@article { author = {Desai, Fanny and Singh, Lisam Shanjukumar and Majachunglu, Gracy and Kamei, Helen}, title = {Diagnostic Accuracy of Conventional Cell Blocks Along with p16INK4 and Ki67 Biomarkers as Triage Tests in Resource-poor Organized Cervical Cancer Screening Programs}, journal = {Asian Pacific Journal of Cancer Prevention}, volume = {20}, number = {3}, pages = {917-923}, year = {2019}, publisher = {West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.}, issn = {1513-7368}, eissn = {2476-762X}, doi = {10.31557/APJCP.2019.20.3.917}, abstract = {Background: Liquid based cytology with dual biomarkers has improved sensitivity and specificity in detectinghigh grade cervical intraepithelial neoplasia (CIN). In low resource settings, especially in organized camps, LBC iscostly and immunohistochemistry on conventional pap smears is difficult to standardize with consumption of lots ofreagents. In present study, to improve the accuracy of conventional pap smears and reduce the cost of biomarkertesting, we evaluated conventional cell blocks (CCBs) preparations with biomarkers to detect high-grade CIN inresource-poor organized screening programs. We also studied feasibility of using CCB as primary screening test.Material and Methods: A total of 350 participants were included in the cross-sectional evaluation of the screeningtests. A conventional Papanicolaou (Pap) smear was obtained, and another sample was then collected and placed in10% neutral buffered formalin for CB preparation. All abnormal Pap tests and CBs were stained for the biomarkersp16INK4a and Ki67. Histopathology with p16INK4a expression was considered the gold standard. Diagnostic testswere compared using MacNemar’s test and receiver operating curves were plotted. Results: The sensitivity, specificity,and diagnostic accuracy of CCB cytology, CB + p16 cytology and CB + p16Ki67 cytology for detecting CIN2+ lesionswere 85.71%, 100%, 97.44%; 100%, 93.75%, 94.87%; and 85.71%, 100%, 97.44%, respectively. The Ki67 indexcould further categorize low grade lesions into lesions with low proliferative index and with high proliferative index(Pearson chi-square p value <0.001). Conclusion: If CB preparation is standardized, CCB cytology with biomarkerscan have better diagnostic accuracy than conventional cytology, can classify low grade lesions likely to progress andcan be used in field settings as primary screening test.}, keywords = {Diagnostic accuracy,Conventional Cell block,P16ink4a,Ki67,cervical cancer screening}, url = {https://journal.waocp.org/article_84283.html}, eprint = {https://journal.waocp.org/article_84283_4cc6cefae85e85e805acfab1ed16dc25.pdf} }