Efficiency of an inexpensive liquid-based cytology performed by cytocentrifugations: a comparative study using the histology as reference standard

BACKGROUND Although liquid-based cytology (LBC) is now recommended for cervical cancer screening, it requires expensive automated devices and materials. To evaluate the efficiency of inexpensive LBC methods relying on an inexpensive fixative liquid, Easyfix, we compared the results obtained by the liquid-based cytology (LBC) diagnoses performed by cytocentrifugations (Papspin and Turbitec) with those obtained by histology. Furthermore, we evaluated the efficiency of the fixative liquid, Easyfix, to preserve HPV DNA in the collected samples. METHOD 266 LBC were compared with 174 colposcopies and 91 Loop Electrosurgical Excision Procedure (LEEP). Among the LBC, 51 were performed using the Papspin system and 215 were performed using the Turbitec system. To control the quality of the preservation liquid, Easyfix, we correlated the results of HCII assays with those of HPV PCR. RESULTS For Papspin and Turbitec systems, the sensitivities were respectively 82.6% (95% CI: 61.2-95.0%, p < 0.001) and 75.0% (95% CI: 64.4-89.8%, p < 0.001) and the specificities were 92.6% (95%CI: 76.5-99.1%, p < 0.001) and 96.2% (95% CI: 91.3-98.7%, p < 0.001). We find no statistical difference between the results of the both systems (p = ns). The sensitivity of the HCII was 86.4% (95% IC: 77.4-92.8%, p < 0.001) and the specificity was 39.4% (95% CI: 31.2-48.1%, p < 0.001). The comparison between HCII and HPV-PCR shows a good correlation: the kappa was 0.89. CONCLUSION LBC performed by cytocentrifugations are inexpensive, reduce inadequate smears, show excellent efficiency and allow HPV detection by molecular biology.