title: Pap test in a high-risk population comparison of conventional and liquid-base cytology.
abstract: Liquid-based cytology (LBC) is believed to have better sensitivity than conventional smears (CSs) and offers the possibility to perform molecular assay. The goal of this work was to study the performance of CS and LBC in a high-risk population and to compare the results with the hybrid capture (HC) II for high-risk human papillomavirus (HPV). Samples were collected from selected women with clinical suspicions of low genital tract lesion at Pérola Biygnton Hospital (São Paulo, Brazil). After CS preparation, the brush was introduced in the endocervix and a new sample was collected and rinsed in the preservative medium of the system. The residual material was used to HC2. From 925 cases, LBC was unsatisfactory in 4 (1.51%) cases and CS was unsatisfactory in 100 cases (10.81%); among theses cases HC2(+) reactions was observed in 54 (54%) CSs and 3 (21.4%) LBCs. Considering cases with atypia of undetermined significance (squamous and glandular), 85 (77.27%) cases from LBC and 44 (86.4%) from CS were positive for HC2 assay for high-risk DNA-HPV. The difference among the methods was not significant (P < 0.38). The diagnosis improvement of LBC in comparison with CS was 86% in satisfactory samples, 92.76% in undetermined atypical lesions (including glandular), 83% in positive low-grade squamous intraepithelial lesions (LSIL(+)), and 86.84% in high-grade SIL(+) (HSIL(+)). HC2(+) reactions were observed in 144 CS cases and 266 LBC cases with abnormalities. Our results have showed that LBC was superior to CS in a high-risk population to detect lesions with high concordance with HC2(+) reactions; CSs also exhibit a high concordance with HC2 assay but with inferior performance to detect lesions.
authors.affiliation: Division of Pathology of Adolfo Lutz Institute, 01246-902 São Paulo, Brazil.
authors.forename: Maria Lúcia
authors.initials: ML
authors.lastname: Utagawa
authors.forename: Sônia Maria Miranda
authors.initials: SM
authors.lastname: Pereira
authors.forename: Sérgio
authors.initials: S
authors.lastname: Makabe
authors.forename: Marina Yoshié Sakamoto
authors.initials: MY
authors.lastname: Maeda
authors.forename: José A
authors.initials: JA
authors.lastname: Marques
authors.forename: Carmen L F
authors.initials: CL
authors.lastname: Santoro
authors.forename: Celso
authors.initials: C
authors.lastname: Di Loreto
authors.forename: Luciana Silva
authors.initials: LS
authors.lastname: Aguiar
authors.forename: Janaina Erika
authors.initials: JE
authors.lastname: Pitolli
authors.forename: Gerson Botacini
authors.initials: GB
authors.lastname: Das Dores
authors.forename: Adauto
authors.initials: A
authors.lastname: Castelo
authors.forename: Adhemar
authors.initials: A
authors.lastname: Longatto Filho
mesh_terms: D003581:Cytodiagnosis / Q000379:methods; D003584:Cytological Techniques / Q000379:methods; D005260:Female; D006801:Humans; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000175:diagnosis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013048:Specimen Handling; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears