The Comparison of Cytology and Biomarker (P53 and Bcl2) Analysis in Cervical Neoplasia: A Prospective Study

Background and aim: Cervical cancer is females' fourth most common cancer. A Pap smear is most commonly used for cervical cancer screening but has a low sensitivity. So, biomarkers can improve the diagnostic efficiency of screening programs. The aim of this study is to evaluate the sensitivity and specificity of cytology and biomarkers p53 and Bcl2 in detecting cervical neoplasia considering histopathological examination as the gold standard.
Material and methods: It was a prospective hospital-based observational study. All cervical biopsies and surgically resected specimens received in the Histopathology laboratory of patients between 30-65 years were included.
Results: One hundred and sixty patients who visited the Gynae-Oncology Outpatient department during the study period were enrolled. Out of these 10 cases were premalignant lesions and 97 cases of invasive carcinoma. Squamous cell carcinoma was the most common histological subtype of invasive cancer. Keratinizing Squamous cell carcinoma was the most common histological subtype of squamous cell carcinoma, and also Endocervical Adenocarcinoma was the most common histological subtype of Adenocarcinoma. Cytology had high specificity of 96.2% and low sensitivity of 59.8% in detecting cervical neoplasia. p53 staining on immunohistochemistry had a sensitivity of 77.6% and specificity of 90.6%. Bcl2 staining on IHC had the highest specificity of 100% and sensitivity of 48%.
Conclusions: Combined use of cytology and biomarkers analysis increases the chances of detecting cervical cancer at early stages than using any single screening test. It will help in reducing patient morbidity and mortality.