Perspectives In Medical Research (Dec 2019)
ASSESSMENT OF PAP SMEAR QUALITY BY AYRE'S SPATULA VERSUS AYRE'S SPATULA PLUS CYTOBRUSH COMBINATION - ANALYSISINATERTIARY CARE HOSPITAL
Abstract
Background: Papanicolaou (Pap) smear is a very important screening tool for cervical cancer. The challenge for Pap smear is a high rate of false-negative results. Of the several factors compounding this problem the most important one is the incorrect sampling method and sampling tool limitations. We in the present study tried to evaluate the quality of Pap smear samples obtained by two methods Ayres Spatula and Ayres spatula plus cytobrush combination. Methods: This cross-sectional study was conducted in the Department of Obstetrics and gynecology, Prathima Institute of Medical Sciences, Nagunoor, Karimnagar. The patients were selected from those who were attending the OPD of the Department of gynecology. A total of n=155 women who were sexually active in reproductive age or menopausal were included in the study. Two samples were taken first using Ayres spatula and then the cytobrush. Results: With cytobrush and Ayres spatula n=135(87.09%) of smear were satisfactory compared to the n=98(63.22%) with Ayres spatula alone the p values were found the <0.01 which is considered as significant. Inadequate smear quality due to absent endocervical cells was found in n=12 (7.74%) of the combination and n=80(51.61%) in Ayres spatula alone the p values were also found to be significant. Blood obscuring the slide was found in n=1(0.64%) of spatula and n=3(1.93%) of the combinationA comparison of cytological results by two methods showed n=1(0.6%) of spatula smear versus n=2(1.29%) of combined cytobrush-spatula smears showed atypical squamous cells of undetermined significance. Low-grade Squamous Intraepithelial Lesions were found in n=3(1.93%) of spatula versus n=10(6.45%) of combined smears. High - grade Squamous Intraepithelial Lesions were found in n=1(0.6%) of spatula smear versus n=3(1.93%) of the combined smear Conclusion: that the ability of Ayres spatula and cytobrush combination was more effective in obtaining adequate specimens and it has a better ability to obtain the endocervical cells. The added advantage of the cervical brush is it could be easily used in postmenopausal women who tend to have stenoticos. Therefore this method must be used for screening programs
