Comparasion of Pap test reporting rates in conventional smear and liquid-based cytology

doi:10.3877/cma.j.issn.2095-5820.2017.02.008

Abstract

Abstract:

Objective

To compare the reporting rates in conventional Pap smears (CPS) and liquid-based cytology (LBC), and to show the efficiency of the two methods in the cervical screening.

Methods

From 2008 to 2015, 100 066 cases of CPS and 997 162 cases of LBC were obtained from more than 900 hospitals and medical centers in Shandong province, and sent to the department of pathology, Jinan Kingmed Diagnostics for Pap staining and cytological diagnosis. The Pap reports and histopathologic follow-up results were retrospectively analyzed.

Results

The positive results reported with in CPS and LBC were similar in 2008 and 2009, and this might be due to the small sample size of CPS. The total reporting rates of LBC in 2010, 2011, 2012, 2013, 2014 and 2015 were 1.6, 2.66, 2.47, 2.72, 2.52 and 1.63 times higher than those of CPS, respectively (χ²=8.32, 128.02, 131.43, 525.88, 578.59, 209.82, all P<0.01). Comparison among the average ages of different cytologically interpretated lesions demonstrated obvious differences (F=193.28, P<0.001). Post hoc analysis showed that the average age of the patient with high grade squamous intraepithelial lesions (HSIL) was 3.9 years older than that with low-grade squamous intraepithelial lesions (LSIL) (P<0.05), and the average age of the patient suffer cervical cancer was 8.2 years older than that with LSIL (P<0.05), and 4.3 years older than that with HSIL (P<0.05). Except for the cancer cases, the rates of atypical squamous cells of unknown significance (ASC-US), atypical squamous cells that cannot exclude HSIL (ASC-H), LSIL, HSIL, atypical glandular cells (AGC) and the total positive rate of LBC were 2.0, 1.6, 2.9, 2.9, 5.0, 2.2 times higher than those of CPS, respectively (χ²=784.82, 33.01, 447.28, 217.66, 3.79, 26.3, P<0.001). The ASC/SIL ratio of CPS and LBC were 3.16, 2.14, respectively. The distribution of ASC and SIL was significantly different when using the two methods (χ²=60.91, P<0.001). Histopathologic CINⅡ, CINⅢ and invasive cervical carcinoma were diagnosed in 57.22%(103/180)、84.70%(393/464) and 100%(17/17) of the patients with cytologic interpretation of ASC-H, HSIL and carcinoma, respectively. No follow-up histopathologic diagnosis was documented in cytology-abnormal patients with CPS test.

Conclusions

The present study show that the Pap reporting rates of LBC are much higher than those of CPS. LBC method should be the first choice for cervical cancer screening.

Key words: Cervical cancer, Liquid-based cytology, Conventional Pap smears, Screening

Liran Zhang, Fengxiang Xie, Xinguo Wang, Dezhi Peng, Chunrui Bi, Dongman Zhao, Xin Zhang, Botao Fan, Xin Li, Debo Qi. Comparasion of Pap test reporting rates in conventional smear and liquid-based cytology[J]. Chinese Journal of Clinical Laboratory Management(Electronic Edition), 2017, 05(02): 98-102.

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References 20

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年份	CPS			LBC			χ ²值	P值
年份	例数	阳性例数	阳性率(%)	例数	阳性例数	阳性率(%)	χ ²值	P值
2008	192	7	3.65	8 253	334	4.08	0.078	0.78
2009	209	7	3.35	25 128	795	3.31	0.023	0.879
2010	3 362	47	1.40	43 319	925	2.24	8.32	0.004
2011	10 193	133	1.31	52 315	1 789	3.49	128.02	<0.001
2012	10 039	158	1.57	73 157	2 806	3.88	131.43	<0.001
2013	22 029	496	2.30	130 471	7 912	6.26	525.88	<0.001
2014	28 626	614	2.19	236 697	12 914	5.52	578.59	<0.001
2015	25 416	838	3.33	427 822	23 045	5.42	209.82	<0.001
总计	100 066	2 300	2.30	997 162	50 520	5.07	1 520.48	<0.001

年份	CPS			LBC			χ ²值	P值
年份	例数	阳性例数	阳性率(%)	例数	阳性例数	阳性率(%)	χ ²值	P值
2008	192	7	3.65	8 253	334	4.08	0.078	0.78
2009	209	7	3.35	25 128	795	3.31	0.023	0.879
2010	3 362	47	1.40	43 319	925	2.24	8.32	0.004
2011	10 193	133	1.31	52 315	1 789	3.49	128.02	<0.001
2012	10 039	158	1.57	73 157	2 806	3.88	131.43	<0.001
2013	22 029	496	2.30	130 471	7 912	6.26	525.88	<0.001
2014	28 626	614	2.19	236 697	12 914	5.52	578.59	<0.001
2015	25 416	838	3.33	427 822	23 045	5.42	209.82	<0.001
总计	100 066	2 300	2.30	997 162	50 520	5.07	1 520.48	<0.001

细胞学判读	CPS		LBC		合计
细胞学判读	例数	平均年龄	例数	平均年龄	例数	平均年龄
ASC-US	1 585	43.6±11.5	31 677	43.0±10.2	33 262	43.0±10.2
ASC-H	151	47.1±11.4^d	2 424	45.4±10.7^d	2 575	45.4±10.8^d
LSIL	364	39.5±10.2	10 575	40.4±9.9	10 939	40.3±9.9
HSIL	180	45.9±9.9^a	5 202	44.2±9.3^a	5 382	44.2±9.3^a
AGC	6	40.4±9.3	132	42.4±9.6	138	41.2±9.3
SCC	14	52.5±9.4^b	510	48.2±9.6^bc	524	48.5±9.6^bc
总计	2 300	43.3±11.3	50 520	42.7±10.1	52 820	42.6±10.2

细胞学判读	CPS		LBC		合计
细胞学判读	例数	平均年龄	例数	平均年龄	例数	平均年龄
ASC-US	1 585	43.6±11.5	31 677	43.0±10.2	33 262	43.0±10.2
ASC-H	151	47.1±11.4^d	2 424	45.4±10.7^d	2 575	45.4±10.8^d
LSIL	364	39.5±10.2	10 575	40.4±9.9	10 939	40.3±9.9
HSIL	180	45.9±9.9^a	5 202	44.2±9.3^a	5 382	44.2±9.3^a
AGC	6	40.4±9.3	132	42.4±9.6	138	41.2±9.3
SCC	14	52.5±9.4^b	510	48.2±9.6^bc	524	48.5±9.6^bc
总计	2 300	43.3±11.3	50 520	42.7±10.1	52 820	42.6±10.2

细胞学判读	CPS		LBC		χ ²值	P值
细胞学判读	例数	阳性率(%)	例数	阳性率(%)	χ ²值	P值
ASC-US	1 585	1.58	31 677	3.18	784.82	<0.001
ASC-H	151	0.15	2 424	0.24	33.01	<0.001
LSIL	364	0.36	10 575	1.06	447.28	<0.001
HSIL	180	0.18	5 202	0.52	217.66	<0.001
癌	6	0.01	132	0.01	3.79	0.051
AGC	14	0.01	510	0.05	26.3	<0.001
总计	2 300	2.3	50 520	5.07	1520.48	<0.001

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