Singh Vikrant Bhar, Gupta Nalini, Nijhawan Raje, Srinivasan Radhika, Suri Vanita, Rajwanshi Arvind
Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Pathol Microbiol. 2015 Jan-Mar;58(1):17-21. doi: 10.4103/0377-4929.151157.
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."
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.
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.
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.
使用传统细胞学方法（传统巴氏涂片，CPS）的筛查项目已成功降低了宫颈癌的发病率，但像液基细胞学（LBC）和人乳头瘤病毒检测等新检测方法可能会提高筛查效果。本研究的主要目的是使用“分割样本”评估LBC与CPS的诊断准确性。
这是一项前瞻性研究，在1年时间内连续收集了1000份宫颈“分割样本”。使用宫颈刷获取分割样本。从刷头上制备CPS，刷头则悬浮于LBC瓶中，采用SurePath™ LBC方法进行处理。
CPS中有4.3%的样本不满意（U/S），LBC中有1.7%；主要原因是细胞数量不足以及CPS中血液过多。约25/100（2.5%）的分割样本在CPS和LBC中均有上皮异常（1.2%——意义不明确的非典型鳞状细胞；0.4%——低级别鳞状上皮内病变；0.2%——高级别鳞状上皮内病变；0.5%——鳞状细胞癌；0.1%——倾向于肿瘤的非典型腺细胞；0.2%——腺癌）。两种技术检测到的炎症微生物数量几乎相同，但在LBC样本中看得更清楚。
LBC技术可显著降低U/S率。LBC样本涂片清晰度更高、分布更均匀，筛查时间更短，对出血性和炎症性样本的处理更好。LBC与CPS具有同等的敏感性和特异性。
