A Comparative Analysis of Conventional Smear Technique (PAP) with Manual Liquid Based Cytology and Histopathological Correlation of Cervical Lesions in GMKMCH, Salem

Priya, T S (2020) A Comparative Analysis of Conventional Smear Technique (PAP) with Manual Liquid Based Cytology and Histopathological Correlation of Cervical Lesions in GMKMCH, Salem. Masters thesis, Government Mohan Kumaramangalam Medical College, Salem.

[img]
Preview
Text
200301020priya.pdf

Download (5MB) | Preview

Abstract

BACKGROUND: Cervical carcinoma is the second most common malignancy among women Worldwide, with approximately 5,30,000 new cases per year (8.8%) and a mortality of 2,75,000 death per year. In India, cervical cancer accounts for 3.3% of disease morbidity and 9 % of overall mortality. This makes cervical cancer a major public health problem. Cervical cancer is preceded by squamous intraepithelial lesion which can be detected before it transforms into an invasive malignancy. This forms the basis of cytological screening. AIM OF THE STUDY: 1. To evaluate the diagnostic efficacy of Manual Liquid based cytology in cervical lesions. 2. To compare the results of Conventional Pap smear and Manual Liquid based Cytology, to correlate with histopathological findings from cervix biopsy wherever applicable. MATERIALS AND METHODS: This was a prospective study, conducted on 100 patients, attending the Obstetrics and Gynaecology department of our college, during the period of January 2018 to June 2019.Cervical exfoliative cytology smears were taken for both CPS method and MLBC method. The smears were stained by Pap stain and reported using Bethesda system for reporting cervical cytology. Both CPS results and MLBC results were correlated with the gold standard - Histopathology. Cervix biopsy is done only for suspected cases of precancerous lesions. OBSERVATION AND RESULTS: Out of 100 patients, most of them were in the age group of 20 to 65 years and 52% of women presented with leucorrhoea. Unsatisfactory smear rate was lower with MLBC method (4%). Overall cellularity was good with MLBC method. MLBC showed uniform distribution of cells in about 96% of cases, clean background in about 95% of cases without any cellular overlapping. MLBC smears showed nuclear distortion in only 2 cases (2%) and cytoplasmic distortion in only 8 cases (8%). Sensitivity and specificity of CPS was 68.42% and 25% respectively. Sensitivity and specificity of MLBC method was 94.44% and 40% respectively. The results of MLBC test correlated with HPE results, correlation was observed for CIN I, CIN II, CIN III cases and inflammatory smears. The results of CPS test correlated with HPE results, correlation was observed for CIN I, CIN II, CIN III cases and inflammatory smears. CONCLUSION: MLBC provides better cytomorphological details when compared to CPS. At the same time, residual sample can also be used for ancillary techniques. In our study, MLBC method performed better than Conventional Pap smear. MLBC methods, sensitivity, specificity, Positive predictive value, Negative predictive value and accuracy were more than the values of CPS. So, Manual Liquid based cytology can be used as a screening method for cervical cancer in poor resource areas.

Item Type: Thesis (Masters)
Additional Information: 201713755
Uncontrolled Keywords: Conventional Pap smear (CPS), Manual Liquid based cytology (MLBC).
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 29 Jan 2021 17:42
Last Modified: 29 Jan 2021 17:42
URI: http://repository-tnmgrmu.ac.in/id/eprint/13427

Actions (login required)

View Item View Item