Liquid-based cytology provides higher diagnostic accuracy than conventional Papanicolaou smears in uterine cervical cytology

Abstract

Background and aims: The objective of this study was to evaluate diagnostic accuracy and cytomorphological quality of MonoPrep2 (MP) (a manual liquid-based cytology preparation system) in comparison with the conventional Papanicolaou smear (CP) in cervical cancer screening. Methods: Six departments of pathology in university hospitals, and one pathology laboratory center, in Korea were included in the study. Retrospective analysis of 795 patients in whom CP, MP or both CP and MP with cervical biopsy had been performed was undertaken. A total of 33 cases were unsatisfactory for evaluation. A total of 933 cervical specimens (290 CP, 301 MP, and 171 CP & MP) were enrolled. Among of them, 461 cases of CP and 472 cases of MP were correlated with histopathological diagnoses. Results: Diagnostic accuracy by MP was greater than CP in all parameters including sensitivity (92.7% versus 90.2%), specificity (87.2% versus 66.2%), positive likelihood ratio (7.23 versus 2.67) and negative likelihood ratio (0.08 versus 0.15). There was marked decrease in the ratio of atypical squamous cells of undetermined significance to low-grade squamous intraepithelial lesions. Conclusions: MP provides higher diagnostic accuracy when compared with CP. MP is an easy and economic preparation with high-quality results, making the technique useful in primary screening for cervical cytology.