The study aimed to pilot the modern approach to cervical cancer screening program, which means: a) the application of liquid based cytology, and b) human papillomavirus (HPV) genotyping.
1500 cervical cytology samples and 1800 blood samples have been analyzed in country of Georgia. The cytology samples had been collected and processed by the usage of materials and equipment provided by Hologic. Prepared smears were post-fixed in 96% ethanol and stained accordingly with Papanicolau protocol. The Bethesda 2001 system terminology was employed for reporting and diagnoses of cervical smears. The blood samples have been collected and processed by the usage of reagents provided by Norgen Biotek for the aim to reveal and genotype HPV. The polymerase chain reaction has been performed.
The negative for intraepithelial lesion or malignancy (NILM) category was equal to 1341 cases (89.40%). Other categories in decreasing order were atypical squamous cells of undetermined significance (ASCUS) with 120 cases (8.00%), low grade squamous intraepithelial lesion (L-SIL) with 9 cases (0.60%), high grade squamous intraepithelial lesion (H-SIL) with 2 cases (0.13%), atypical squamous cells, cannot exclude high grade intraepithelial lesion (ASC-H) with 24 case (1.6%) and atypical glandular cells of undetermined significance (AGUS) with 4 case (0.27%). Cellularity was lower in liquid based cytology (LBC) as compared with conventional smears (CS). Also, nuclear overlap was significantly less observed compared to CS. The smear background was notably cleaner and cell morphology was better evaluated in LBC. In terms of Trichomonas and Candida detection, LBC was superior compared to CS. Doderlein lactobacilli were seen in significantly lesser amounts and were mainly situated in close vicinity to the squamous epithelial cells. Due to lack of pretreatment, the degree of inflammation was better assessed in CS.
The prevalence of HPV DNA has been observed in 586 cases (32.56%). In 320 cases (54.61%) have been determined oncogenic (16/18/31/33/53) HPV.
Our experience shows that LBC is superior to CS in the evaluation of cell morphology and detection of certain microorganisms such as Trichomonas and Candida. The degree of inflammation is better assessed with CS. CISH is effective and easy for implementation method for HPV genotyping on cervical smears. There has been revealed that HPV genotyping is the effective and accurate screening method.
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