Study of Ascitic Fluid by Liquid Based Cytology and Its Comparision with Conventional Cytosmears and Cell Block Preprations.

ABSTRACT

Background: Ascites refers to increased volume of fluid collecting within peritoneal cavity which becomes clinically detectable when atleast 500 ml has accumulated. Cytological examination of ascitic fluid gives information about inflammatory and noninflammatory lesions including malignancies, which is done by conventional cytosmears, SurePath liquid based cytological smears and cell block preparations. Aims: The aim of our study was to study the different causes of ascites and their comparison on liquid based cytology with conventional cytology and cell blocks. Methods: Ascitic fluid was obtained from 75 patients of either sex. Microscopic examined was carried out by SurePath liquid based cytology, conventional fixed sediment smears, and cell blocks. Results: Observations were categorised into inflammatory, malignant and inconclusive. Out of 75 cases examined by conventional smears, cytological diagnosis of inflammatory or benign was rendered in 45(60%), 7(9.3%) were diagnosed as malignant and 5(6.7%) were given suspicious of malignancy and 18(24%) were inconclusive. By liquid based cytology 53(70.7%) were rendered inflammatory or benign, 12 (16%) as malignant, 2(2.7%) as suspicious of malignancy and 8(10.7%) were rendered inconclusive. By cell block methodology 52(69.3%) were rendered inflammatory or benign, 11(14.7%) as malignant and 12(16%) as inconclusive. Statistical analysis: Revealed that liquid based cytology was most sensitive (85.71%) and accurate (97.33%) method for analysis of ascitic fluid and conventional smears were least sensitive (50%) and accurate (90.67%). Conclusion: Liquid based cytology showed more sensitivity and accuracy than conventional cytosmears and cell block methods in diagnosing malignant lesions.