ABSTRACT
Cervical lesions are one of the most common cause of female morbidity, cervical cancer being the second most common malignancy only after breast in women in India as well as the world. The aim of this study was to analyse the spectrum of cervical lesions in Liquid based cytology and categorizing them according to the Bethesda System for Reporting Cervical cytology. This is a 3 year retrospective study . Total number of cases collected were 1228, of which majority were in the age group of 21-30 years comprising of 450 cases (36.6%) . The most common complain was whitish discharge followed by pain lower abdomen. Out of 1228 cases ,1131 (92.10%) were NILM, 11(0.89%) LSIL,10(0.80%) each of HSIL &ASCUS,5(0.42%) Atypical endocervical cells(NOS), 4(0.35%) SCC and 2(0.16%) Atypical glandular cells(NOS) .55 cases (4.48%) were inadequate. Out of 1131cases of Negative for intraepithelial lesion or Malignancy, 1048 were non -neoplastic and 83 were associated with speci?c infection. Premalignant and malignant lesions of the cervix are very common, therefore proper screening and categorization of cervical lesion is necessary for treatment and follow up,thereby reducing the mortality and morbidity.
ABSTRACT
Introduction: Cervical cancer is one of the most commonforms of cancer worldwide. In developing countries, cancerof uterine cervix is ranked second with a relative frequency of15% of all cancers in women. Screening women with regularPap smears allows diagnosis of treatable pre-invasive lesions.The objective of the study was to correlate the Pap smeardiagnosis with histopathology and to know the accuracy ofPap smears, so as to assess the efficacy of Pap smears indiagnosing cervical lesions.Material and methods: This two year retrospective study wasdone in the department of Pathology in a tertiary care centre,which includes 250 Pap smears for which histopathologicaldiagnosis was also done. Detailed clinical history of patientswas taken from requisition forms received in cytologydepartment along with Pap smears. The cervical biopsies orhysterectomies received from the same patients were alsostudied and then correlated with the diagnosis of Pap smears.Results: Out of 250 Pap smears, maximum patients (32%)belonged to the age group of 41-50 years and were multipara.Maximum cases were reported as NILM (59%),followedby ASCUS (16%), LSIL (15%), HSIL (7%), squamous cellcarcinoma (1.6%) and 0.8% cases of adenocarcinoma werediagnosed. On histopathology, 41.2% cases were diagnosedas chronic cervicitis, 27.2% cases as chronic cervicitis withsquamous metaplasia, CIN I (22.4%),CIN II (4.0%),CIN III(2.8%), squamous cell carcinoma (1.6%) and (0.8)% casesof adenocarcinoma. Overall sensitivity, specificity, positivepredictive value, negative predictive value and diagnosticaccuracy was 75.24%, 97.98%, 96.20%, 85.38% and 88.8%.Conclusion: As per our study, maximum number of casesdiagnosed on Pap smears correlated on histopathology,thereby concluding that Pap smears have an important role indiagnosis of cervical lesions.
ABSTRACT
Background: Cervical cancer is the most common, preventable cancer and does not develop suddenly from normal epithelium but is presented by a spectrum of intraepithelial neoplasia. Pap smear is an ideal screening and low cost effective test to detect intraepithelial neoplasia especially in developing countries but has limitations and needs confirmation by histopathology. The study aimed to determine the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of pap smears as screening test in cervical lesions by comparing with histopathology. Methods: This is a prospective study conducted at a tertiary care centre in Department of pathology from October 2012 to September 2014. A complete clinical history and demographic status of the subjects was recorded. Conventional pap smears were reported adopting Bethesda system and biopsies were taken in cases of epithelial cell abnormality, routinely processed and stained with H&E. Results: Total number of pap smears analysed were 356. NILM (negative for intraepithelial lesions or malignancy) constituted major group 248/356 (69.64%) and epithelial cell abnormality were 98/356 (27.5%). In the present study overall sensitivity was 94.11% specificity 64.28% positive predictive value 82.75%,negative predictive value 85%,diagnostic accuracy 83.33%,concordance rate 78.2% and P value <0.001. Concordance rate for CIN I was 78.9%, for CINII and CINIII 60% and for squamous cell carcinoma 100%. Conclusion: Pap smear is simple, inexpensive and can be performed in the outpatient department. Hence, it should be recommended routinely as a method of improving reproductive health, early detection of premalignant and malignant cervical lesions.