DOI QR코드

DOI QR Code

Performance of Siriraj Liquid-Based Cytology: a Single Center Report Concerning over 100,000 Samples

  • Sangkarat, Suthi (Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University) ;
  • Laiwejpithaya, Somsak (Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University) ;
  • Rattanachaiyanont, Manee (Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University) ;
  • Chaopotong, Pattama (Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University) ;
  • Benjapibal, Mongkol (Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University) ;
  • Wongtiraporn, Weerasak (Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University) ;
  • Laiwejpithaya, Sujera (Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University)
  • Published : 2014.03.01

Abstract

Background: To evaluate the performance of Siriraj liquid-based cytology (LBC) for cervical neoplasia screening after increasing use of this technology. Materials and Methods: Cytological reports of 103,057 Siriraj-LBC specimens obtained in 2007-2009 were compared with those of 23,676 specimens obtained in 2006. Results: Comparing with the year 2006, the 2007-2009 patients were slightly older ($43.4{\pm}12.yr$ vs $42.7{\pm}12.2yr$, p <0.001), and their specimens had much lower proportion of unsatisfactory slides (OR=0.06, 95%CI 0.04-0.09) with comparable detection rates (3.96% vs 3.70%, p=0.052) but different proportions of various cytological abnormalities (p<0.001). The 2007-2009 Siriraj-LBC had a negative predictive value (NPV) for cervical intraepithelial neoplasia 2+ (CIN2+) of 97.6% and an overall positive predictive value (PPV) of 43.9%. The PPV for CIN2+ varied with types of abnormal cytology, from 13.7% to 93.8% in atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), atypical squamous cells cannot exclude HSIL (ASC-H), high-grade squamous intraepithelial lesion (HSIL), atypical glandular cells (AGC), to squamous cell carcinoma (SCC), respectively. The PPVs for CIN2+ in ASCUS and LSIL were comparable, but the PPV for CIN1 was higher for LSIL than for ASCUS (41.63% vs 16.32%). Conclusions: Siriraj-LBC has demonstrated a stable detection rate and NPV for CIN2+ of >95% since the first year of use. The comparable PPVs for CIN2+ of ASCUS and LSIL suggests that these two conditions may undergo similar management; other cytological abnormalities need immediate evaluation.

References

  1. Papillo JL, Zarka MA, St John TL (1998). Evaluation of the ThinPrep Pap test in clinical practice. A seven-month, 16,314-case experience in northern Vermont. Acta Cytol, 42, 203-8. https://doi.org/10.1159/000331547
  2. Wright TC, Kurman RJ, Ferenczy A (2002). Precancerous lesions of the cervix. In 'Blaustein's Pathology of the Female Genital Tract, 5th ed', Ed RJ K. New York, Springer Verlag, 253-324.
  3. Fremont-Smith M, Marino J, Griffin B, et al (2004). Comparison of the SurePath liquid-based Papanicolaou smear with the conventional Papanicolaou smear in a multisite direct-to-vial study. Cancer, 102, 269-79. https://doi.org/10.1002/cncr.20599
  4. Laiwejpithaya S, Rattanachaiyanont M, Benjapibal M, et al (2008). Comparison between Siriraj liquid-based and conventional cytology for detection of abnormal cervicovaginal smears: a split-sample study. Asian Pac J Cancer Prev, 9, 575-80.
  5. Laiwejpithaya S, Benjapibal M, Wongtiraporn W, et al (2009). Performance and cost analysis of Siriraj liquid-based cytology: a direct-to-vial study. Eur J Obstet Gynecol Reprod Biol, 147, 201-5. https://doi.org/10.1016/j.ejogrb.2009.08.002
  6. Lee KR, Ashfaq R, Birdsong GG, et al (1997). Comparison of conventional Papanicolaou smears and a fluid-based, thinlayer system for cervical cancer screening. Obstet Gynecol, 90, 278-84. https://doi.org/10.1016/S0029-7844(97)00228-7
  7. Nandini NM, Nandish SM, Pallavi P, et al (2012). Manual liquid based cytology in primary screening for cervical cancer - a cost effective preposition for scarce resource settings. Asian Pac J Cancer Prev, 13, 3645-5. https://doi.org/10.7314/APJCP.2012.13.8.3645
  8. Ruengkhachorn I, Laiwejpithaya S, Leelaphatanadit C, et al (2012). Clinicopathologic importance of women with squamous cell carcinoma cytology on Siriraj liquid-based cervical cytology. Asian Pac J Cancer Prev, 13, 4567-70. https://doi.org/10.7314/APJCP.2012.13.9.4567
  9. Solomon D, Davey D, Kurman R, et al (2002). The 2001 Bethesda System: terminology for reporting results of cervical cytology. JAMA, 287, 2114-9. https://doi.org/10.1001/jama.287.16.2114
  10. World Health Organization (2012) GLOBOCAN 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012.
  11. Canda MT, Demir N, Sezer O, et al (2009). Clinical results of the liquid-based cervical cytology tool, Liqui-PREP, in comparison with conventional smears for detection of squamous cell abnormalities. Asian Pac J Cancer Prev, 10, 399-402.
  12. Bales CE (2006). Laboratory techniques. In 'Koss' diagnostic cytology and its histopathologic bases 5th ed', Eds Koss LG and Melamed MR. Philadelphia, Lippincott William & Wilkins, p. 569-622.
  13. Beerman H, van Dorst EB, Kuenen-Boumeester V, et al (2009). Superior performance of liquid-based versus conventional cytology in a population-based cervical cancer screening program. Gynecol Oncol, 112, 572-6. https://doi.org/10.1016/j.ygyno.2008.12.012
  14. Bishop JW, Bigner SH, Colgan TJ, et al (1998). Multicenter masked evaluation of AutoCyte PREP thin layers with matched conventional smears. Including initial biopsy results. Acta Cytol, 42, 189-97. https://doi.org/10.1159/000331545
  15. Castle PE, Bulten J, Confortini M, et al (2010). Age-specific patterns of unsatisfactory results for conventional Pap smears and liquid-based cytology: data from two randomised clinical trials. BJOG, 117, 1067-73. https://doi.org/10.1111/j.1471-0528.2010.02650.x
  16. Davey DD, Naryshkin S, Nielsen ML, et al (1994). Atypical squamous cells of undetermined significance: interlaboratory comparison and quality assurance monitors. Diagn Cytopathol, 11, 390-6. https://doi.org/10.1002/dc.2840110416
  17. Diaz-Rosario LA, Kabawat SE (1999). Performance of a fluidbased, thin-layer papanicolaou smear method in the clinical setting of an independent laboratory and an outpatient screening population in New England. Arch Pathol Lab Med, 123, 817-21.
  18. Dupree WB, Suprun HZ, Beckwith DG, et al (1998). The promise and risk of a new technology: The Lehigh Valley Hospital's experience with liquid-based cervical cytology. Cancer, 84, 202-7. https://doi.org/10.1002/(SICI)1097-0142(19980825)84:4<202::AID-CNCR4>3.0.CO;2-O
  19. Abulafia O, Pezzullo JC, Sherer DM (2003). Performance of ThinPrep liquid-based cervical cytology in comparison with conventionally prepared Papanicolaou smears: a quantitative survey. Gynecol Oncol, 90, 137-44. https://doi.org/10.1016/S0090-8258(03)00176-8

Cited by

  1. Clinical Significance of Atypical Squamous Cells of Undetermined Significance in Detecting Preinvasive Cervical Lesions in Post-Menopausal Turkish Women vol.15, pp.16, 2014, https://doi.org/10.7314/APJCP.2014.15.16.6639
  2. Comparison of Siriraj liquid-based solution and standard transport media for the detection of high-risk human papillomavirus in cervical specimens vol.90, pp.12, 2018, https://doi.org/10.1002/jmv.25259