A comparative analysis of conventional and SurePath liquid-based cervicovaginal cytology: A study of 140 cases.
BACKGROUND
The role of Papanicolaou (Pap) test in cervical cancer screening need not be overemphasized. While most Western countries have adopted the liquid-based cytology (LBC), which is considered superior, many developing countries are still using the conventional Pap smear (CPS) technique.


OBJECTIVE
To compare the staining and cytomorphological features on conventional versus liquid-based cervicovaginal smears.


METHODS
One hundred and forty cervicovaginal smears prepared by the standard conventional and LBC techniques were interpreted as per the Bethesda system of reporting cervicovaginal smears. Twelve parameters were studied, compared, and statistically analyzed. A P value <0.05 was considered to be statistically significant.


RESULTS
129/140 (92%) of CPSs and 130/140 (93%) LBC smears were satisfactory. LBC had a significantly shorter screening time (2.0 ± 0.08 vs 4.0 ± 0.65) and better representative material than that of CPS (50% vs 42%). Neutrophils were significantly more in CPS than LBC (96% vs 92%) with a P value <0.05 while hemorrhagic background and red blood cells (RBCs) were more prominent in CPS. LBC showed significant artifactual changes in squamous epithelial cells. Epithelial abnormalities ranging from atypical squamous cells of undetermined significance (ASCUS) to high grade squamous intraepithelial lesion (HSIL) were seen in 3% (4) and 2% (2) of CPSs and LBCs, respectively. Organisms were better picked up in CPS (99% in CPS vs 73% LBC) with a value of P = 0.0001.


CONCLUSIONS
Although a shorter screening time and cleaner background are the major advantages of LBC, CPS is not inferior to LBC. Considering the high cost, rather than the advantages associated with LBC, we feel that CPS is a better option for developing countries.
Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Jyotsna
J
Sharma
Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Pampa Ch
PCh
Toi
Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Neelaiah
N
Siddaraju
Department of Cytopathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Malliga
M
Sundareshan
Department of Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Syed
S
Habeebullah
Conventional Pap smear (CPS); liquid-based cytology (LBC); morphology