Abstract:
Background:
Cervical carcinoma is the second most common malignancy in women
worldwide after breast cancer, but is the most common among women in developing
countries. Cytological screening leads to a reduction in the rate of invasive cancer of
uterine cervix. The present study highlights the use of cytospin i.e, manual method of
liquid based cytology in preparing cervical smears which is a cost effective alternative in
low resource settings to improve the efficacy of Pap smears.
Objectives:
1. To study the conventional Papanicolaou smears according to the Bethesda system
of classification, 2014.
2. To study the cytospin Papanicolaou smears according to the Bethesda system of
classification, 2014.
3. To compare efficacy of cytospin Papanicolaou smears with conventional
Papanicolaou Smears in cervical cancer screening based on Bethesda system of
classification, 2014.
Materials and methods:
A prospective study of 134 samples was carried out in the Department of
Pathology, B.L.D.E.U’S Shri B M Patil Medical College, Hospital & Research Centre,
Vijayapur by split smear technique for conventional Pap smear and liquid-based cytology
during 1st December 2014 to 30th June 2016. Cervical cytology samples from women
from 18-65 years attending the Obstetrics and gynaecology Out Patient Department weretaken by using Ayre’s spatula and one slide was prepared and immediately fixed in
fixative and the residual material was rinsed in fixative then spun in cytospin to obtain
direct smear. Both smears were stained by Pap stain.
Results:
Of the 134 cervical cytospin smears studied, 3 were unsatisfactory, 118 were
non-neoplastic and 13 were neoplastic lesions. The most common neoplastic lesion was
LSIL and HSIL accounting for 4 cases each followed by ASCUS, squamous cell
carcinoma and adenocarcinoma. Cytospin showed significant difference in the
morphological features compared to conventional.
Interpretation and Conclusion:
Cytospin method of manual liquid based cytology is strongly recommended in
the best interest of public health as it improves the sample quality, reduces the likelihood
of false negative results and better morphology. It over comes the limitation of
conventional smear as it significantly reduces unsatisfactory smears, improves specimen
adequacy, detects more intraepithelial lesion. It is of value as an alternative more
effective screening strategy in low resource settings, like developing countries including
India where women are at high risk for developing cervical cancer.
