Pamela Michelow1, Amanda Sherrin1, Louise Rossouw1, Samson Mohaleamolla1, Denise Evans2, Avril Swarts3, Ntombiyenkosi Rakhombe4, Jennifer S Smith5,6, Cynthia Firnhaber3,4. 1. Department of Anatomical Pathology, University of the Witwatersrand and National Health Laboratory Service, Johannesburg, South Africa. 2. Department of Internal Medicine, University of the Witwatersrand, Johannesburg, South Africa. 3. Department of Medicine, University of the Witwatersrand, Johannesburg, South Africa. 4. Right to Care, Helen Joseph Hospital, Johannesburg, South Africa. 5. Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, United States. 6. Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, United States.
Abstract
BACKGROUND: Many women undergoing cervical screening as part of a national South African screening programme may be positive for HIV. The performance of liquid-based cytology (LBC) on samples from HIV-positive women needs to be determined. OBJECTIVES: The performance of the Cellslide® automated LBC system was evaluated as a possible alternative to conventional cytology in a national cervical cancer screening programme. METHODS: Split samples from 348 HIV-positive women attending an HIV treatment clinic in Johannesburg, South Africa were examined by conventional cytology and monolayer LBC methods. All samples were stained, examined and reported in the same manner. Cytotechnologists were blinded to the conventional smear diagnosis if the LBC smear was screened and vice versa. RESULTS: The same percentage of inadequate smears (1.4%) was obtained by conventional cytology and LBC. Atypical squamous cells of undetermined significance were observed in 5.2% of conventional smears and 4.0% of LBC smears. Low-grade squamous intraepithelial lesions were found in 35.6% of conventional smears and 32.7% of LBC smears. Only one conventional smear was categorised as atypical squamous cells - cannot exclude a high-grade lesion, whereas five such cases were identified on LBC. High-grade squamous intraepithelial lesions were seen in 21.6% of conventional smears and 23.3% LBC smears. No invasive carcinoma was identified. CONCLUSION: The performance of the Cellslide® LBC system was similar to that of conventional cytology in this population of high-risk HIV-positive women, indicating that it may be introduced successfully as part of a cervical cancer screening programme.
BACKGROUND: Many women undergoing cervical screening as part of a national South African screening programme may be positive for HIV. The performance of liquid-based cytology (LBC) on samples from HIV-positive women needs to be determined. OBJECTIVES: The performance of the Cellslide® automated LBC system was evaluated as a possible alternative to conventional cytology in a national cervical cancer screening programme. METHODS: Split samples from 348 HIV-positive women attending an HIV treatment clinic in Johannesburg, South Africa were examined by conventional cytology and monolayer LBC methods. All samples were stained, examined and reported in the same manner. Cytotechnologists were blinded to the conventional smear diagnosis if the LBC smear was screened and vice versa. RESULTS: The same percentage of inadequate smears (1.4%) was obtained by conventional cytology and LBC. Atypical squamous cells of undetermined significance were observed in 5.2% of conventional smears and 4.0% of LBC smears. Low-grade squamous intraepithelial lesions were found in 35.6% of conventional smears and 32.7% of LBC smears. Only one conventional smear was categorised as atypical squamous cells - cannot exclude a high-grade lesion, whereas five such cases were identified on LBC. High-grade squamous intraepithelial lesions were seen in 21.6% of conventional smears and 23.3% LBC smears. No invasive carcinoma was identified. CONCLUSION: The performance of the Cellslide® LBC system was similar to that of conventional cytology in this population of high-risk HIV-positive women, indicating that it may be introduced successfully as part of a cervical cancer screening programme.
Authors: Esther W de Bekker-Grob; Inge M C M de Kok; Johan Bulten; Joost van Rosmalen; Judith E M Vedder; Marc Arbyn; Paul J J M Klinkhamer; Albertus G Siebers; Marjolein van Ballegooijen Journal: Cancer Causes Control Date: 2012-06-17 Impact factor: 2.506
Authors: V Cocchi; D Carretti; S Fanti; P Baldazzi; M T Casotti; R Piazzi; L Prosperi; A M Morselli-Labate Journal: Diagn Cytopathol Date: 1997-01 Impact factor: 1.582
Authors: Cynthia Firnhaber; Nomtha Mayisela; Lu Mao; Sophie Williams; Avril Swarts; Mark Faesen; Simon Levin; Pam Michelow; Tanvier Omar; Michael G Hudgens; Anna-Lise Williamson; Bruce Allan; David A Lewis; Jennifer S Smith Journal: PLoS One Date: 2013-01-11 Impact factor: 3.240