Estudo comparativo entre as técnicas de citologia Convencional e em meio líquido no rastreio do câncer do colo uterino: uma revisão integrativa da literatura

Abstract

The conventional cytology technique, cervical compression, was developed in 1928 as a preventive test for cervical cancer, which had characteristic problems and errors in screening and interpretation. In 1991, cytology in liquid medium was created, a new technique that intended to overcome the flaws caused by the conventional technique. Cervical cancer is the third most common type of malignancy among women in Brazil. Occurrence is observed in a significant number of case estimates. Objective: To compare the effectiveness of conventional and liquid cytology techniques for screening and preventing cervical cancer, based on the analysis of screening for precursor lesions, sensitivity, specificity, advantages and limitations of cytopathological techniques, through the review of literatures. This work is an integrative literature review study. We selected evaluated full-text articles, in Portuguese and English published in the time period from 2013 to 2022, in the INCA (National Cancer Institute), SciELO (Scientific Electronic Library Online), PubMed and LILACS repositories, using the Health Sciences Descriptors (DeCS): “Cytological Techniques”, “Cytodiagnosis”, “Neoplasms of the Cervix”, and the following keywords: “Conventional Cytology” and “Cytology in Liquid Medium”. Thirteen articles on the subject were selected within the inclusion and exclusion criteria and the reading and evaluation of the articles for the selection of studies that really approached and emphasized the subject in question. Cytology in liquid medium has shown to be more effective in detecting precursor lesions of cervical cancer from the detection of lesions such as high-grade squamous intraepithelial lesion, low-grade squamous intraepithelial lesion and identification of atypical squamous cells of undetermined significance, when in conventional cytology these were diagnosed as negative for intraepithelial lesion or malignancy (NILM). As for the sensitivity and specificity of the technique, cytology in liquid medium was superior at both points of analysis, due to better identification of precursor lesions of cervical cancer and fewer false negatives when compared to the conventional technique. Cytolysis in a liquid medium proved to have a greater advantage over the conventional method, due to greater accuracy in the diagnosis of lesions, clarity of the slide-resistant method and use of samples preserved in conservative liquid. It had a lower number of limitations compared to the conventional technique, which had low accuracy in tracking some precursor lesions, a greater number of inappropriate mats, generating a higher rate of false negatives, loss of most of the sample and the need for recollection. Although the use of conventional cytology is advocated and of paramount importance for the diagnosis of several lesions, it was observed in the present study that the smears prepared by cytology in liquid medium offered better smear quality, sample specificity and greater sensitivity of the technique for screening. and detection of precursor lesions of cervical cancer.