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209-49. doi: 10.3322/caac.21660.
Fowler JR, Maani EV, Dunton CJ, Gasalberti DP, Jack BW. Cervical Cancer. Treasure Island (FL): StatPearls Publishing; 2024.
Naib ZM. Pap Test. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The history, physical, and laboratory examinations. 3rd Ed. Boston: Butterworths; 1990:178.
Muntean M, Simionescu C, Taslîcă R, Gruia C, Comanescu A, Pătrană N et. al. Cytological and histopathological aspects concerning preinvasive squamous cervical lesions. Curr Health Sci J. 2010;36(1):26-32.
Damjanov I. The female genital tract and breasts. In: Damjanov I, editor. Pathology secrets (Third Edition). Mosby; 2009. p. 339-64.doi: 10.1016/B978-0-323-05594-9.00017-9.
Al Dallal H, Salih ZT. LSIL / CIN I. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/cervixLSIL.html.
Alkhateeb KJ, Salih ZT. HSIL / CIN II / CIN III. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/cervixHSILCINIII.html.
Nayar R, Wilbur DC. The Pap test and Bethesda 2014. "The reports of my demise have been greatly exaggerated." (after a quotation from Mark Twain). Acta Cytol. 2015;59(2):121-32. doi: 10.1159/000381842.
Brisson M, Drolet M. Global elimination of cervical cancer as a public health problem. Lancet Oncol. 2019; 20(3):319-21.doi: 10.1016/S1470-2045(19)30072-5.
Low-grade squamous intraepithelial lesion. National Cancer Institute.https://www.cancer.gov/publications/dictionaries/cancer-terms/def/low-grade-squamous-intraepithelial-lesion.
Khieu M, Butler SL. High-Grade Squamous Intraepithelial Lesion of the Cervix. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2024.
Kamal M, Topiwala F. Nonneoplastic cervical cytology. Cytojournal. 2022;19:25. doi: 10.25259/CMAS_03_06_2021.
Taskin-Turkmenoglu T. Liquid-based cytology for cervical cytology and automated screening devices. BosnianPathology.org. 2023.
Jeong H, Hong SR, Chae SW, Jin SY, Yoon HK, Lee J, et al. Comparison of unsatisfactory samples from conventional smear versus liquid-based cytology in uterine cervical cancer screening test. J Pathol Transl Med. 2017; 15;51(3):314–9. doi: 10.4132/jptm.2017.03.17.
Gibb RK, Martens MG. The impact of liquid-based cytology in decreasing the incidence of cervical cancer. Rev Obstet Gynecol. 2011; 4(Suppl 1):S2–11.
Kitchen FL, Cox CM. Papanicolaou smear. In: StatPearls. Treasure Island: StatPearls Publishing. 2022.
Makde MM, Sathawane P. Liquid-based cytology: Technical aspects. Cytojournal. 2022; 19:41. doi: 10.25259/CMAS_03_16_2021.
Shobana R, Saranya B. Comparison of conventional papanicolaou smear and liquid-based cytology for cervical cancer screening. Int J Sci Stud. 2019; 6(12):64–73.
Nishio H, Iwata T, Nomura H, Morisada T, Takeshima N, Takano H, et al. Liquid-based cytology versus conventional cytology for detection of uterine cervical lesions: a prospective observational study. Jpn J Clin Oncol. 2018; 48(6):522–8.doi: 10.1093/jjco/hyy050.
Tanabodee J, Thepsuwan K, Karalak A, Laoaree O, Krachang A, Manmatt K, et al. Comparison of efficacy in abnormal cervical cell detection between liquid-based cytology and conventional cytology. Asian Pac J Cancer Prev. 2015; 16(16):7381–4. doi: 10.7314/apjcp.2015.16.16.7381.
Dhananjaya C, Kumari M.K K. Comparison of manual liquid based cytology and conventional Pap smear in cervical cancer screening. NJLM. 2017; 6(2):32–7. doi: 10.7860/NJLM/2017/26632:2221.
Haghighi F, Ghanbarzadeh N, Ataee M, Sharifzadeh G, Mojarrad JS, Najafi-Semnani F. A comparison of liquid-based cytology with conventional Papanicolaou smears in cervical dysplasia diagnosis. Adv Biomed Res. 2016; 5:162. doi: 10.4103/2277-9175.192735.
Hashmi AA, Naz S, Ahmed O, Yaqeen SR, Irfan M, Asif MG, et al. Comparison of liquid-based cytology and conventional Papanicolaou smear for cervical cancer screening: an experience from Pakistan. Cureus. 2020; 12(12): e12293. doi: 10.7759/cureus.12293.
Atla B, Prasad U, Botta VSK, Namballa U, Pujari L, Lalam N. Comparative study of conventional Pap smear and liquid based cytology as a screening method for cervical cancer. International Journal of Research in Medical Sciences. 2021;9(8):2439-44. doi:10.18203/2320-6012.ijrms20213096.
Ezzat N, Abusinna E. Comparison between conventional Pap smear and liquid-based cytology in cervical cancer screening. Egyptian Journal of Pathology. 2019;39(2):280-9. doi: 10.4103/EGJP.EGJP_36_19
Ranjana H, Sadhna S. Comparison of conventional pap smear versus liquid based cytology in a diagnostic centre of central Madhya Pradesh. Indian J Pathol Oncol. 2016;3(1):42-7.
Kaban I, Bacanakgil BH, Koca S. The comparison of two methods in cervical smear screening — which method is better for smear adequacy rates? Ginekol Pol. 2021; 92(5):335–8. doi: 10.5603/GP.a2020.0185.
Honarvar Z, Zarisfi Z, Salari Sedigh S, Masoumi Shahrbabak M. Comparison of conventional and liquid-based Pap smear methods in the diagnosis of precancerous cervical lesions. J Obstet Gynaecol. 2022; 42(6):2320-4. doi: 10.1080/01443615.2022.2049721.
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