Comparison of cervical acid phosphatase papanicolaou stain and standard papanicolaou stain as a screening tool for cancer cervix
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20223120Keywords:
Papanicolaou, Cervical acid phosphatase test, Premalignant, Biopsy, ScreeningAbstract
Background: Carcinoma cervix is the second most common cancer in women (18%). Cervical smear by routine Papanicolaou (Pap) smear screening has significant rates of false-positive and false-negative results. To minimise this, we compare the efficacy of cervical acid phosphatase-papanicolaou (CAP-Pap) smear with conventional Pap smear in detecting premalignant lesions of cervix. The red-colored granules (enzyme coated abnormal cells) that are clearly detected, CAP-Pap positive aids in the quick and early diagnosis of aberrant cells, which speeds up the screening procedure
Methods: The present observational study conducted among the patients presenting to gynaecology department for cancer cervix screening. Two cervical smears were collected for Pap and CAP-Pap staining. Cytology report showing abnormality either in Pap smear or CAP-Pap smear were subjected for colposcopy guided cervical biopsy after VIA/VILI and their results were correlated with histopathology reports as gold standard.
Results: Total of 321 women were enrolled in the study. On comparison with Cervical biopsy, Pap smear had a sensitivity of 83.3%, specificity of 50%, Positive predictive value of 88.2%, Negative predictive value of 40.0%. CAP-Pap had a sensitivity of 100%, specificity of 50%, PPV of 90%, NPV of 100%. As evidenced by the 100% sensitivity, CAP-Pap meets the screening test criteria.
Conclusions: The CAP- Pap test has a bright future as a rapid, inexpensive, and efficient method for initial screening or as an addition to Pap smear in primary health care of India for effective cervical cancer screening.
References
Cancer. Available at: http://cancerindia.org.in/ globocan-2018-india-factsheet/. Accessed on 20 November 2021.
Niranjan J. Cervical acid phosphatase: evaluation as an adjuvant to papanicolaou’s smear screening in cervical cancer detection. J Evid Based Med Health. 2015;2:714-23.
Haq Nawaz F, Aziz AB, Pervez S, Rizvi JH. Prevalence of abnormal papanicolaou smears and cytohistological correlation: a study from Aga Khan university hospital, Pakistan. Asia-Pacific J Clin Oncol. 2005;1(4):128-32.
Patra P. Sample size in clinical research, the numberwe need. Int J Med Sci Public Heal. 2012;1: 5-9.
Batra N, Agarwal, Santwani PM. Study of cap pap versus conventional pap in suspicious cervical lesions. Int J Res Med. 2015;4(1):102-8.
Santis H, Shklar G, Chauncey HH. Histochemistry of experimentally induced leukoplakia and carcinoma of the hamster buccal pouch. Oral Surg Oral Med Oral Pathol. 1964;17(2):207-18.
Fishman WH, Mitchell GW, Dimitrakis H, Hayashi M. Enzymorphology of adenocarcinoma of the endometrium. β-glucuronidase, acid phosphatase, reduced diphosphopyridine nucleotide (DPNH) diaphorase, and α-naphthyl esterase. Cancer. 1963; 16(1):126-32.
Blonk DI, Schaberg A, Willighagen RG. Enzyme cytochemistry of benign and malignant cells in pleural and peritoneal fluid. Acta Cytol. 1967;11(6): 460-5.
Yam LT. Clinical significance of the human acid phosphatases: a review. Am J Med. 1974;56(5):604-16.
Gross SJ, Danziger S. Histochemical techniques applied to the study of benign and malignant squamous epithelium of the cervix uteri. Am J Obstet Gynecol. 1957;73(1):94-119.
Gross SJ, Kinzie G. Cytochemistry of benign and malignant squamous epithelium of the cervix uteri: i. acid phosphatase, nonspecific esterase, and alkaline phosphatase. Obstet Gynecol. 1960;15(3):261-79.
