Leishman Giemsa cocktail as a new, potentially useful cytological technique comparable to Papanicolaou staining for oral cancer diagnosis

Abstract

Background:Papanicolaou staining is commonly used for staining exfoliative cytology smears with Romanowsky stains being used sparingly. Leishman Giemsa (LG) cocktail, being a relatively new staining technique, has not been used in exfoliative cytology. This easy, cost-effective and one-step technique warrants further study because of its potential application in screening of oral cancer.Aim:To study and evaluate the diagnostic efficiency and reliability of Leishman Giemsa (LG) cocktail in comparison with Papanicolaou (Pap) and May-Grünwald Giemsa (MGG) stains in exfoliated cells for the detection of oral squamous cell carcinoma.Materials and Methods:Three smears were prepared from each 100 controls (buccal mucosa) and 100 patients, clinically diagnosed with oral squamous cell carcinoma and stained with Pap, MGG and LG cocktail stains. The slides were evaluated for the staining characteristics of nucleus and cytoplasm. The diagnostic efficiency of each stain was evaluated by comparing the cytologic diagnosis of each stain with the histopathological diagnosis. Finally, the diagnostic reliability was evaluated by comparing the three stains with each other and the histologic diagnosis.Statistical Analysis:The data were statistically evaluated with Friedman test, Wilcoxon sign rank test and McNemar chi square test using SPSS15 software.Results:The results from the histologically confirmed cases of squamous cell carcinoma and the number of cases diagnosed by Pap and LG cocktail were almost identical and both were superior to MGG. The P value obtained for the confirmed cases of squamous cell carcinoma in comparison for Pap vs MGG was 0.001, MGG vs LG cocktail was 0.001 and LG cocktail vs Pap was 0.157. Hence, no statistical significant difference was observed between the diagnostic ability of Pap and LG cocktail stains.Conclusion:LG cocktail is an easy, cost-effective and one-step technique comparable to Pap staining; however, it warrants further study in its potential application in screening of oral cancer.

Comparing Trio-Modified Papanicolaou Staining Methods for Assessing Liquid-Based Cytology Samples

“…The nucleus reveals less dark pyknotic staining, and the cytoplasm shows a better hue of colour differentiation with lighter colouration shades. These distinct characteristics are typical of a good Pap staining and have been reported [13,14] ; while, the background appears clear and more revealing compared to RAT (Figure 2). Furthermore, the staining uptake for SAP reveals prominent superficial and intermediate cells which appear distinct and well differentiated.…”

“…In respect to the turn-around time, SAP (5±0.5) partially aligns with MEM (7±0.5) by Odigie and Obaseki [1] and the report by Choudhary et al [4] but is dissimilar to RAT as reported by Richard [5] . In an earlier report, SAP staining quality agrees with MEM, which was well preserved even after some months of storage and is essential for smear review and retrospective studies [1,8,13,14] . Again, we stored the left over stains used for the three modified Papanicolaou methods and observed that the stains are well preserved in both MEM and SAP apart from being very active in smear staining even after one year (April 2016 to April 2017).…”

“…The reasons for the disparity may not be readily ascertained. However, cutting cost and turn-around time, cost effectiveness is a leading role in any organized screening centers and hospitals across the country, especially in an economically depressed-developing country like Nigeria [1,14] . Our study thus agrees with Gupta et al [3] ; Belgaumi and Shetty [14] ; in which modification of Pap staining was achieved with the aim of costcutting measure for resource-limited settings and may be suitable for use in Nigeria.…”

“…However, cutting cost and turn-around time, cost effectiveness is a leading role in any organized screening centers and hospitals across the country, especially in an economically depressed-developing country like Nigeria [1,14] . Our study thus agrees with Gupta et al [3] ; Belgaumi and Shetty [14] ; in which modification of Pap staining was achieved with the aim of costcutting measure for resource-limited settings and may be suitable for use in Nigeria. Again, SAP agrees with MEM (45% reduction in consumables), which has been published by Odigie and Obaseki [1] ; and is also consistent with the report by Gupta et al [3] , which favors minimum alcohol use but disagrees with Dighe et al [2] ; where 25% reduction was achieved.…”

Leishman and Giemsa stain: a new reliable staining technique for blood/bone marrow smears

“…The typical colour of nucleus is due to the molecular interaction between eosin and Azure B‐DNA complex. Leishman Giemsa (L‐G) cocktail, being a relatively new staining technique used previously for cytology smears , is largely unexplored and not documented in haematology for staining of peripheral blood/bone marrow smears. We created a newer modification of the conventional Leishman and Giemsa stains as a Leishman and Giemsa (L&G) stain, for staining the peripheral smear and bone marrow aspirate smears, and compared the efficacy and reliability of this stain with these conventional stains.…”