Comparative Study of Modified Ultrafast Papanicolaou and Standard Papanicolaou Staining Technique for the Assessment of Cervical Smears

Abstract

Introduction: Cervical invasive carcinoma is one of the most frequent cancers in the world, and it can be prevented with screening. The papanicolaou (Pap) smear is the most common screening procedure. Pap staining, as it is now done, is costly, requires a large amount of alcohol, and takes a long time. Materials and Methods: A total of 170 patients were recruited. One hundred and sixty-six patients, considering eligibility criteria, undergoing Pap smear test. Eligibility criteria: Age: 18–49 years females, who did not have a total hysterectomy done, who consented to participate in the study. Each patient had two smears taken on glass slides. Standard Pap smears were fixed for at least 15 min in 95% ethanol. The other smear was air-dried before being fixed with alcohol formalin and stained with modified ultrafast Pap (MUFP) stain. A comparison of two different techniques was made on the basis of cytomorphological features. Results: In studied smears, a clean background was seen in 18.24% and 14.12% of the cases in Pap stain and MUFP, respectively. Kappa analysis found a good correlation between Pap stain and MUFP (kappa: 0.81, P < 0.01). Crisp chromatin was seen in 89.41% and 67.65% of MUFP and Pap staining, respectively. About 88.82% of MUFP stains showed optimal cytoplasmic details and the same was revealed by 81.18% of Pap stains. MUFP has a better quality index (QI) as compared to Pap staining as no case in MUFP had QI of < 0.80 with a statistically significant difference as P < 0.05. Conclusion: MUFP is a simple, user-friendly, affordable, and less time-consuming alternative in low-resource areas in comparison to the traditional technique for mass cervical cancer screening.