Comparative Evaluation of Aqueous Toluidine Blue Stain and Conventional Papanicolaou Stain in Cervicovaginal Smear

BACKGROUND: Cervical cancer is the fourth most frequently diagnosed cancer. In India, cervical cancer is the second most diagnosed cancer among women following breast cancer. Early detection of precursor lesions of cervical cancer on cervical cytology by a screening program remarkably reduces the death rate. OBJECTIVE: The objective of this study is to see the efficacy of aqueous toluidine blue stain in cervicovaginal smears in comparison with conventional Papanicolaou stain, compare staining properties on nucleus as well as cytoplasm, reporting time, cost-effectiveness, and clinicopathological profile of the patient. MATERIALS AND METHODS: An institution-based, prospective cross-sectional study of 100 sexually active females aged 21-60 years. Two to three cervical smears were collected from each patient over a period of 18 months. Two percent aqueous toluidine blue stain and conventional Papanicolaou stain were performed on the smears. Cytomorphology of the smears was studied and compared in reference to staining in the nucleus and cytoplasm, timing, and efficacy of stain. RESULTS: Efficacy and nuclear staining properties by 2% aqueous toluidine blue stain are as good as in conventional Papanicolaou stain in cervicovaginal smears. Reporting time and cost are less in aqueous toluidine blue stain. CONCLUSION: Both stains show identical results; however, reduced staining time and cost-effectiveness are critical in a lower-middle-income country like India.