title: Liquid-based cytology versus conventional cytology for evaluation of cervical Pap smears: experience from the first 1000 split samples.
abstract: OBJECTIVE
  Screening programs using conventional cytology conventional Pap smear (CPS) have successfully reduced cervical cancer, but newer tests like liquid-based cytology (LBC) and human papillomavirus testing might enhance screening. The main aim of the present study was to assess the diagnostic accuracy of LBC versus CPS using "split samples."
  
  
  METHODS
  This was a prospective study comprising of 1000 consecutive cervical "split samples" over a period of 1 year. Split sample was obtained using cervex-brush. CPS was prepared from the brush and the brush head was suspended in the LBC vial and processed by SurePath™ LBC.
  
  
  RESULTS
  There were 4.3% unsatisfactory (U/S) cases in CPS and 1.7% in LBC; the main cause is insufficient cells, and excess of blood in CPS. About 25/100 (2.5%) split samples had epithelial abnormalities both in CPS and LBC (1.2%-atypical squamous cells of undetermined significance; 0.4%-low grade squamous intraepithelial lesion; 0.2%-high grade squamous intraepithelial lesion; 0.5%-squamous cell carcinoma; 0.1%-atypical glandular cells favouring neoplasia; 0.2%-adenocarcinoma). Inflammatory organisms were almost equally identified in both techniques but were better seen in LBC samples.
  
  
  CONCLUSIONS
  LBC technique leads to significant reduction of U/S rate. LBC samples offered better clarity, uniform spread of smears, less time for screening and better handling of hemorrhagic and inflammatory samples. LBC had equivalent sensitivity and specificity to CPS.
authors: Vikrant Bhar
authors: VB
authors: Singh
authors: Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Nalini
authors: N
authors: Gupta
authors: Raje
authors: R
authors: Nijhawan
authors: Radhika
authors: R
authors: Srinivasan
authors: Vanita
authors: V
authors: Suri
authors: Arvind
authors: A
authors: Rajwanshi
mesh_terms: D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D065006:Papanicolaou Test / Q000379:methods*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013048:Specimen Handling / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*