Comparative study of conventional papanicolaou smears and liquid based direct-to-vial thin-layer preparation in the detection of microorganisms in cervical smears

Introduction: In addition to its primary benefit as a cancer screening test, other benefits of Pap test include detection of cervicovaginal microorganisms. Very few studies have been performed in our country to compare Liquid based cytology (LBC) and Conventional papanicolaou smear (CPS) for detection of cervicovaginal infection by microorganisms. Materials and Methods: Our study focuses on non neoplastic findings which correlate to the presence of Microorganisms- Trichomonas Vaginalis, Candida Species, Bacterial Species, Actinomycosis Species, and Herpes simplex virus. Papanicolaou smear by conventional and liquid based cytology have been used to study effectiveness of each method in diagnostic cytology. A comparative prospective study from March 2017 to May 2017 of 45 split samples for comparing effectiveness of liquid based Thin-layer preparation with that of conventional papanicolaou (Pap) smears to demonstrate microorganisms in cervicovaginal smears was undertaken. These two methods have been compared for reporting the presence of microorganisms, essential for a complete diagnostic evaluation of cervicovaginal specimens by the 2001 Bethesda system under the specific category of "Organisms". Results: Altered Flora (AF) Bacterial Vaginosis (BV) in CPS and by LBC were reported. Candidal infection, Trichomonas infection and Leptothrix were compared in CPS and LBC preparations. The comparison showed that Candidal hyphae were more easily seen on LBC while the Candidal yeast forms are more easily detected on CPS. Trichomonas & shift of vaginal flora are detected more easily on CPS than on LBC preparations. Conclusion: Our findings suggest utility of both methods for the detection of microorganisms commonly seen in cervical cytology practice.