Comparison of Efficacy in Abnormal Cervical Cell Detection between Liquid-based Cytology and Conventional Cytology

  • Tanabodee, Jitraporn (Chonburi Cancer Hospital) ;
  • Thepsuwan, Kitisak (Chonburi Cancer Hospital) ;
  • Karalak, Anant (Department of Pathology, National Cancer Institute) ;
  • Laoaree, Orawan (Chonburi Cancer Hospital) ;
  • Krachang, Anong (Chonburi Cancer Hospital) ;
  • Manmatt, Kittipong (Chonburi Cancer Hospital) ;
  • Anontwatanawong, Nualpan (Chonburi Cancer Hospital)
  • Published : 2015.11.04


This study was conducted to 1206 women who had cervical cancer screening at Chonburi Cancer Hospital. The spilt-sample study aimed to compare the efficacy of abnormal cervical cells detection between liquid-based cytology (LBC) and conventional cytology (CC). The collection of cervical cells was performed by broom and directly smeared on a glass slide for CC then the rest of specimen was prepared for LBC. All slides were evaluated and classified by The Bethesda System. The results of the two cytological tests were compared to the gold standard. The LBC smear significantly decreased inflammatory cell and thick smear on slides. These two techniques were not difference in detection rate of abnormal cytology and had high cytological diagnostic agreement of 95.7%. The histologic diagnosis of cervical tissue was used as the gold standard in 103 cases. Sensitivity, specificity, positive predictive value, negative predictive value, false positive, false negative and accuracy of LBC at ASC-US cut off were 81.4, 75.0, 70.0, 84.9, 25.0, 18.6 and 77.7%, respectively. CC had higher false positive and false negative than LBC. LBC had shown higher sensitivity, specificity, PPV, NPV and accuracy than CC but no statistical significance. In conclusion, LBC method can improve specimen quality, more sensitive, specific and accurate at ASC-US cut off and as effective as CC in detecting cervical epithelial cell abnormalities.


Liquid-based cytology;conventional cytology;accuracy;sensitivity;specificity


  1. Arbyn M, Bergeron C, Klinkhamer P, et al (2008). Liquid compared with conventional cervical cytology: a systemic review and meta-analysis. Obstet Gynecol, 111, 167-77.
  2. Arunratsamee P, Siwadune T (2012). Comparison of diagnostic efficacy between cytoneph liquid-based cytology and conventional pap smear cytology in colposcopic clinic at chonburi hospital. Thai J Obstet Gynaecol, 20, 41-7.
  3. Austin RM, Ramzy I (1998). Increased detection of epithelial cell abnormalities by liquid-based gynecologic cytology preparations: A review of accumulated data. Acta Cytol, 42, 178-84.
  4. Bishop JW, Bigner SH, Colgan TJ, et al (1998). Multicenter masked evaluate of AutoCyte PREP thin layers with matched conventional smear. Including Initial biopsy results. Acta Cytol, 42, 189-97.
  5. Corkill M, Knapp D, Hutchinson ML (1998). Improved accuracy for cervical cytology with the ThinPrep method and the endocervical brush-spatula collection procedure. J Lower Genital Tract Dis, 2, 12-6.
  6. 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.
  7. Khuhaprema T, Attasara P, Sriplung H, et al (2013). Cancer in Thailand 2007-2009. Bangkok, Thailand: National Cancer Institute, 47-50.
  8. Laiwejpithaya S, Rattanachaiyanont M, Benjapibal M, et al (2008). Comparison between Siriraj liquid-based and conventional cytology for detection of abnormal cervicovaginal smear: a split-sample study. Asian Pac J Cancer Prev, 9, 575-80.
  9. Nanda K, McCrory DC, Myers ER, et al (2000). Accuracy of the Papanicolaou test in screening for and follow-up of cervical cytologic abnormalities: a systemic review. Ann Intern Med, 132, 810-9.
  10. Park IA, Lee SN, Chae SW, et al (2001). Comparing the accuracy of thinprep pap tests and conventional papanicolaou smears on the basis of the histologic diagnosis: a clinical study of women with cervical abnormalities. Acta Cytol, 45, 525-31.
  11. Roberts JM, Gurley AM, Thurloe JK, et al (1997). Evaluation of the ThinPrep Pap test as an adjunct to the conventional Pap smear. Med J Aust, 167, 466-9.
  12. Sieber AG, Klinkhamer PJ, Arbyn M, et al (2008). Cytologic detection of cervical abnormalities using liquid-based compared with conventional cytology:a randomized controlled trial. Obstet Gynecol, 112, 1327-34.
  13. Weintraub J, Morabia A (2000). Efficacy of a liquid-based thin layer method for cervical cancer screening in a population with a low incidence of cervical cancer. Diagn Cytopathol, 22, 52-9.<52::AID-DC14>3.0.CO;2-#