Liquid Based Cytology over Conventional Pap Staining Method in Evaluating Cervical Smears.

Sangeetha, A (2013) Liquid Based Cytology over Conventional Pap Staining Method in Evaluating Cervical Smears. Masters thesis, Tirunelveli Medical College, Tirunelveli.

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Abstract

Cervical Cancer Is The Third Most Common Cancer Among Women Worldwide & Second Most Common Cancer In Developing Countries, Over Half Of Which Are Fatal (Jemal A Et Al 2011)1. About 80% Of These Cases And Deaths Occurred In Developing Countries (Ferlay Et Al 2010)2.This High Mortality Makes Cervical Cancer An Important Public Health Problem. Cervical Cancer Is Slow Growing And Hence Has Potential For Effective Prevention Through Various Screening Procedures. Cervical Cytology Has Proved To Be One Of The Most Successful Examples Of Cancer Screening In Many Developed Countries And Has Resulted In Significant Decrease In Incidence And Mortality From Invasive Cancer By Detecting And Eradicating The Pre Invasive Lesions (Clarke EA 1979)3(Hakama M Et Al 1985)4(Miller AB Et Al 1990)5 (Mathew A Et Al 2009)6. Invasive Cervical Cancer Is The End Result Of A Long Pathological Process That Begins With Precursor Lesion Called Squamous Intraepithelial Lesions .Early Changes In The Cervix In The Form Of CIN Can Be Detected Years Before Invasive Carcinoma Develops And This Is The Basis Of Effectiveness Of Cytological Screening (Wright T Et Al 1994)7. The Main Objective Of Cervical Screening Is To Decrease Worldwide Incidence And Mortality Of Cervical Cancer, By Detecting And Treating Precancerous Lesions. The Screening Of Cervical Cytology Smears Was Introduced In 1928 By Dr.George N.Papanicolaou When He Reported The Observation Of Dysplastic/Malignant Cells In Women With Cervical Cancer By Sampling Vaginal Smears. Subsequently Papanicolaou And Dr.Herbert Traut Identified Cells Of Both Invasive And Pre Invasive Cervical Neoplastic Lesions By Cervical Cytology. This Test Is Now Known As The Conventional Pap Smear Or Pap Test (Papanicolaou Et Al 1941)8. For Conventional Cervical Cytology Cell Samples Taken From The Cervix By Using Ayre’s Spatula Is Smeared Onto Slides, Fixed And Stained With Papanicolaou Stain. Specificity Of This Test Is 98 To 99%. But The Sensitivity, Ranges From 50%-75% (Fahey MT Et Al 1995)9(Nanda K Et Al 2000)10. Several Limitations Of Conventional Pap Test Are Identified Such As 1) Inadequate Transfer Of Cells To Slide, 2) Un Uniform Distribution Of Abnormal Cells, 3) Presence Of Obscuring Inflammation, Blood And Overlapping Of Epithelial Cells (Richart RM Et Al 1965)11. Liquid Based Thin Layer Technology Was Introduced As A FDA Approved Alternative Method To Conventional Pap In 1996 To Address These Limitations. The First Generation Automated Liquid-Based Cytology (LBC) Involves Rinsing The Sampling Device Into A Vial Of Fixative To Form A Suspension Of Cells From Which A Monolayer Of Cells On A Slide Is Prepared. These Slides Can Be Read More Quickly Than Conventional Smears & The Residual Sample Can Be Used For HPV DNA Testing. There Are Two Methods Of FDA Approved LBC Technologies -Thinprep And Surepath (Lee RL Et Al 1997)12 (Monsonego J Et Al 2001)13(Fang-Hui Zhao Et Al 2011)14.These New LBC Techniques Require An Automated Instrument And So Higher Cost Per Test. Liquiprep, The Second Generation Liquid Based Cytology System Eliminates Most Of The Instruments Required By The First Generation Techniques Thereby Offering A Simpler Method With Lower Costs For Cervical Cancer Screening. Liquiprep System Consist Of Fixative Fluid Vial, A Cleaning Solution & A Cell Base That Act As A Membrane Matrix To Produce A Monolayer Of Cells(Geyer J Et Al 2004)15. Easy Method Of Preparation & High Correlation Of Results Obtained With CS Makes This Method Highly Suitable For Cervical Cytology In Developing Countries (Jongkolnee Settakorn Et Al 2008)16. There Are A Few Studies Showing An Indigenous Method Of Liquid Based Cytology Called Manual Liquid Based Cytology (MLBC). In This Method Chemicals Available In Their Own Laboratory Were Used To Prepare Fixative And Polymer Solution And Use Simple Equipments To Prepare Cervical Smear Slides. This Is A Low Cost Method Of Cervical Pap Smear Screening (Maksem Et Al 2001)17 (Maksem Et Al 2005)18 (Lee Et Al 2006)19(Kavatkar Et Al 2008)20(Nandini Et Al 2012) 21. The Present Study Was Undertaken To Compare This Low Cost Manual LBC With Conventional Pap Cytology .In Addition We Also Compared Second Generation Liquiprep System With Conventional Smears.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Liquid Based Cytology ; Conventional Pap Staining Method ; Evaluating Cervical Smears.
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 29 Jun 2017 10:37
Last Modified: 29 Jun 2017 10:37
URI: http://repository-tnmgrmu.ac.in/id/eprint/646

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