The pap smear is a commonly used screening test for cervical cancer detection. First generation automated Liquidbasedcytology improves the quality of cervical smears through an improved way of slide preparation following collection of samples in a standard way. It provides more representative sample of specimen with reduced obscuring background material which allows faster and more reliable screening .The cost of this test is high, but there is increase in detection of pre invasive lesions and decrease in the number of indeterminate results such as ASC (Limaye et al 2003) 73 (Trench 2000) 74 . In addition ancillary studies such as HPV testing can be done on residual sample (Levi et al 2003) 75 .
Screening for cervical cancer has resulted in the reduction of incidence of cancer cervix and its complications. Pap smear has been used for the screening purpose since 1940’s but studies have shown that the sensitivity of a single Pap test is low and it has high false negative rate .This is said to be due to improper sampling and ineffective interpretation. In Pap smear only 20% of the scraped cells in the Ayer’s spatula are transferred to the slide while smearing, which is done manually. Therefore alternative screening methods which overcome these pitfalls in Pap smear is developed, one such method is LiquidBasedCytology where all the scraped cells in the cyto brush are transferred in the liquid transport medium to the laboratory where it is processed and a uniform thin layer of smear is prepared in the laboratory than manually. This study is done for evaluating the performance of LiquidBasedCytology and for doing comparative study of the sensitivity of LBC and the conventional Pap method.
cultural, climatic and geographical profile as compared to the rest of the country. Hence, it becomes increasingly important for implementation of regular cervical screening programmes. LiquidBasedCytology (LBC) is now the standard procedure for carrying out cervical smear examination and the Bethesda system of reporting for cervical cytology offers a standardized system for reporting of gynecological cytology. The present study was undertaken to study the distribution and spectrum of cervical lesions in Western Rajasthan population. To the best of our knowledge, the present study is the largest and first study of cervical liquid-basedcytology in patients visiting a tertiary care hospital in Western Rajasthan. The study was carried out with the primary objective of finding the overall prevalence and distribution of various cervical non-neoplastic and Intra-epithelial neoplastic lesions in liquid-basedcytology in Western Rajasthan population.
IJSRR, 8(3) July. – Sep., 2019 Page 519 In LiquidBasedCytology, two methods are well known, Thin Prep R and BD Sure Path TM . We have used BD Sure Path TM for our study. Thin Prep Sample (TPS) method is a vacuum filtration method, whereas Sure Path Sample(SPS)method is a density-gradient centrifugation method. In SPS system, the cell-enrichment process substantially removes blood, mucus, and up to 50% of inflammatory cells from the diagnostic material, resulting in an enriched cellular sample, providing better visualization of clinically relevant cells. SPS with ethanol-based fixative provides cellular detail more familiar to thecytologist than the methanol-based fixative used by TPS. 14 Even though the area of the smear is smaller than in conventional preparations, SPS preparations are on an average more cellular with a cleaner background. Norimatsuet al., and Bentz et al., demonstrated that reduced cellularity on TPS slide glass from bloody samples results from blood and fibrin competing with epithelial cells and clogging the TPS filter pores. 14,15 Sweeney et al., and Kenyon et al., have shown that specimens processed in the SPS system had effectively no loss of cellularity with any amount of added mucus. 16,17
in 50 % cases of CPS while in LBC it was 28.75%. Our study showed presence of mucin in 90% cases of CPS which was found to be higher as compared to LBC showing presence of mucin in 5% cases. Presence of hemorrhage in our study in CPS was fond in 18.75% of cases while in LBC it was 3.75%. This finding that’s that in our study clarity of background was found to be more for LBC in comparison of CPS. Background clarity findings were compared between conventional Pap smear and liquidbasedcytology in terms of background clarity, (p=0.002). Comparison of endocervical cells detection in between conventional Pap smear and liquidbasedcytology showed, endocervical cells were present in 46.25 % of cases in CPS while in LBC it was present in 20 % cases (Figure 3). Significantly difference was observed between conventional Pap smear and liquidbasedcytology in detection of endocervical cells (p<0.0001).
conventional smears . Arbyn et al.  in a systematic review concluded that LBC was neither more sensitive nor more specific for detection of high-grade cervical intraepithelial neoplasia compared with the conventional Pap test. In the other hand, Ronco et al.  reported that LBC for primary screening of cervical cancer showed a significant increased sensitivity for cervical intraepithelial neoplasia grade 1 but not for lesions grade 3 or more. Consensually, LBC is associated with a relevant reduction in unsatisfactory samples. The high quality of LBC preparations is certainly out of discussion. Colgan et al.  studied 352,680 specimens and they com- pared the detection and adequacy rates of the SurePath liquid-basedcytology system (SP-LBC) with the ade- quacy and detection rates from a historical conventional smear (CS) group from the same laboratories during the same period of the previous year. They found unsatisfactory rate of 0.24% and importantly increased detection rate of HSIL by LBC as compared with the detection rate of HSIL by the historical CS group (P = 0.0182). We have also experienced similar findings since we do not observed unsatisfactory samples in this series. Fre- mont-Smith et al.  evaluated 58,580 SurePath™ slides and 58,988 historic conventional slides. They found a SurePath detection rate for the clinically important categories of HSIL (64.4%) and LSIL (107.16%), and a sta- tistically significant lower proportion of unsatisfactory slides.
Liquidbasedcytology has evolved as a newer method in the field of fine needle aspiration cytology. The introduction of liquidbased technique tries to overcome the limitations faced by conventional method. Liquidbased smears are easier to screen and less time consuming due to spread of cells in monolayer with a clean background. The cellular morphology is always well preserved. Only a small amount of is used for LBC preparation and the remaining solution is stored in appropriate preservative solution for few months at an appropriate temperature for future studies.
Abstract: Liquid-basedcytology (LBC) has been progressively used for evaluating fine needle aspiration (FNA) speci- mens. However, limited studies have examined LBC in FNA of parathyroid lesions. We retrospectively reviewed 24 FNA specimens of parathyroid lesions, including 6 specimens prepared by conventional smear, 12 specimens prepared using ThinPrep method, and 6 specimens prepared using SurePath method. The 18 LBC specimens were also used for cell block preparation and immunostaining for parathyroid hormone (PTH). LBC specimens more fre- quently showed variable cellularity; microfollicular structure; bubbly or vacuolated cytoplasm; and small, round cells with distinct borders compared to specimens prepared by conventional smear. ThinPrep specimens showed a clean background and fewer isolated cells and naked nuclei compared to specimens prepared using the other methods. SurePath specimens showed many white blood cells in the background and more scattered single cells and naked nuclei compared to ThinPrep specimens. Specimens prepared using the 3 methods often showed colloid-like mate- rial but did not contain dense globular colloidal structures. White blood cells in the background of LBC specimens serve as useful indicators for estimating cell size. The nuclear size of parathyroid cells was similar to or smaller than that of inflammatory cells in the background. Cell block sections showed definite histological features of the parathyroid tissue and strong positive immunostaining for PTH. Awareness of these cytologic features of parathyroid FNA specimens prepared using ThinPrep and SurePath methods may help in preventing misdiagnosis. Cell block preparation and PTH immunostaining should be performed for the definitive diagnosis of parathyroid lesions.
The details of the study have been explained to me in writing and the details have been fully explained to me. I am aware that the results of the study may not be directly beneficial to me but will help in the advancement of medical sciences. I confirm that I have understood the study and had the opportunity to ask questions. I understand that my participation in the study is voluntary and that I am free to withdraw at any time, without giving any reason, without the medical care that will normally be provided by the hospital being affected. I agree not to restrict the use of any data or results that arise from this study provided such a use is only for scientific purpose(s). I have been given an information sheet giving details of the study. I fully consent to participate in the study titled ” DIAGNOSTIC EFFICACY OF THIN PREP PREPARATION(LIQUIDBASEDCYTOLOGY) IN COMPARISON TO CONVENTIONAL PAP SMEAR AS A PRIMARY SCREENING TOOL FOR CERVICAL LESIONS.”
Introduction: Pap smear has been most widely used screening method for cervical cytology since last 50 years. Despite of it reducing morbidity and mortality from cervical cancer by detecting precancerous lesions, false negativity rate of Pap smear is very high. Manual liquidbasedcytology has been developed as an alternative to conventional Pap smear to overcome its drawbacks. Main advantages of MLBC over CPS are increased percentage of representative cells, better presentation on slide, increased detection of abnormal or dysplastic cell and overall reduced number of unsatisfactory smears.
Bronchogenic carcinoma is the most common malignant tumor worldwide and it is the leading cause of cancer mortality [1-4]. The bronchial brushing cytology is a kind of very useful meth- od for detecting pulmonary malignant tumors including bronchogenic carcinomas. It also can be used to detect the secondary malignancies involved the lung. Conventional smear (CS) was the major method of cytological preparation in China for many years. Liquid-basedcytology (LBC) which emerged in 1990s is a kind of rela- tively new cytological preparation method, its applications in screening and diagnosis of cer- vical cancer have been well recognized. LBC is also increasing applied for the non-gynecologi- cal cytology in China these years [5, 6]. This
Liquidbasedcytology increases the sensitivity of cervical cancer detection and its ability to do molecular testing using the same sample. LBC also improves sample quality by reducing the number of unsatisfactory smears, reduces the number of false negative smears, causes reduction in interobserver bias and less time consuming. Funding: No funding sources
Cervical cancer is the 4th most common cancer in women in low to middle income group countries (LMIC). Various methods for screening cervical cancer are practiced, such as the Conventional Pap Smear (CPS), LiquidBasedCytology with its ancillary techniques like Cell Block with immunocytochemistry. VIA is another method which is being advocated as a primary screening tool. Molecular diagnostics such as use of HPV DNA testing has been at the forefront of the screening programs. In the present study, we have utilized all the above methods by using cost effective in-house procedures to explore their possible utility in the clinical settings. We found them useful with need for more work and training of personnel for better diagnosis of cervical cancer.
All the eligible women were selected into the study by purposive sampling, till the sample size is reached. After obtaining the informed written consent, all the study participants were evaluated by detailed clinical history and physical examination. Pap smear specimen was collected by an Ayers spatula and smeared on a slide and fixed with 95% of ethanol (conventional Pap smear cytology (CPAP). Liquid-basedcytology (LBC) was done using Cytobrush specimen and was collected in a vial containing preservative for liquid-based preparation processing After the Pap smear and LBC is collected Visual inspection with 5% acetic acid (VIA) and visual inspection with Lugol’s iodine (VILI) procedure was carried out and following that cervix biopsy was taken. Abnormal areas in cervix turn acetowhite in VIA and yellow in VILI.
The study was approved by the Department of Clinical Pharmacology, Xiangya Hospital, Central South University, People’s Republic of China. During the period between December 2011 and April 2013, women referred for a colposcopic examination were invited to participate in the study. The eligible women were sexually active, scheduled to undergo a liquid-basedcytology test (LBC) within a week, not pregnant, possessed an intact uterus, and no history of treatment for CIN or cervical cancer. The exclusion criteria included women who had a history of cancer related to the reproductive tract, underwent therapy for cervical lesions, received the HPV vaccination, or were currently pregnant. Standard guidelines for the management and treatment of cervical neoplasia were followed in all subjects . The cytology results were classified according to the 2001 Bethesda System .
There are multiple screening techniques including con- ventional cytology (CC) and liquidbasedcytology (LBC). 2 CC, also called the Papanicolaou or Pap test has been around for over 50 years and has been the standard screen- ing technique in Germany since screening began in the 1970s. 2,11,12 The test involves a sample of cells being taken from the cervix and smeared directly onto a glass slide. 13 Since then, LBC has been introduced in a number of developed countries, such as New Zealand, the United Kingdom and the United States of America. 14 – 16 With LBC, the sample of cervical cells is collected and rinsed in a vial of preservative solution. 11 The vial containing the suspended cells in solution is transferred to a cytology processor that is used to place a uniform layer of cells on a slide. 13 It has been reported that LBC yields a better representation of the cells than CC and fewer inadequate results. 13,17 LBC also has the advantage that the residual liquid sample can also be used for HPV testing, if required. 2 The current German guidelines invite women for an annual cytology cervical screen, although these guide- lines are changing. 18,19 From 2020, women between 20 and 34 years of age will be offered an annual cytology cervical screen. Women who are 35 years of age and above (with no upper age limit) will be offered a combined cytology and HPV test every three years. 19 The objective of this study was to investigate the cost- effectiveness and cost-bene ﬁ t of cervical screening with
According to the manufacturer, the hc2 test has CE In Vitro Diagnostics (IVD) certification for cell samples harvested in 3 media, namely STM (Qiagen), PreservCyt (Hologic) and SurePath (BD). Some studies have re- ported the potential use of cell samples processed with different liquid-basedcytology media for hrHPV testing by hc2 [11, 14–17]. We report here that the performance characteristics of the hc2 assay are appropriate for its intended use with cells stored in the new Novaprep® HQ+ medium with or without DTT. Thus, pretreatment of cervical smears with a mucolytic agent (DTT up to 0.03 %) to obtain single-cell suspensions does not alter the specimen for further hrHPV DNA testing by hc2. In the
studies are available in the literature where results using LiquidBasedCytology have been compared with conventional cytology. No differences were found in diagnostic accuracy between LBC and conventional cytology of bronchial wash specimen. [12, 13] The limitation of CS such as suboptimal smears with insufficient squamous cells, presence of obscuring blood, dense inflammation, mucin, and thick smears with overlapping epithelial cells reduce its sensitivity to as low as 50% with a rise in false negativity rate ranging between 14% and 33%. [14-16] Liquid-basedcytology which is widely practiced in the western setup, was developed to improve the diagnostic reliability of Pap smears by reducing the number of inadequate smears and false negativity rate, and also allow important ancillary tests such as human papillomavirus (HPV) testing. [14,17] Although there is sufficient western literature on LBC, the studies from India comparing CPS and LBC techniques are sparse. [14,15] Moreover, there have been conflicting results with regard to the quality of LBC results. [18,19] Some studies done using bronchial brushing for cytodiagnosis of lung cancer have emphasized its high accuracy rate in the evaluation of neoplastic and non- neoplastic pulmonary lesions. 
Objectives: (1) To evaluate the various causes of unhealthy cervix in Kashmiri women. (2) To assess the utility of colposcopy and cytology in detecting the various causes of unhealthy cervix. (3) To correlate the findings of cytology and colposcopy with each otherand with histopathology. Methodology: 200 women attending gynecology OPD with clinicallyunhealthy cervix were subjected to evaluation by liquid- basedcytology, colposcopy and directed biopsyand the findings were noted. Results: Majority of women were in the age group of 30-39 years. Commonest complaint was vaginaldischarge in 50% cases followed by menorrhagia in 19.5% women18% had abnormal discharge in 50% cases followed by menorrhagia in 19.5% women, 18% had abnormal LBC findings with 11% women had LSIL, 5.5% had HSIL, and 1.5% had squamous cellcarcinoma (SCC). 32.5% had abnormal women had LSIL, 5.5% had HSIL, and 1.5% had squamous cell carcinoma (SCC). 32.5% had abnormal colposcopic findings, 21% had low grade lesion and 11.5% had high grade lesion. In our study, on correlating LBC findings with histopathology, out of 8.5% women with ASCUS on LBC, 4% had positive histopathological findings. Out of 5% patients with LSIL on LBC, 3.5% were having positive histopathologicalfindings. Out of 3% patients with HSIL on LBC, 1.5% were positive on histopathological examination. On correlating colposcopic findings with histopathology, 5.5% patients which appeared normal on colposcopic evaluation had dysplasia on histopathology, 15.5% women with low grade lesion on colposcopy had
Great advances in screening have lowered the death rate from cervical cancer in the advanced countries. The major ad- vances in cervical cancer screening include the Papanicolaou (Pap) test and liquid-basedcytology (LBC). In this study, we aimed to use cell remnants from LBC specimens from uterine cervix and endometrium, aspirates from breast and thyroid tumors, and liquid samples (ascites, pleural effusion, and urine). Cell blocks made from cell remnants of LBC specimens were immunohistochemically or immunocytochemically stained for several biomarkers including certain tumor markers such together with hematoxylin and eosin staining for accurate diagnosis of malignancies in different samples. The findings from the cell blocks stained with these biomarkers combined with those from Pap stain led to easily diagnosis of the presence or absence of malignancies. Our findings suggest the utility of LBC and cell blocks from cell remnants in cytologic diagnosis in certain specimens.