Comparison of Diagnostic Efficacy between Cytoneph®Liquid-based Cytology and Conventional Pap Smear Cytology in Colposcopic Clinic at Chonburi Hospital

Abstract

Objective: This study propose to compare diagnostic efficacy of cervical cytology using conventional Pap test(CP) and Liquid-based Cytology(LBC) in the high prevalence setting.Design Diagnostic test.Methods:250 women with abnormal Pap smear were enrolled for cervical biopsy under colposcopy. The volunteers were randomized by computer calculation sequences. The options were put in the blinded paired numbers in seal envelope. They were performed CP and LBC then both specimens were labeled only number and were separatly sent to cytopathologist for evaluation. The correlation between cytology results and tissue diagnosis was analyzed to compare accuracy, sensitivity and specificity.Results:The specificity was higher in LBC (37.7% vs. 56.7%) when an atypical squamous cell of undetermined significance (ASC-US) is cut-off. There was a trend toward more accuracy for LBC (70.7% vs. 76.4% p = 0.187), sensitivity was 90.4% vs. 87.5% (95%CI 83.2 -95.3% vs. 79.6 - 93.2%) for LBC and CP respectively, but no statistic significance. Unsatisfied smear found in 2 (0.8%) and 5 (2%) (p= 0.45) by CP and LBC respectively and ASC-US rate has slight decrease with LBC (10% vs. 8% p=0.53). When subgroup analyzed only test that performed first we still cannot detect superior of LBC over CP.Conclusion:In this our high prevalence setting, the LBC has shown higher specificity. No significant difference in unsatisfactory and ASC-US rate. Larger studies and cost-effective analysis of this test in our country are necessary.

Keywords

• Liquid-base cytology
• Pap smear
• cervical cytology
• accuracy
• Cytoneph