A study of papanicolaou stain and cervical acid phosphatase papanicolaou stain in the detection of cervical intra epithelial neoplasm a comparative study

Introduction: In order to increase the sensitivity of the routine PAP test, a new test was introduced called the CAP-PAP test. In this test, lysosomal enzyme and cervical acid phosphatase (CAP) enzyme are labeled with conventional PAP test which will help in detecting abnormal squamous cells of cervix. This enzyme can be used as a biomarker for cervical dysplasia when CAP positivity is detected inside abnormal squamous cells of cervix and can also be used as a surrogate in detection of CIN. Aims: To perform CAP-PAP and PAP staining on cervical smears. To compare CAP-PAP results with PAP results and correlate with cervical histopathology reports. Methods and Materials: 150 females undergoing cervical cancer screening at OBG Department, of our institute were studied. Two cervical smears each were collected from all patients for PAP and CAP-PAP staining. The results were compared and correlated with respective histopathology reports.| Statistical Analysis Used: Chi-square test, Kappa statistics, P value of <0> Results: 75 PAP positive cases out of which 34 were LSIL, 17 were HSIL, 13 were ASCUS, 9 were ASC-H, and 2 were SCC cases. In the remaining 75 PAP negative smears, 38 cases were inflammatory smears and 37 cases were of NLIM smears. Among the PAP positive cases, CAP-PAP results were similar to PAP results in all the LSIL, HSIL, ASCUS, ASC-H and SCC cases. Among the PAP negative cases, CAP-PAP was negative in all the 37 NILM cases, but of the 38 inflammatory cases, CAP-PAP was negative in 30 cases but was positive in 8 cases. CAP-PAP results had good agreement with PAP results and correlated well with histopathology results. Conclusion: CAP positivity is identified by presence of res granules in abnormal squamous cells which helps in its early detection. In screening of cervical cancer on a large scale. CAP PAP acts as a quick and efficient method. The test promises a great future in health centers as the technicians can be easily trained for identification of abnormal cells. A large trial is requires before widespread use of CAP-PAP staining can be recommended in routine clinical practice.