Title: The Utility of a Manual Liquid Based Cytology in Screening for Pre-Cancerous Lesion and Cervical Cancer
Authors: Mutuku Onesmus Muia, Kavoi Boniface Mwanzia, Kahato Michael Ngugi, Kyama Cleophas Mutinda
DOI: https://dx.doi.org/10.18535/jmscr/v6i2.93
Abstract
Introduction: Liquid-based cytology is a technique that enables cells to be suspended in a liquid medium and spread in a monolayer, thereby enabling a better morphological assessment. Automated techniques have been widely used especially in the developed countries but limited in the developing countries due to cost and availability.
Conventional Pap smear (CPS) examination has been the commonly used method for detection of cervical cancer. However, there have been challenges in its use due to the inherent limitations, like presence of obscuring blood and inflammation which has reduced its sensitivity considerably. On the other hand, manual liquid based cytology (MLBC) is a technique that is cost effective and improves detection of precursor lesions and specimen adequacy.
Methodology: A total of 295 women were assessed for pre-cancerous lesions and cervical cancer using Manual Liquid Based Cytology and Conventional Pap Smear method.Cohen Kappa test was run to determine the level of agreement the two methods.
Results: There was moderate agreement between the two methods (k=0.673, 95% CI, p=0.065). Specimen adequacy was found to be better with MLBC than CPS with 12 unsatisfactory smears in MLBC and 22 in CPS. There was increased detection rate of abnormal cervical cytology smears with MLBC of 85.7%.
Conclusion: Manual liquid based cytology was found to give better results than conventional Pap smear and therefore it can be used as an alternative liquid based cytology technique for cervical cancer screening in limited resource settings.
Keywords: Manual Liquid Based Cytology, Conventional Pap Smear.
References
- Sankaranarayanan, Rengaswamy, Atul Madhukar Budukh, and Rajamanickam Rajkumar. "Effective screening programmes for cervical cancer in low-and middle-income developing countries." Bulletin of the World Health Organization10 (2001): 954-962.
- Gatune, Jane W., and Isaac K. Nyamongo. "An ethnographic study of cervical cancer among women in rural Kenya: is there a folk causal model?." International Journal of Gynecological Cancer6 (2005): 1049-1059.
- Ferlay, Jacques, et al. "Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012." International journal of cancer5 (2015).
- Sharma, Jyotsna, et al. "A comparative analysis of conventional and SurePath liquid-based cervicovaginal cytology: A study of 140 cases." Journal of Cytology/Indian Academy of Cytologists2 (2016): 80.
- Kirschner, Benny, KåreSimonsen, and JetteJunge. "Comparison of conventional Papanicolaou smear and SurePath® liquid‐based cytology in the Copenhagen population screening programme for cervical cancer." Cytopathology4 (2006): 187-194.
- Kavatkar, Anita N., C. A. Nagwanshi, and S. M. Dabak. "Study of a manual method of liquid-based cervical cytology." Indian Journal of Pathology and Microbiology2 (2008): 190.
- Sherwani, R. K., et al. "Conventional Pap smear and liquid based cytology for cervical cancer screening-A comparative study." Journal of cytology 24.4 (2007): 167.
- Nandini, N. M., et al. "Manual liquid based cytology in primary screening for cervical cancer-a cost effective preposition for scarce resource settings." Asian Pacific Journal of Cancer Prevention8 (2012): 3645-3651.
- Moosa, NajlaYussuf, et al. "Comparison of cervical cell morphology using two different cytology techniques for early detection of pre-cancerous lesions." Asian Pac J Cancer Prev2 (2014): 975-981.
- Simion, N. I. C. O. L. E. T. A., et al. "Conventional cytology versus liquid based cytology in cervical pathology: correspondences and inconsistencies in diagnosis, advantages and limits." Rom J MorpholEmbryol4 (2014): 1331-1337.
- Akbar, Shehla, Shgufta Nasir Pervez, and Walayat Shah. "Manual liquid based cytology for Pap smear preparation and HPV detection by PCR in Pakistan." Asian Pac J Cancer Prev2 (2015): 579-583.
- Bergeron, Christine, and Francis Fagnani. "Performance of a new, liquid-based cervical screening technique in the clinical setting of a large French laboratory." Acta cytologica5 (2003): 753-761.
- Garbar, Christian, Corinne Mascaux, and Véronique Fontaine. "Efficiency of an inexpensive liquid-based cytology performed by cytocentrifugations: a comparative study using the histology as reference standard." Cytojournal1 (2005): 15.
- Burd, Eileen M. "Human papillomavirus and cervical cancer." Clinical microbiology reviews1 (2003): 1-17.
- ELNASHAR, AFAF, and HAZEM ABDEL GHAFFAR. "The Use of Cytology Tests in the Diagnosis of Cervical Lesions in High Risk Patients." The Medical Journal of Cairo University 80.2 (2012).