DETECTION OF ABNORMAL CERVICAL CYTOLOGY BY LBC (LIQUID BASED CYTOLOGY)

Abstract

Introduction: Cancer cervix is the fourth most common cancer among women globally. It is responsible for 7.7% of all female cancer death.It takes around 15-20 years in normal immunity patients and 5-10 years in immune-compromised patients to convert precancerous lesions of the cervix into cancer cervix. Cervical cytology plays a very important role in the early diagnosis and management of these precancerous lesions to improve prognosis.quite low Pap smear sensitivity, in the range of 50%, but as low as 20%10 has been reported by some recent meta-analysis studies. LBC was introduced in the mid-1990s as an alternative technique to process cervical smear samples for cytological evaluation.11Studies of the accuracy of liquid-based preparations reports sensitivity of 61-66% and specicity of 82- 91%. A retrospective study was done at a private clinic and pathology lab in Di Materials And Methods: strict Shivpuri (MP) from 1st October 2020to 30th November 2022 on 760 patients. Inclusion criteria:-Patients in the age group of 21-65 years with complaints of abnormal vaginal discharge, intermenstrual bleeding, ostmenopausal bleeding, post-coital bleeding, dyspareunia, foul-smelling discharge, backache, and Lower abdominal pain were included in this study. Sample was taken with Broom, and Cyto-brush from the transformation zone and endocervix and placed in liquid xative buffered methanol solution and send to the pathology lab. Results Most of the patient 42% were between 31-40 years of age group. The majority 48.42% of them were educated up to High school. Most of them 84.07%were from rural back ground, multiparous 86.05%, and married 99.73%. 25% ofwomen visited OPD with complaints of abnormal vaginal discharge followed by menstrual abnormalities in 20.79%, other complaints were, Pain abdomen 16.97%, Vulval itching12.11%, Low back pain 3.95%, Dyspareunia 3.03% and others 5.13%. (Loss of weight and appetite, STD/genital warts) .9.08% women came for routine checkup. The most common nding on per speculum examination was Cervical ectopy in 33.95% .Normal cervix was found in 26.05%. Other ndings on Per-speculum examination were, Hypertrophied cervix, Inammation, Cervical Polyp, UV Prolapse/ cystocele, Cervical Ulcer ,Cervix ushed with the vagina and Cervical growth in. 20%, 9.08%, 4.34% 4.61% 3.03% 0.13% and 0.13% respectively. Out of 760 cases, 61.05% of patients were reported as negative for intraepithelial lesion (NILM). The most common non-neoplastic cytological nding was an inammatory smear in 25.00% of cases. Various Infections were found in 6.18% of cases, and epithelial cell abnormalities were found in 3.42% of cases. The most common abnormalities were ASC-US 0.92% and ASC-H 0.92%, followed by LSIL 0.53%, HSIL 0.66%, AGUS 0.26%, and SCC 0.13%. Bacterial vaginosis 2.37% was the most common infective organism found in cytology followed by Candida albicans 1.97%, Trichomonas vaginalis 1.71%, and Herpes simplex virus 0.13%. The cytology-based screening program is still the mainstay in the earl Conclusion y diagnosis of cancer cervix. To improve diagnostic accuracy as sensitivity and specicity in the eld of cervical cytology, Liquid-based cytology (LBC) is preferred. Its advantages over conventional Pap smears include proper visualization of cellular features due to a reduction in air-drying artifacts and reduced number of unsatisfactory smears. The residual specimens from the LBC technique can be used to detect human papillomavirus DNA through immune-cytochemistry if needed. thus, LBC is recommended as a cervical cytology screening tool to achieve the WHO elimination strategy.