The incidence of cervical cancer (CC) varies greatly with a large difference between developing and developed countries, where CC cases have been significantly reduced since the implementation of effective screening programmes. .1.Exfoliative cervicovaginal cytology has been regarded as the gold standard for cervical cancer screening programs limitations are Incorrect and inadequate sampling in 5-10% of cases2 Manual Liquid Based Cytology (MLBC) is a technique that enables cells to be suspended in a monolayer and thus improves detection of precursor lesions and specimen adequacy.. the residual sample can be used for other tests like detection of HPV, DNA and immunocyto chemistry Cell blocks can be prepared from all types of cytological specimens, .with advantage of cell blocks is that many slides can be prepared for extensive panels of immunostains.4 Overexpression of p16INK4a in almost all cervical precancer has been shown to be directly linked to the transforming activity of E7 oncoprotein, which is produced by HPV. Cellular accumulation of p16INK4a 1Our current PCR set-up gives rapid, type-specific HPV detection with a turnaround time of less than 24 hrs and cost-effectiveness compare to commercial available alternatives.4,5
Samplesfrom examined patients were collected using the direct to vial technique from 75 patients in the age group of 20 to 60.cervex brush was used to scrape the cervix. were done for collecting samples for hpv testing and cell block processing in separate vials containing 5ml of the fixative and centrifuged at 2000 rpm for 5 minutes. The supernatant was decanted and 1-2 ml of polymer solution was added, . The cell blocks studied were lesser than the liquid based cytology cases.)using equal amount of cell block fixative(10% formalin and 95%alcohol) and to compare it with conventional pap smears In the present study p16 markers were done on cell block preparation.DNA was extracted from 50 LBC samples using the manual Phenol IsoChloroform method.
conventional pap smear(CPS)vs cell block (C B))is 75casesVS 50
NILM vs Chronic cervicitis (47/36), LSIL (3/1), HSIL (2/1), SCC (3/3), infections (7/7), Koilocytic atypia (1/1), AGUS (1/1), Unsatisfactory on CPS vs No deposit on CB (5+6/25).
Histopathological correlation was available for 25 cases . Out of which 22 being chronic cervicitis and 3 neoplastic which correlated with cell block diagnosis.
The results for hpv dna testing done for 50 cases showed 5 cases positive for hpv . 4 cases were low risk hpv while one case was high risk hpv dna 16.
MLBC is an useful costeffective method for early detection of cervical cancer in resource poor settings.
1Rosa Catarino, Patrick Petignat, Gabriel Dongui, Pierre Vassilakos Cervical cancer screening in developing countries at a crossroad: Emerging technologies and policy choices World J Clin Oncol; 6: 281-290, 2015
2 Rajendra A Kerkar, Yogesh V Kulkarni Screening for cervical cancer : an overview. J Obstet Gynecol India. 56, 115-122, 2006
3 Lynette Denny , Michael Quinn , R. Sankaranarayanan Screening for cervical cancer in developing countries. Vaccine 24S3 S3/71–S3/77, 2006
4 Nandini N. Manoli, Nandish S. Manoli, Lopamudra Kakoti, Akshata Kamath, Shweta Kulkarni. Manual Liquid Based Cytology in Diagnosis of Gynecologic Pathology. Cancer Research Journal
4: 58-68, 2016
5 Pairoj Junyangdikul , Watcharaporn Tanchotsrinon, Jira Chansaenroj Human Papillomavirus Detection by Hybrid Capture 2 for Clinical Prediction. Asian Pacific Journal Cancer Prevention, 2013:14 (2), 903-907
6Joan Murphy, Erin B. Kennedy, Sheila Dunn, et al. HPV Testing in Primary Cervical Screening:
A Systematic Review and Meta-Analysis. Journal of Obstetrics andGynaecology.;34(5):443–452.2012