title: DCS liquid-based system is more effective than conventional smears to diagnosis of cervical lesions: study in high-risk population with biopsy-based confirmation.
abstract: OBJECTIVE
  To compare the performances of Papanicolaou test (PapTest) and of a new liquid-based cytology method, DNA-Citoliq System (DCS), in a high-risk population, with histology confirmation.
  
  
  METHODS
  Paired specimens of exfoliated cervical cells were collected under split-sample protocol. All patients were submitted to colposcopy and a biopsy taken when any atypical transformation zone was seen. Sensitivity, specificity, positive and negative predictive values, and overall accuracy of both conventional and DCS methods were computed in relation to histology.
  
  
  RESULTS
  A total of 1095 patients were analyzed by two cytology methods and, in 425 (38.8%), histologically. There were significantly more adequate samples with DCS (98.63%) than with conventional (89.6%) smears (P < 0.001). ASCUS was diagnosed significantly more with DCS than with conventional Pap (P < 0.001). Conventional Pap misclassified as normal 55.4% (158/285) of cases with either LSIL or HSIL or cancer at histology, whereas DCS misclassified 31.2% (89/285) of cases (P < 0.001). DCS had a significantly higher sensitivity (70% and 91.3%) than the conventional Pap (49.8% and 72.8%) to detect both LSIL+ and HSIL+ at histology, respectively. On the other hand, specificity of conventional smear (88.2% and 85.2%) was significantly higher than DCS (75.4% and 70.9%) considering both LSIL+ and HSIL+ at histology, respectively.
  
  
  CONCLUSIONS
  This study confirms the superiority of the liquid-based cytology system DCS to detect cervical lesions. The rate of adequate DSC slides was significantly higher than with conventional cytology.
authors.affiliation: Division of Pathology, Adolfo Lutz Institute, Dr. Arnaldo Avenue, 355-Cerqueira Cezar, 01246-902 São Paulo, Brazil. longatto16@hotmail.com
authors.forename: Adhemar
authors.initials: A
authors.lastname: Longatto Filho
authors.forename: Sônia Maria Miranda
authors.initials: SM
authors.lastname: Pereira
authors.forename: Celso
authors.initials: C
authors.lastname: Di Loreto
authors.forename: Maria Lúcia
authors.initials: ML
authors.lastname: Utagawa
authors.forename: Sérgio
authors.initials: S
authors.lastname: Makabe
authors.forename: Marina Yoshiê
authors.initials: MY
authors.lastname: Sakamoto Maeda
authors.forename: José A
authors.initials: JA
authors.lastname: Marques
authors.forename: Carmen L F
authors.initials: CL
authors.lastname: Santoro
authors.forename: Adauto
authors.initials: A
authors.lastname: Castelo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002584:Cervix Uteri / Q000166:cytology* / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D012307:Risk Factors; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology*; D014626:Vaginal Smears / Q000379:methods*