Rehydration of Air‑Dried Smears with Normal Saline: An Alternative for Conventional Wet Fixation Method in Cervical Cytological Study.

Abstract

Context: Papanicolaou (Pap) smear is an effective exfoliative cytological investigation done for early recognition of cervical cancer. It also plays role in diagnosis of inflammatory lesions of cervix. Aims: The aim of this study is (1) to compare the cytomorphological features in conventional Pap smear (C‑PAPS) and rehydrated air‑dried Pap smear (RADPS) and (2) to evaluate the efficacy of RADPS in cytodiagnosis of cervical lesion by comparing with cytomorphological features of conventional wet‑fixed Pap smear. Subjects and Methods: Paired cervical smears were prepared for 247 patients. One was labeled as C‑PAPS and another was labeled as RADPS. Comparison of both smears was done for various cytomorphological parameters. Results: Out of 247 smears, 2.4% RADPS and 7.3% C‑PAPS were reported as unsatisfactory. Red blood cell (RBC) background was present in 2% of RADPS and 42% of C‑PAPS. Cytolysis and air‑drying artifact were observed more in C‑PAPS amounting to 2% and 4% in RADPS and 11% and 15% in C‑PAPS. Cytoplasmic staining (97% RADPS vs. 94% C‑PAPS) was superior in RADPS. Cell border, nuclear border, and chromatin of squamous and endocervical cells were better appreciated on RADPS compared to C‑PAPS, and also statistically significant difference was observed. Conclusion: Rehydrated air‑dried technique can be satisfactory alternative for conventional wet fixation method which can be followed routinely or in conjugation with C‑PAPS, especially in cervical screening programs.