Comparison of Conventional PAP smear and Manual Liquid Based Cytology with P16 marker in screening for cervical cancer in Indian tertiary healthcare setups in Mysuru

Authors

Gayathri Sureshkumar Nair, JSS Academy of Higher Education and Research
Nandini Manoli, JSS Academy of Higher Education and Research
Nandish Manoli, JSS Academy of Higher Education and Research

Abstract

In India, there are 20.2 per 100000 new cases of Cervical Cancer diagnosed and 11.1 per 100000 deaths annually accounting for more than one fifths of global cervical cancer deaths. [1] Thus, due to an absence of a national immunization program to cover human papillomavirus (HPV) vaccination and lack of accessible cervical cancer screening, the disease is characterized by late detection, lack of access to affordable and quality health care, and high mortality rates. [2]

Papanicolaou Smear Test was a novel invention by Dr George Papanicolaou in the year 1927 which gained maximum popularity in 1950 as a screening test for Cervical Cancer. Liquid based cytological technique has been recently developed and has gained popularity because in preliminary studies the use of such techniques was associated with a reduction in incidence of inadequate cervical smears. [3, 4]

Manual Liquid Based Cytology (MLBC) is a technique that enables cells to be suspended in a monolayer and thus improves detection of precursor lesions and improvement of specimen adequacy. MLBC has been reported to improve the effectiveness of cervical cancer screening in a population by increasing the detection of histologically confirmed neoplastic and preneoplastic disease while simultaneously decreasing over diagnosis of benign processes. [1]

Liquid-based cytology (LBC), although claimed to provide clearer background and better preservation of nuclear and cytoplasmic details, have yet to be proven to have better sensitivity and specificity for identification of high-grade cervical intraepithelial lesions compared to the conventional smears.[5]

P16 expression, which can be detected immunohistochemically, is directly related to the presence of HPV [8]. Thus, this protein can be used as a biomarker that can add significant diagnostic precision in the assessment of CIN lesions [7, 9].

Add about ancillary technique like use of immunomarker p16 on mlbc.

The aim of this study is establishing that MLBC with p16 immunomarker is very effective in screening for cervical cancer as it overcomes the major setbacks like inadequate sampling, drying artefacts and obscuring blood which are seen in conventional PAP smear technique.

First Page

107

Last Page

144

Conflict of Interest

None

Keywords

PAP smear, Liquid based cytology, P 16, Cervical cancer

Word Count

9048

Recommended Citation

Nair GS, Manoli N, Manoli N. Comparison of Conventional PAP smear and Manual Liquid Based Cytology with P16 marker in screening for cervical cancer in Indian tertiary healthcare setups in Mysuru. Digital Journal of Clinical Medicine. 2022; 4(3): 107-144. doi: https://doi.org/10.55691/2582-3868.1119

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Cover Page Footnote

I would like to express my heartfelt gratitude towards the Professor of Department Of Pathology (my guide for this ICMR STS Project) and Professor of Department of Obstetrics and Gynaecology (Dr. Nandish S Manoli) for guiding me throughout this project. I would also like to thank the Postgraduate students of the Department of Obstetrics and Gynaecology, Dr. Gopika and Dr. Neha for helping me learn the correct technique of sample collection; the technicians of the Department Of Pathology, Mrs. Ushadevi, Mrs. Sulochana, Mrs. Babita, Mr.Vishwanathan , without whom I would not have been able to complete this Project. A special word of thanks to Dr.Prabhu Meganathan from Hybrinomics for his help in IHC study.