Conventional cytology versus liquid based cytology in cervical pathology: correspondences and inconsistencies in diagnosis, advantages and limits.

Liquid Based Cytology (LBC) has replaced Papanicolaou standard cytology due to its practical advantages. Our study aimed to analyze the diagnosis correlations and differences between the conventional and liquid based cytology. The study group has been composed by 104 patients, diagnosed in the Laboratory of Cytology, Galati County Hospital, Romania by using both methods on the same patients group. Our study revealed a good correlation between the results. Thus, in 78 from the total of 104 (75%) analyzed cases, the diagnoses established by conventional smears have been identical to that obtained in LBC. The diagnoses have been different in 26 (25%) cases, the inherent errors of conventional Pap diagnosis being corrected by LBC. LBC resulted in the diagnosis of some entities missed in conventional cytology, namely: ASC-US (atypical squamous cells of undetermined significance) (one case), ASC-US associated to AGC-NOS (atypical glandular cells not otherwise specified) (one case), and HSIL (high-grade squamous intraepithelial lesion) associated to AIS (adenocarcinoma in situ) (one case). LBC provided the identification of a higher number of cases of associated lesions, as LSIL (low-grade squamous intraepithelial lesion) and AGC-NOS (five versus two cases), and HSIL and AGC-NOS (seven versus five cases). The national experience is mainly based on conventional cytology usage, after Papanicolaou staining method. Extremely rare centers have benefited by the necessary infrastructure for LBC, thus there are no constant reports in the mainstream. The main impediments in large-scale application of this method, in all national screening centers are connected to costs for capital investments and by conditions of exploitation. Our experience and results support the simultaneous use of the two methods.