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Liquid-based cytology: do ancillary techniques enhance detection of epithelial abnormalities?

  • Gynecologic Oncology
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Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Cervical cancer is the fourth most common cancer in women worldwide with very high incidence in India. Liquid-based cytology (LBC) provides the use of ancillary techniques in addition to a good morphology and detection of cytologic abnormalities. The current study was designed to assess the diagnostics of P16INK4a immunoexpression, p16 promoter hypermethylation, human papilloma virus (HPV), and DNA ploidy in LBC samples with cervical precancer and cancer.

Methods

A series of LBC samples categorised by Bethesda system including 22 atypical squamous cells of undetermined significance (ASC-US), 21 low-grade squamous intraepithelial lesion (LSIL), 41 high-grade squamous intraepithelial lesion (HSIL), 54 squamous cell carcinoma (SCC), and 26 controls with normal cytology were included. Ancillary techniques evaluated included P16INK4a immunoexpression, p16 promoter methylation DNA ploidy by flow cytometry, and HPV was detected using PGMY09/PGMY11 primers.

Results

The test positivity rate of p16 expression in women with ASC-US, LSIL, HSIL, and SCC was 21.1, 39.0, 67.7, and 85.4%. For the p16 methylation the corresponding test positivity rate was 36.4, 76.2, 92.7, and 92.6%. The test positive rate of HPV in women with ASC-US, LSIL, HSIL, and SCC was 45.5, 76.2, 87.8, and 92.6%. Diploid G1 and diploid S values significantly (p < 0.05 or p < 0.01) discriminate LSIL versus HSIL and LSIL versus. SCC.

Conclusions

P16 gene promoter methylation and HPV seem more sensitive in detection of ASC-US and LSIL cytology with higher specificity. Diploid G1 and diploid S phase study provides progressive change in parameters with progression from LSIL to HSIL and SCC.

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Acknowledgements

The authors wish to acknowledge and thank Council of Science & Technology, Uttar Pradesh (CST, UP), India, for providing grant (Grant No.CST/SERPD/D-372) and Integral University, Lucknow for Ph.D. registration to Mr. Sridhar Mishra (MCN No. IU/R&D/2017-MCN000184).

Funding

This study was funded by Council of Science & Technology, Uttar Pradesh (CST, UP), India (Grant No.CST/SERPD/D-372).

Author information

Authors and Affiliations

  1. Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, UP, 226010, India

    Sridhar Mishra, Nuzhat Husain & Namrata P. Awasthi

  2. Department of Obestrics and Gynaecology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, UP, India

    Yashodhara Pradeep

  3. Department of Bioengineering, Integral University, Lucknow, UP, India

    Roohi Roohi

  4. Department of Obestrics and Gynaecology, Ram Manohar Lohia Combined Hospital, Lucknow, UP, India

    Sarita Saxena

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  1. Sridhar Mishra
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  4. Yashodhara Pradeep
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Contributions

MS: protocol development, data collection, data analysis, and manuscript writing/editing. HN: project and protocol development, data analysis, manuscript writing/editing, and final approval. ANP: data analysis and manuscript writing/editing. PY: contribution towards samples, and clinical data and interpretation of data. R: formal analysis and manuscript writing/editing. SS: contribution towards samples, clinical data, and interpretation of data.

Corresponding author

Correspondence to Nuzhat Husain.

Ethics declarations

Conflict of interest

Mishra S declares that he has no conflict of interest; Husain N declares that she has no conflict of interest; Awasthi NP declares that she has no conflict of interest; Pradeep Y declares that she has no conflict of interest; Roohi declares that she has no conflict of interest; Saxena S declares that she has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Ethic committee of Ram Manohar Lohia Institute of Medical Sciences and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Mishra, S., Husain, N., Awasthi, N.P. et al. Liquid-based cytology: do ancillary techniques enhance detection of epithelial abnormalities?. Arch Gynecol Obstet 298, 159–169 (2018). https://doi.org/10.1007/s00404-018-4763-z

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  • DOI: https://doi.org/10.1007/s00404-018-4763-z

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