Liquid-based cytology screening in Gynecologic oncology

Authors

  • K Lakshmi Chettinad School of Pharmaceutical Sciences, Chettinad Hospital and Research Institute (CHRI), Chettinad Academy of Research and Education (CARE), Kelambakkam-603103, Tamilnadu, India.
  • R Balaji Research and Development, Regenix Drugs Limited, Chennai - 600094, Tamilnadu, India.
  • A Ramamurthy Research and Development, Regenix Drugs Limited, Chennai - 600094, Tamilnadu, India.
  • Senthil Devi Research and Development, Regenix Drugs Limited, Chennai - 600094, Tamilnadu, India.
  • V Jayakumar Chettinad School of Pharmaceutical Sciences, Chettinad Hospital and Research Institute (CHRI), Chettinad Academy of Research and Education (CARE), Kelambakkam-603103, Tamilnadu, India.
  • K Vijayalakshmi Department of Obstetrics and Gynaecology, Chettinad Hospital and Research Institute (CHRI), Chettinad Academy of Research and Education, (CARE), Kelambakkam-603103, Tamilnadu, India.

Abstract

Liquid-based cytology (LBC) is transforming the diagnostic landscape of gynecologic oncology, offering enhanced accuracy in the early detection and effective management of cancers like cervical, ovarian, and endometrial. This article provides an in-depth review of the principles underpinning LBC, elaborates on its application in modern gynecologic oncology, and discusses the distinctive advantages that it holds over traditional cytology methods. Furthermore, the article recognizes the potential limitations of LBC, including cost implications and residual challenges with sample interpretation. The discussion also highlights the ability of LBC to synergistically work with additional testing methods such as high-risk HPV DNA testing, which enriches the diagnostic information gathered from each sample. With this comprehensive analysis, the article illustrates the compelling role of LBC in revolutionizing the quality of diagnostic samples and its consequent potential for improving patient outcomes in gynecologic oncology. This exploration paves the way for future research to further harness and optimize the benefits of LBC in advancing gynecologic healthcare.

Keywords: Liquid-based cytology, Gynecology, Oncology

Keywords:

liquid based cytology, uPrep, Gynecology, oncology

DOI

https://doi.org/10.22270/jddt.v13i10.6243

Author Biographies

K Lakshmi, Chettinad School of Pharmaceutical Sciences, Chettinad Hospital and Research Institute (CHRI), Chettinad Academy of Research and Education (CARE), Kelambakkam-603103, Tamilnadu, India.

Professor and Head, Chettinad School of Pharmaceutical Sciences, Chettinad Hospital and Research Institute (CHRI), Chettinad Academy of Research and Education (CARE), Kelambakkam-603103, Tamilnadu, India.

R Balaji, Research and Development, Regenix Drugs Limited, Chennai - 600094, Tamilnadu, India.

Research and Development, Regenix Drugs Limited, Chennai - 600094, Tamilnadu, India.

A Ramamurthy, Research and Development, Regenix Drugs Limited, Chennai - 600094, Tamilnadu, India.

Research and Development, Regenix Drugs Limited, Chennai - 600094, Tamilnadu, India.

Senthil Devi, Research and Development, Regenix Drugs Limited, Chennai - 600094, Tamilnadu, India.

Research and Development, Regenix Drugs Limited, Chennai - 600094, Tamilnadu, India.

V Jayakumar, Chettinad School of Pharmaceutical Sciences, Chettinad Hospital and Research Institute (CHRI), Chettinad Academy of Research and Education (CARE), Kelambakkam-603103, Tamilnadu, India.

Chettinad School of Pharmaceutical Sciences, Chettinad Hospital and Research Institute (CHRI), Chettinad Academy of Research and Education (CARE), Kelambakkam-603103, Tamilnadu, India.

K Vijayalakshmi, Department of Obstetrics and Gynaecology, Chettinad Hospital and Research Institute (CHRI), Chettinad Academy of Research and Education, (CARE), Kelambakkam-603103, Tamilnadu, India.

Department of Obstetrics and Gynaecology, Chettinad Hospital and Research Institute (CHRI), Chettinad Academy of Research and Education, (CARE), Kelambakkam-603103, Tamilnadu, India.

References

Olson AJ. Perspectives on structural molecular biology visualization: from past to present. Journal of molecular biology [Internet]. 2018 Oct 19;430(21):3997-4012. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6186497/ https://doi.org/10.1016/j.jmb.2018.07.009 PMid:30009769 PMCid:PMC6186497

Venkat PS, Parikh N, Beron P. Recent advances in gynecologic radiation oncology. Current Opinion in Obstetrics and Gynecology. 2019 Feb 1;31(1):38-42. https://doi.org/10.1097/GCO.0000000000000519 PMid:30531605

Haghighi F, Ghanbarzadeh N, Ataee M, Sharifzadeh G, Mojarrad JS, Najafi-Semnani F. A comparison of liquid-based cytology with conventional Papanicolaou smears in cervical dysplasia diagnosis. Advanced Biomedical Research [Internet]. 2016 Oct 26 [cited 2020 Sep 24];5. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5137229/?fbclid=IwAR3Gcx0lilXKLr42ooC0j4zewrZ8AJsxC19e3oLSrgCga2aPDUhalsRlVDQ

Strander B, Andersson‐Ellström A, Milsom I, Rådberg T, Ryd W. Liquid‐based cytology versus conventional Papanicolaou smear in an organized screening program: a prospective randomized study. Cancer cytopathology. 2007 Oct 25;111(5):285-91. https://doi.org/10.1002/cncr.22953 PMid:17724676

Norimatsu Y, Yanoh K, Hirai Y, Kurokawa T, Kobayashi Tadao K, Fulciniti F. A Diagnostic Approach to Endometrial Cytology by Means of Liquid-Based Preparations. Acta Cytologica. 2019 Aug 30;64(3):195-207. https://doi.org/10.1159/000502108 PMid:31473735

Akira Mitoro, Nishikawa T, Yoshida M, Sawai M, Okada Y, Kitagawa K, et al. Diagnostic Efficacy of Liquid-Based Cytology in Endoscopic Ultrasound-Guided Fine Needle Aspiration for Pancreatic Mass Lesions During the Learning Curve. Pancreas. 2019 May 1;48(5):686-9. https://doi.org/10.1097/MPA.0000000000001304 PMid:31091216

Einstein A, Shukla S, Shukla A, Mishra D. Comparison of specimen adequacy and smear quality in oral smears prepared by manual liquid-based cytology and conventional methods. Journal of Oral and Maxillofacial Pathology. 2015;19(3):315. https://doi.org/10.4103/0973-029X.174611 PMid:26980958 PMCid:PMC4774283

Singh U, Qureshi S, Negi N, Singh N, Goel M, Srivastava K. Comparative study between liquid-based cytology & conventional Pap smear for cytological follow up of treated patients of cancer cervix. The Indian journal of medical research. 2018 Mar;147(3):263. https://doi.org/10.4103/ijmr.IJMR_854_16 PMid:29923515 PMCid:PMC6022377

Daoud T, Sardana S, Stanietzky N, Klekers AR, Bhosale P, Morani AC. Recent Imaging Updates and Advances in Gynecologic Malignancies. Cancers. 2022 Nov 10;14(22):5528. https://doi.org/10.3390/cancers14225528 PMid:36428624 PMCid:PMC9688526

Priscilla, Rutger Quispel, Cahen DL, Snijders-Kruisbergen MC, Petri van Loenen, Erler NS, et al. Diagnostic yield and agreement on fine-needle specimens from solid pancreatic lesions: comparing the smear technique to liquid-based cytology. Endoscopy International Open. 2020 Jan 22;08(02):E155-62 https://doi.org/10.1055/a-1038-4103 PMid:32010748 PMCid:PMC6976322

Celik C, Gezginc K, Toy H, Findik S, Yilmaz O. A comparison of liquid-based cytology with conventional cytology. International Journal of Gynecology & Obstetrics. 2008 Feb 1;100(2):163-6. https://doi.org/10.1016/j.ijgo.2007.07.023 PMid:17920599

Arbyn M, Herbert A, Schenck U, Nieminen P, Jordan J, McGoogan E, Patnick J, Bergeron C, Baldauf JJ, Klinkhamer P, Bulten J. European guidelines for quality assurance in cervical cancer screening: recommendations for collecting samples for conventional and liquid‐based cytology. Cytopathology. 2007 Jun;18(3):133-9. https://doi.org/10.1111/j.1365-2303.2007.00464.x PMid:17573762

Pankaj S, Nazneen S, Kumari S, Kumari A, Kumari A, Kumari J, et al. Comparison of conventional Pap smear and liquid-based cytology: A study of cervical cancer screening at a tertiary care center in Bihar. Indian Journal of Cancer. 2018;55(1):80. https://doi.org/10.4103/ijc.IJC_352_17 PMid:30147099

Pankaj S, Kumari A, Kumari S, Choudhary V, Kumari J, Kumari A, Nazneen S. Evaluation of sensitivity and specificity of pap smear, LBC and HPV in screening of cervical cancer. Indian Journal of Gynecologic Oncology. 2018 Sep;16:1-5. https://doi.org/10.1007/s40944-018-0186-9

Klug SJ, Neis KJ, Harlfinger W, Malter A, König J, Spieth S, Brinkmann‐Smetanay F, Kommoss F, Weyer V, Ikenberg H. A randomized trial comparing conventional cytology to liquid‐based cytology and computer assistance. International journal of cancer. 2013 Jun 15;132(12):2849-57. https://doi.org/10.1002/ijc.27955 PMid:23175270

Sherwani RK, Khan T, Akhtar K, Zeba A, Siddiqui FA, Rahman K, Afsan N. Conventional Pap smear and liquid based cytology for cervical cancer screening-A comparative study. Journal of cytology. 2007 Oct 1;24(4):167-72. https://doi.org/10.4103/0970-9371.41888

Abulafia O, Pezzullo JC, Sherer DM. Performance of ThinPrep liquid-based cervical cytology in comparison with conventionally prepared Papanicolaou smears: a quantitative survey. Gynecologic oncology. 2003 Jul 1;90(1):137-44. https://doi.org/10.1016/S0090-8258(03)00176-8 PMid:12821354

Hashmi AA, Naz S, Ahmed O, Yaqeen SR, Irfan M, Asif MG, et al. Comparison of Liquid-Based Cytology and Conventional Papanicolaou Smear for Cervical Cancer Screening: An Experience From Pakistan. Cureus [Internet]. 2020 Dec 26;12(12). Available from: https://www.cureus.com/articles/48210-comparison-of-liquid-based-cytology-and-conventional-papanicolaou-smear-for-cervical-cancer-screening-an-experience-from-pakistan https://doi.org/10.7759/cureus.12293

Bindhuja J, Aswathy Jeyachadran. Validity of UPREP liquid based cytology in FNAC examination for palpable lesions type of article - original article. Tropical Journal of Pathology and Microbiology. 2019 May 31;5(5):300-8. https://doi.org/10.17511/jopm.2019.i05.08

Martini M, Capodimonti S, Cenci T, Bilotta M, Guido Fadda, Luigi Maria Larocca, et al. To Obtain More With Less: Cytologic Samples With Ancillary Molecular Techniques-The Useful Role of Liquid-Based Cytology. Archives of Pathology & Laboratory Medicine. 2018 Mar 1;142(3):299-307. https://doi.org/10.5858/arpa.2017-0148-RA PMid:29494225

Makde MM, Sathawane P. Liquid-based cytology: Technical aspects. Cytojournal [Internet]. 2022 Jun 14;19(41):41. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9345114/ https://doi.org/10.25259/CMAS_03_16_2021 PMid:35928530 PMCid:PMC9345114

Barbieri D, Venturoli S, Costa S, Landini MP. Improving Laboratory Efficiency by Automation of Preanalytic Processing of ThinPrep Specimens for Real-Time PCR High-Risk HPV Testing. Journal of Laboratory Automation. 2016 Jun;21(3):432-8. https://doi.org/10.1177/2211068215569347 PMid:25673634

Plönes T, Engel-Riedel W, Stoelben E, Limmroth C, Schildgen O, Schildgen V. Molecular Pathology and Personalized Medicine: The Dawn of a New Era in Companion Diagnostics-Practical Considerations about Companion Diagnostics for Non-Small-Cell-Lung-Cancer. Journal of Personalized Medicine. 2016 Jan 15;6(1):3. https://doi.org/10.3390/jpm6010003 PMid:26784235 PMCid:PMC4810382

Bhardwaj N, Gupta N, Gupta P, Malhotra P. Flow cytometric immunophenotyping in Liquid‐based Cytology Sample of Pleural Fluid: Connecting the dots. Cytopathology. 2021 Dec 8; https://doi.org/10.1111/cyt.13086 PMid:34878677

Sharma R, Zaheer S, Ahluwalia C. Diagnostic utility of conventional and liquid-based cytology in the management of thyroid lesions; an institutional experience. Cytojournal. 2022 Jun 7;19:36. https://doi.org/10.25259/Cytojournal_34_2021 PMid:35928535 PMCid:PMC9345136

Traynor D, Shiyamala Duraipandian, Bhatia R, Cuschieri K, Martin C, O'Leary J, et al. The potential of biobanked liquid based cytology samples for cervical cancer screening using Raman spectroscopy. Journal of Biophotonics. 2019 Mar 25;12(7). https://doi.org/10.1002/jbio.201800377 PMid:30653819

Zhang H, Wen J, Xu PL, Chen R, Yang X, Zhou LE, et al. Role of Liquid-based Cytology and Cell Block in the Diagnosis of Endometrial Lesions. Chinese Medical Journal. 2016 Jun 20;129(12):1459-63. https://doi.org/10.4103/0366-6999.183431 PMid:27270542 PMCid:PMC4910370

Hodgson A, Kim V, Murali R. Cytologic features of gynecologic germ cell tumors and carcinomas exhibiting germ cell tumor differentiation. Cancer Cytopathology. 2022 Dec 27; https://doi.org/10.1002/cncy.22673 PMid:36574209

Michael CW, Bedrossian C. The Implementation of Liquid-Based Cytology for Lung and Pleural-Based Diseases. Acta Cytologica. 2014 Jan 1;58(6):563-73. https://doi.org/10.1159/000369198 PMid:25427721

Prendergast EN, Elvin JA. Genomic profiling of gynecologic cancers and implications for clinical practice. Current Opinion in Obstetrics & Gynecology. 2017 Feb 1;29(1):18-25. https://doi.org/10.1097/GCO.0000000000000335 PMid:27984344

Gothwal M, Nalwa A, Singh P, Yadav G, Bhati M, Samriya N. Role of Cervical Cancer Biomarkers p16 and Ki67 in Abnormal Cervical Cytological Smear. The Journal of Obstetrics and Gynecology of India. 2020 Nov 18;71(1):72-7. https://doi.org/10.1007/s13224-020-01380-y PMid:33814802 PMCid:PMC7960869

Patel NM, Rupali Bavikar, Buch A, Kulkarni M, Arpana Dharwadkar, Viswanathan V. A Comparison of Conventional Pap Smear and Liquid-Based Cytology for Cervical Cancer Screening. Gynecology and Minimally Invasive Therapy. 2023 Jan 1;12(2):77-82. https://doi.org/10.4103/gmit.gmit_118_22 PMid:37416097 PMCid:PMC10321340

ŞAHİNER F. Current Problems and Recent Advances in the Molecular Diagnosis of Genital Human Papillomavirus Infections. Mikrobiyoloji Bulteni. 2014 Oct 28;48(4):689-706. https://doi.org/10.5578/mb.7631 PMid:25492665

Barodawala SM, Chadha K, Kavishwar V, Murthy A, Shetye S. Cervical cancer screening by molecular Pap‐transformation of gynecologic cytology. Diagnostic Cytopathology. 2018 Nov 23;47(5):374-81. https://doi.org/10.1002/dc.24116 PMid:30468313

Published

2023-10-15
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How to Cite

1.
Lakshmi K, Balaji R, Ramamurthy A, Devi S, Jayakumar V, Vijayalakshmi K. Liquid-based cytology screening in Gynecologic oncology. J. Drug Delivery Ther. [Internet]. 2023 Oct. 15 [cited 2026 May 15];13(10):129-33. Available from: https://jddtonline.info/index.php/jddt/article/view/6243

How to Cite

1.
Lakshmi K, Balaji R, Ramamurthy A, Devi S, Jayakumar V, Vijayalakshmi K. Liquid-based cytology screening in Gynecologic oncology. J. Drug Delivery Ther. [Internet]. 2023 Oct. 15 [cited 2026 May 15];13(10):129-33. Available from: https://jddtonline.info/index.php/jddt/article/view/6243