Georgios Papanikolaou - Discoveries

Discoveries

The fact that malignant cells could be seen under the microscope was first pointed out in a book on diseases of the lung, by Walter Hayle Walshe (1812–92), professor and physician to University College Hospital, London, in 1843. This fact was recounted by Papanikolaou.

In 1923 Papanikolaou told an incredulous audience of physicians about the noninvasive technique of gathering cellular debris from the lining of the vaginal tract and smearing it on a glass slide for microscopic examination as a way to identify cervical cancer. That year he had undertaken a study of vaginal fluid in women, in hopes of observing cellular changes over the course of a menstrual cycle. In female guinea pigs, Papanicolaou had already noticed cell transformation and wanted to corroborate the phenomenon in human females. It happened that one of Papanicolaou's human subjects was suffering from uterine cancer.

Upon examination of a slide made from a smear of the patient's vaginal fluid, Papanicolaou discovered that abnormal cancer cells could be plainly observed under a microscope. "The first observation of cancer cells in the smear of the uterine cervix," he later wrote, "gave me one of the greatest thrills I ever experienced during my scientific career."

Dr. Aurel Babeş, of Romania, made similar discoveries in the cytologic diagnosis of cervical cancer. Babeş's 1927 work, however, was published in the Proceedings of the Bucharest Gynecological Society, and it is unlikely that Papanicolaou was aware of it. Recent papers have proven beyond doubt that Babe's method was radically different from Papanicolaou's and that the paternity of Pap test belongs solely to Papanicolaou

At a 1928 medical conference in Battle Creek, Michigan, Papanicolaou introduced his low-cost, easily performed screening test for early detection of cancerous and precancerous cells. However, this potential medical breakthrough was initially met with skepticism and resistance from the scientific community. Papanicolaou's next communication on the subject did not appear until 1941 when, with gynecologist Herbert Traut, he published a paper on the diagnostic value of vaginal smears in carcinoma of the uterus. This was followed 2 years later by an illustrated monograph based on a study of over 3000 cases. In 1954 he published another memorable work, the "Atlas of Exfoliative Cytology", thus creating the foundation of the modern medical specialty of Cytopathology.