To Compare the Manual Liquid-Based Cytology (MLBC) Technique on Fine-Needle Aspiration Cytology (FNAC) Material with Conventional Technique

Abstract

Dr. Dayal Singh Bisht, Dr. Sanjyokta and Dr. Sandhya Panjeta Gulia

Liquid Based Cytology (LBC) is a monolayer slide preparation technology that has outperformed conventional pap smears due to improved fixation, reduced masking factors and standardised cell transfer. In LBC, samples are collected by total immersion of the sampling apparatus in a vial containing a preservative solution, with cells being preserved and fixed at the same time, as opposed to conventional smears where the sample is sprayed onto a glass slide and fixed separately. Two main liquid preparation methods are currently known - ThinPrep and SurePath. In our study we used MLBC in fine-needle aspiration cytology (FNAC). It aimed to observe morphological characteristics, compare the outcomes of direct smear examinations with those of manual liquid-based smears, and correlate these findings with histopathological results in cases where a biopsy was also performed.

AIM: The aim was to establish manual liquid-based cytology (MLBC) technique on fine-needle aspiration cytology (FNAC) material and compare its results with conventional technique.

Material and Methods: In this progressive study, a total of 100 fine needle aspiration (FNA) samples from various anatomical sites were examined using MLBC and CS preparations. Direct smears and MLBC smears were assessed for cellularity, background, cellular preservation, and nuclear preservation. The slides were reviewed independently by two cytologists, each with more than 5 years of experience. The ANOVA test was utilized for statistical analysis. A p-value of less than 0.05 is considered statistically significant.

Result: The cellularity observed in MLBC was marginally lower than that found in conventional smears; nevertheless, the cellularity, in conjunction with the quality of nuclear assessment, background, and necrosis, is less evident when compared to traditional methods. Overlapping of nuclei is reduced, and occurrences of hemorrhage and necrosis are lessened, facilitating a better examination of cell morphology through the MLBC technique. The P value obtained was <0.05, which is considered statistically significant.

Conclusion: The process of preparing MLBC in FNAC is a method that is secure, uncomplicated, and time-efficient, potentially providing considerable diagnostic benefits when evaluating FNA samples from various anatomical sites. However, it is recommended to employ both MLBC and CS preparations to maximize the diagnostic yield.

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