Figure 4. Micrograph of MLBC Slides Stained with Regular Papanicolaou Staining with Score 2 for Cellular Overlapping
Figure 5. Micrograph of MLBC Slides Stained with Modified Acetic Acid Pap Staining with Score 1 for Cellular Overlapping.
Figure 6. Scoring for Quality of Nuclear Staining by Using Different Techniques.
Table 5. Individual Scores of Morphological Parameters and Quality Index of Techniques
Morphological Parameters Conventional Manual liquid
Pap Smear based cytology
Cellularity
No cells 0 1
Scant cells 2 2
Adequate cells 43 33
Abundant cells 2 11
Total 94 101
Clear Background
Abundant debris present 0 0
Debris present but adequate for diagnosis 28 7
Clear background 19 40
Total 66 87
Uniformity of distribution
Cell restricted to only one area of slide 0 3
Cellular clumps through slide adequate for diagnosis 9 5
Few areas of cells 15 8
Cells uniformly distributed on slide 23 31
Total 108 114
Folded Cytoplasmic Borders
Inadequate for diagnosis 11 6
Interfering but acceptable 30 33
Absent 6 8
Total 42 49
Cellular overlapping
Cells only in clumps 2 1
Few regions of clumps 29 14
Minimal overlapping 16 32
Total 61 78
Obtained Score 371 429
Maximum Score 658 658
Quality Index 0.563 0.651
Table 6. Individual Scores of Staining Parameters and Quality Index of Four Staining Techniques
Staining Acetic CPS MLBC MLBC
parameters Acid Acetic Acid Pap
Staining Staining Staining
Nuclear staining
Indistinct+Hazy 3 12 3 13
Distinct+Hazy/Indistinct+Crisp 18 31 18 21
Distinct+Crispy 45 23 45 32
Total 108 77 108 85
Cytoplasmic Staining
Poor 6 11 5 9
Optimal 11 31 25 23
Transparent 49 24 36 34
Total 109 79 97 91
Obtained Score 217 156 205 176
Maximum Score 264 264 264 264
Quality Index 0.82 0.59 0.77 0.66
Pap staining, there is increased cellularity for both types of well-preserved cell that improves the chances of adequacy for smear selection in Bethesda scrutiny revealed by Figure 1. However in case of Inflammatory smear CPS is not free from obscuring blood and inflammatory cells whereas MLBC gives more clear picture. When slides of MLBC smear follows acetic acid staining, they give results with even more clear background as shown in Figure 2.
Cellular count: recommended cellular count for sample selection is ≥5000 for MLBC according to American