Clinical utility of Liqui-PREP[TM] cytology system for primary cervical cancer screening in a large urban hospital setting in China

Background: Liquid based cytology (LBC) has been reported to increase the sensitivity of cervical cytology, in comparison with conventional cytology Pap smear (CPS). Most LBC systems though require expensive automated devices. Aims: To evaluate the efficiency of a new and inexpensive LBC system - LPT cytology system. Materials and Methods: Cervical screening was performed on 31500 patients utilizing the LPT cytology system test from January 2006 to May 2007. A similar number (n = 31500) of CPS were performed from January 2004 to July 2006. All cytology positive patients underwent colposcopy and cervical biopsy with histopathology examination. Fifty cases positive both on cytology and biopsy were submitted to the high-risk human papillomavirus (HPV) L1 protein (HR-HPV L1) tests. Results: The LPT cytology system adequately preserved cellular structure for morphologic evaluation. There was a significant difference of the histology/cytology diagnosis concordant rate between that of the CPS and LPT systems [93.6 vs. 78.4, p=0.001]. The significant higher concordant rate was also seen in the low grade intraepithelial lesion (LSIL) (95.4 vs. 78.9, p=0.001) and in high grade intraepithelial lesion (HSIL) (90.2 vs. 76.1, p=0.001) cytology diagnosis. There was no statistical difference in rate in atypical glandular cells (AGC) (61.5 vs. 60) and glandular cell carcinoma (GCC) (83.3 vs. 80). LPT resulted in a marked increased global detection over the CPS. Nuclear expression of HPV L1 was seen in 34 (17/50) of cases. Conclusions: LPT showed an increase in detection rate compared to CPS (P = 0.001) and a significantly higher histological versus cytological concordant referral rate.