The correlation of visual inspection, Pap-smear and immunocytochemistry of human papilloma virus in detection of cervical cytology
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20164653Keywords:
ASCUS, DNA, HPV, HSIL, ICC, LSIL, SCC, NILM, p16INK4a, TBSAbstract
Background: Carcinogenicity presents as a major challenge to scientists and society.. Cervical cancer ranks fifth in the world and is the second cause of death in developing countries like India and China. The rate of death due to cervical cancer is greatest in India. At any time women are at risk of harboring HPV infection, which has been seen to cause cervical cancer. Clinical judgment should be used in spite of all high quality modalities available for screening and diagnosis, as initiated by WHO (World health organization) the Down Staging of cervical cancer, VIA, VILI, Pap smear introduced by George Papanicolaou in 1940s , HPV testing by Immunocytochemistry (ICC) and HPV DNA , Colposcopy , are other modalities to screen cervix. The study aims to evaluate the correlation between Pap smear, visual inspection and Immunocytochemistry of Human papilloma virus (HPV).
Methods: All 100 consecutive women were subjected to visual inspection of cervix, Pap smear and immunocytochemistry of HPV. Pap smear was done by conventional method.
Results: it was seen that out 100 consecutive cervico-vaginal, ears for Pap and Immunocytochemistry, only 33 were abnormal, 24 were ASCUS, 6 were LSIL, 2 were HSIL, 1 was SCC and 67 were NILM out of which 3 were reactive for ICC. And all 33 were reactive for ICC.
Conclusions: The p16 immunostaining performed on conventional smears can become alternative or addition to l HPV DNA tests. The Bethesda System (TBS) 2001 for reporting cervical cytology diagnosis is of high value in detecting abnormal cervical cytology. It is further concluded that the ancillary screening for HPV in NILM category seems to be not advisable as percentage of detection of HPV in this category is low.
Metrics
References
WHO I. WHO/ICO Information Centre on HPV and Cervical Cancer (HPV Information Centre). Human Papillomavirus and Related Cancers in Kenya Summary Report. 2010;2010.
Sartwell PE. On the methodology of investigations of etiologic factors in chronic diseases”—Further comments. Journal of Chronic Diseases. 1960;11(1):61-3.
Hilfrich R, Hariri J. Prognostic relevance of HPV L1 capsid protein detection within mild to moderate dysplastic lesions of the cervix uteri in combination with a second biomarker p16. Anal Quant Cytol Histol. 2008;30(2):78-82.
Cuschieri K, Wentzensen N. Human papillomavirus mRNA and p16 detection as biomarkers for the improved diagnosis of cervical neoplasia. Cancer Epidemiology Biomarkers and Prevention. 2008;17(10):2536-45.
Sahebali S, Depuydt CE, Boulet GA, Arbyn M, Moeneclaey LM, Vereecken AJ, et al. Immunocytochemistry in liquid‐based cervical cytology: analysis of clinical use following a cross‐sectional study. International Journal of cancer. 2006;118(5):1254-60.
Bibbo M, Klump WJ, DeCecco J, Kovatich AJ. Procedure for immunocytochemical detection of P16INK4A antigen in thin-layer, liquid-based specimens. Acta Cytologica. 2002;46(1):25-9.
Saqi A, Pasha TL, McGrath CM, Yu GH, Zhang P, Gupta P. Overexpression of p16INK4A in liquid‐based specimens (SurePath™) as marker of cervical dysplasia and neoplasia. Diagnostic Cytopathology. 2002;27(6):365-70.
Yoshida T, Fukuda T, Sano T, Kanuma T, Owada N, Nakajima T. Usefulness of liquid‐based cytology specimens for the immunocytochemical study of p16 expression and human papillomavirus testing. Cancer Cytopathology. 2004;102(2):100-8.
Pientong C, Ekalaksananan T, Kongyingyoes B, Kritpetcharat O, Swadpanich U, Pengsa P, et al. Immunocytochemical staining of p16INK4a protein from conventional Pap test and its association with human papillomavirus infection. Diagnostic Cytopathology. 2004;31(4):235-42.
Bose S, Evans H, Lantzy L, Scharre K, Youssef E. p16INK4A is a surrogate biomarker for a subset of human papilloma virus‐associated dysplasias of the uterine cervix as determined on the Pap smear. Diagnostic Cytopathology. 2005;32(1):21-4.
Meyer JL, Hanlon DW, Andersen BT, Rasmussen OF, Bisgaard K. Evaluation of p16INK4a expression in ThinPrep cervical specimens with the CINtec p16INK4a assay. Cancer Cytopathology. 2007;111(2):83-92.
Stoler MH, Schiffman M. Interobserver reproducibility of cervical cytologic and histologic interpretations: realistic estimates from the ASCUS-LSIL Triage Study. Jama. 2001;285(11):1500-5.
Nene B, Deshpande S, Jayant K, Budukh AM, Dale P, Deshpande D, et al. Early detection of cervical cancer by visual inspection: A population‐based study in rural India. International Journal of Cancer. 1996;68(6):770-3.
Chhabra S, Bhavani M, Mahajan N, Bawaskar R. Cervical cancer in Indian rural women: trends over two decades. Journal of Obstetrics and Gynaecology. 2010;30(7):725-8.
Pientong C, Ekalaksananan T, Swadpanich U, Kongyingyoes B, Kritpetcharat O, Yuenyao P, et al. Immunocytochemical detection of p16INK4a protein in scraped cervical cells. Acta Cytologica. 2003;47(4):616-23.
Sauvaget C, Nene BM, Jayant K, Kelkar R, Malvi SG, Shastri SS, et al. Prevalence and determinants of high-risk human papillomavirus infection in middle-aged Indian women. Sexually Transmitted Diseases. 2011;38(10):902-6.
Aswathy S, Quereshi MA, Kurian B, Leelamoni K. Cervical cancer screening: Current knowledge and practice among women in a rural population of Kerala, India. The Indian Journal of Medical Research. 2012;136(2):205.