Comparison of conventional Papanicolaou cytology samples with liquid-based cervical cytology samples from women in Pernambuco, Brazil

Abstract

In the present study, we compared the performance of a ThinPrep cytological method with the conventional Papanicolaou test for diagnosis of cytopathological changes, with regard to unsatisfactory results achieved at the Central Public Health Laboratory of the State of Pernambuco. A population-based, cross-sectional study was performed with women aged 18 to 65 years, who spontaneously sought gynecological services in Public Health Units in the State of Pernambuco, Northeast Brazil, between April and November 2011. All patients in the study were given a standardized questionnaire on sociodemographics, sexual characteristics, reproductive practices, and habits. A total of 525 patients were assessed by the two methods (11.05% were under the age of 25 years, 30.86% were single, 4.4% had had more than 5 sexual partners, 44% were not using contraception, 38.85% were users of alcohol, 24.38% were smokers, 3.24% had consumed drugs previously, 42.01% had gynecological complaints, and 12.19% had an early history of sexually transmitted diseases). The two methods showed poor correlation (k=0.19; 95%CI=0.11–0.26; P<0.001). The ThinPrep method reduced the rate of unsatisfactory results from 4.38% to 1.71% (χ2=5.28; P=0.02), and the number of cytopathological changes diagnosed increased from 2.47% to 3.04%. This study confirmed that adopting the ThinPrep method for diagnosis of cervical cytological samples was an improvement over the conventional method. Furthermore, this method may reduce possible losses from cytological resampling and reduce obstacles to patient follow-up, improving the quality of the public health system in the State of Pernambuco, Northeast Brazil.

Cytopathologic evaluation of patients submitted to radiotherapy for uterine cervix cancer

“…Normal cells are also compromised, resulting in their death or in nuclear and cytoplasmic changes that may persist for many years. 19,29,32,33 Cervical smear is considered an excellent method of investigation in the follow--up of patients undergoing radiation therapy for cervical cancer. The finding of malignant cells that persist after treatment or that reappear soon after allows immediate clinical and/or surgical intervention before the onset of any symptoms.…”

“…After this period, all malignant cells disappear, and an atrophic cytological pattern is established. 19,27,29,32,33 Cellular changes are related to both the acute and to the chronic phases following radiation therapy. It is not always easy to differentiate these changes from those of malignant cells.…”

“…On the other hand, a cytopathologist with little experience in this area may underestimate the changes, missing the opportunity to detect early or recurrent cancer. 19,[29][30][31] Persistent or recurrent carcinoma is diagnosed in the cervicovaginal smear when malignant cells are identified in the course of radiotherapy or immediately after its completion. It indicates radioresistance of the neoplastic cells, being thus related to a poorer prognosis.…”

Modern Approach to Cervical Cancer Screening Program – Georgian Experience

“…According with global statistics, cervical cancer is on the second place by the frequency and on the third by mortality among the cancers of reproductive system [1][2][3]. 527,000 newly diagnosed cases of cervical cancer and 265,000 deaths due to this health care problem were recorded in 2012 by World Health Organization.…”

“…The Papanicolau stained conventional smear can be used for cervical cancer screening purposes, but some authors [2] complained on low diagnostical sensitivity because of false positive and false negative results. The amount of false-negatives varies from 2% to 50% [1,[4][5][6]. In a meta-analysis study [7] the sensitivity of cervical cancer screening performed by application Volume 2 Issue 6 -2016 1 Georgian Telemedicine Union (Association), Georgia 2 New Vision University, Georgia of conventional smear was declared as 58% (range 11% -99%), with a specificity of 68% (range 14% -97%).…”