Dasgupta Shirin
Dr. B. C. Roy Multi Speciality Medical Research Centre, Indian Institute of Technology Kharagpur, Kharagpur, IND.
Cureus. 2023 Nov 6;15(11):e48343. doi: 10.7759/cureus.48343. eCollection 2023 Nov.
Cervical cancer is one of the leading health burdens globally with a huge incidence in developing countries like India. Cervical cancer has an extended premalignant stage known as cervical dysplasia or cervical intraepithelial neoplasia (CIN). CIN can be grade 1, 2, or 3 depending on its severity. One of the most effective methods of cervical cancer screening and prevention is detecting these premalignant lesions by cervical cytology. Pioneered by Dr. George Nicholas Papanicolaou, the Papanicolaou (Pap) stain became an important advent for the microscopic evaluation of the exfoliated cervical cells. Over the years, this method of conventional Pap smear became more practiced and yielded excellent results, so much so that the incidence of cervical cancer actually started to decline in developed countries. However, few drawbacks started to become evident with conventional Pap smears like unsatisfactory samples due to obscuring materials, false negative results due to sampling error, and low sensitivity. To overcome these drawbacks of conventional Pap smear, liquid-based cytology (LBC) was introduced in 1996. Thereafter, many investigations and studies have been conducted by many authors to compare the efficacy of conventional Pap smear and LBC. This review puts forward the facts and results of various studies pertaining to efficacy of cervical cytology, comparing conventional Pap smear and LBC, and highlighting the pros and cons of each method based on various studies. For this review, relevant articles under the headings "Conventional PAP smear", "Cervical cancer screening", "Liquid-based cytology" and "Comparison" have been searched in PubMed/MEDLINE and Google Scholar. About 100 articles were studied, and all the facts have been highlighted. While many studies did support LBC over conventional Pap smear for screening of cervical abnormalities, some studies did not find any major difference between the two and preferred the practice of conventional Pap smear in our Indian scenario considering the low-resource setting and low price. This research highlights the various facts of the two types of cervical Pap smear and their comparison.
宫颈癌是全球主要的健康负担之一，在印度等发展中国家发病率极高。宫颈癌有一个称为宫颈发育异常或宫颈上皮内瘤变（CIN）的癌前病变扩展阶段。根据严重程度，CIN可分为1级、2级或3级。宫颈癌筛查和预防最有效的方法之一是通过宫颈细胞学检查来检测这些癌前病变。由乔治·尼古拉斯·帕潘尼古拉乌博士开创的帕潘尼古拉乌（巴氏）染色法成为对脱落的宫颈细胞进行显微镜评估的一项重要进展。多年来，这种传统巴氏涂片法的应用越来越广泛，并取得了出色的效果，以至于发达国家宫颈癌的发病率实际上开始下降。然而，传统巴氏涂片法的一些缺点开始变得明显，比如由于遮挡物导致样本不理想、由于采样误差导致假阴性结果以及灵敏度低。为了克服传统巴氏涂片法的这些缺点，1996年引入了液基细胞学（LBC）。此后，许多作者进行了大量调查和研究，以比较传统巴氏涂片法和LBC的效果。这篇综述提出了与宫颈细胞学效果相关的各种研究事实和结果，比较了传统巴氏涂片法和LBC，并根据各种研究突出了每种方法的优缺点。为了进行这篇综述，在PubMed/MEDLINE和谷歌学术中搜索了标题为“传统巴氏涂片”、“宫颈癌筛查”、“液基细胞学”和“比较”的相关文章。研究了约100篇文章，并突出了所有事实。虽然许多研究确实支持LBC在筛查宫颈异常方面优于传统巴氏涂片法，但一些研究没有发现两者之间有任何重大差异，并且考虑到资源匮乏和价格低廉的情况，在我们印度的环境中更倾向于采用传统巴氏涂片法。这项研究突出了两种宫颈巴氏涂片的各种事实及其比较情况。
