Original Research

Performance of the Cellslide® automated liquid-based cytology system amongst HIV-positive women

Pamela Michelow, Amanda Sherrin, Louise Rossouw, Samson Mohaleamolla, Denise Evans, Avril Swarts, Ntombiyenkosi Rakhombe, Jennifer S. Smith, Cynthia Firnhaber
African Journal of Laboratory Medicine | Vol 5, No 1 | a278 | DOI: https://doi.org/10.4102/ajlm.v5i1.278 | © 2016 Pamela Michelow, Amanda Sherrin, Louise Rossouw, Samson Mohaleamolla, Denise Evans, Avril Swarts, Ntombiyenkosi Rakhombe, Jennifer S. Smith, Cynthia Firnhaber | This work is licensed under CC Attribution 4.0
Submitted: 03 November 2014 | Published: 01 February 2016

About the author(s)

Pamela Michelow, Department of Anatomical Pathology, University of the Witwatersrand and National Health Laboratory Service, Johannesburg, South Africa
Amanda Sherrin, Department of Anatomical Pathology, University of the Witwatersrand and National Health Laboratory Service, Johannesburg, South Africa
Louise Rossouw, Department of Anatomical Pathology, University of the Witwatersrand and National Health Laboratory Service, Johannesburg, South Africa
Samson Mohaleamolla, Department of Anatomical Pathology, University of the Witwatersrand and National Health Laboratory Service, Johannesburg, South Africa
Denise Evans, Department of Internal Medicine, University of the Witwatersrand, Johannesburg, South Africa
Avril Swarts, Department of Medicine, University of the Witwatersrand, Johannesburg, South Africa
Ntombiyenkosi Rakhombe, Right to Care, Helen Joseph Hospital, Johannesburg, South Africa
Jennifer S. Smith, Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, United States
Cynthia Firnhaber, Department of Medicine, University of the Witwatersrand, Johannesburg and Right to Care, Helen Joseph Hospital, Johannesburg, South Africa


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Abstract

Background: Many women undergoing cervical screening as part of a national South African screening programme may be positive for HIV. The performance of liquid-based cytology (LBC) on samples from HIV-positive women needs to be determined.

Objectives: The performance of the Cellslide® automated LBC system was evaluated as a possible alternative to conventional cytology in a national cervical cancer screening programme.

Methods: Split samples from 348 HIV-positive women attending an HIV treatment clinic in Johannesburg, South Africa were examined by conventional cytology and monolayer LBC methods. All samples were stained, examined and reported in the same manner. Cytotechnologists were blinded to the conventional smear diagnosis if the LBC smear was screened and vice versa.

Results: The same percentage of inadequate smears (1.4%) was obtained by conventional cytology and LBC. Atypical squamous cells of undetermined significance were observed in 5.2% of conventional smears and 4.0% of LBC smears. Low-grade squamous intraepithelial lesions were found in 35.6% of conventional smears and 32.7% of LBC smears. Only one conventional smear was categorised as atypical squamous cells – cannot exclude a high-grade lesion, whereas five such cases were identified on LBC. High-grade squamous intraepithelial lesions were seen in 21.6% of conventional smears and 23.3% LBC smears. No invasive carcinoma was identified.

Conclusion: The performance of the Cellslide® LBC system was similar to that of conventional cytology in this population of high-risk HIV-positive women, indicating that it may be introduced successfully as part of a cervical cancer screening programme.


Keywords

Liquid based cytology; Cellslide®; Papanicolaou smear; cervical screening; HIV-infected

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Crossref Citations

1. Prevention of cervical cancer in HIV-seropositive women from developing countries through cervical cancer screening: a systematic review
Witness Mapanga, Brendan Girdler-Brown, Shingairai A. Feresu, Tsungai Chipato, Elvira Singh
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doi: 10.1186/s13643-018-0874-7