scholarly journals Evaluation of women with postcoital bleeding by clinical examination, papsmear, colposcopy and histopathology of cervix

2018 ◽  
Vol 7 (6) ◽  
pp. 2184
Author(s):  
Srilakshmi Yarlagadda ◽  
Rangarao Diddi ◽  
Prasuna J. L. Narra
Keyword(s):  
Cervical Cancer ◽  
Clinical Examination ◽  
Predictive Value ◽  
Screening Test ◽  
Pap Smear ◽  
Medical Sciences ◽  
Cervical Lesions ◽  
Guided Biopsy ◽  
Sensitivity Specificity ◽  
Postcoital Bleeding

Background: Postcoital bleeding refers to spotting or bleeding per vagina that occurs after intercourse and is not related to menstruation. Although there are multiple benign etiologies to this complaint, the most serious cause of postcoital bleeding is cervical cancer (3-5.5%). Cervical cancer is the most common and preventable genital cancer of women. It has a long premalignant phase and with an ideal screening test with good sensitivity and specificity, we can diagnose and treat premalignant cervical lesions, preventing cervical cancer. The present study is aimed to evaluate the women with postcoital bleeding by clinical examination, pap smear, colposcopy and guided biopsy to detect premalignant cervical lesions and carcinoma cervix.Methods: This was a prospective and retrospective study conducted from April, 2016 to March, 2018 for a period of 24 months in the Department of Obstetrics and Gynaecology on 100 women with postcoital bleeding at Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation (Dr. PSIMS&RF). After clinical examination, these women were subjected to pap smear, colposcopy and guided biopsy. The findings were correlated with histopathology of cervix. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of both papsmear and colposcopy were calculated.Results: Sensitivity of papsmear was 71.42%, specificity-86.20%, PPV-78.95%, NPV-80.64% and accuracy-80%. Sensitivity of colposcopy was 90.47%, specificity-89.65%, PPV-86.36%, NPV-92.85% and accuracy-90%.          Conclusions: These results establish colposcopy as an effective screening test for carcinoma cervix. Histopathology of suspected cervical lesion in colposcopy remains the gold standard for definitive diagnosis.

scholarly journals A two year retrospective study of cytohistopathological correlation of cervical smear in a tertiary care hospital

2021 ◽  
Vol 12 (8) ◽  
pp. 144-148
Author(s):  
Anil Kumar Sirasagi ◽  
Arpitha K ◽  
Saara Neha ◽  
Pratima Manohar Pattar
Keyword(s):  
Cervical Cancer ◽  
Predictive Value ◽  
Pap Smear ◽  
Tertiary Care ◽  
Histopathological Diagnosis ◽  
Pap Smears ◽  
Care Hospital ◽  
Cervical Smear ◽  
Cervical Lesions ◽  
Sensitivity Specificity

Background: Cervical cancer in women is the second most common cancer and the commonest cause of mortality in developing countries. The introduction of Pap smear test changed the scenario of cervical cancer with an intense drop in the incidence and mortality due to invasive cervical cancer. Aims and Objective: To evaluate the patterns of cervical smear cytology and to correlate the cervical smear diagnosis with histopathological diagnosis and to assess the efficacy of Pap smears in diagnosing cervical lesions. Materials and Methods: This two-year retrospective study (January 2018 to December 2019) was done in the department of Pathology in a tertiary care hospital. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated considering histopathological diagnosis of cervical biopsy as the gold standard. Results: A total of 316 Pap smears were studied, out of which we selected 154 cases who also undergone biopsy or hysterectomy. Epithelial cell abnormalities (ECA) were found in 28 cases (18.2%). Among this the most common ECA was Atypical squamous cells of undetermined significance (ASCUS) seen in 10 cases (6.5%) followed by LSIL (5.2%), HSIL (3.2%) and SCC of cervix (3.2%). The overall correlation between cervical cytology and histopathology was found in 125 out of 154 cases (81.16%). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of pap smear was 90.57%, 62.50%, 95.41%, 43.47% and 87.66% respectively. Conclusion: Pap smear is a simple, safe, non-invasive and effective method for detection of lesions of the cervix and ECA. Hence, better awareness and periodical cytological screening programs can help in the early detection of malignant cervical lesions and thereby reducing the morbidity and mortality related to this malignancy.

scholarly journals VIA (Visual inspection with acetic acid) and VILI (Visual inspection with lugol’s iodine) as an initial approach with colposcopy as a next screening tool with its positive predictive value in low socioeconomic patients

2017 ◽  
Vol 7 (1) ◽  
pp. 210
Author(s):  
Anita Paswan ◽  
Anil Kumar ◽  
Kumudini Jha ◽  
Shail Kumari Sinha
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Positive Predictive Value ◽  
Cervical Carcinoma ◽  
Predictive Value ◽  
Visual Inspection ◽  
Pap Smear ◽  
Lugol’S Iodine ◽  
Resource Setting ◽  
Sensitivity Specificity

Background: Cervical Cancer is the second most common cancer in women worldwide and India alone contribute the 1/4th of the world’s cases of cervical cancer. In view to this huge burden there was need to establish a feasible screening programme to detect cervical carcinoma at earliest in developing country.Methods: This is a prospective study of 500 women who fulfil the selection criteria. 50 pregnant patients for VIA (Visual inspection with acetic acid), 50 pregnant patients for VILI (Visual inspection with lugol’s iodine) and 400 non-pregnant women for VIA, VILI and colposcopy were enrolled. In positive cases, cervical biopsy with histopathological examination was done. The sensitivity, specificity and positive predictive value of each test were obtained and compared. Chi-square (X2) test was used to test the significance of difference between two proportions of a quantitative data.Results: The sensitivity, specificity, positive predictive value and negative predictive value for VIA (85.1%, 84.1%, 41.7%, 97%), VILI (95.7%, 92.4%, 62.5%, 93.4%) and Colposcopy (83%, 86%, 51.3%, 96.6%) were statistically significant with its histopathological report.Conclusions: In a poor developing country like India where pap smear and colposcopy is not available in low resource setting VIA and VILI can prove a very helpful tool in picking up abnormal looking cervix which can then be confirmed by pap or colposcopy. It will go a long way in reducing the incidence of cervical carcinoma.

scholarly journals Comparative evaluation of colposcopy, cytology and histopathology for diagnosis of cervical lesions

2019 ◽  
Vol 8 (9) ◽  
pp. 3584
Author(s):  
Rashmi Saxena ◽  
Alpana Agrawal ◽  
Neelima Agarwal ◽  
Manisha Gupta ◽  
Divya Shubham ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Predictive Value ◽  
Pap Smear ◽  
Tertiary Care ◽  
Hpv Infection ◽  
Cervical Lesions ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Test Parameters ◽  
Chief Complaints

Background: Cervical cancer is the fourth most frequent cancer globally in women with an estimated 570,000 new cases and 311,000 deaths in 2018 representing 6.6% of all female cancers. To correlate the cytology, colposcopy and histopathology of cervical lesions in patients attending gynaecology OPD in a tertiary care centre, Ghaziabad.Methods: 208 women were enrolled from Gynaecology OPD of Santosh Medical College and Hospital, Ghaziabad, irrespective of their chief complaints. Women aged 19-80 years were included in the study group. Those with pregnancy and already diagnosed or treated with CIN, Cervical cancer or Cervical HPV infection were excluded from the study. PAP-smear was taken for all the patients followed by colposcopy without waiting for PAP-smear report. Cervical biopsy was taken from patients with abnormal colposcopic findings (90 patients).Results: Majority of women were in age group 30-39 years. 37.5% had unhealthy, 21.6% had hypertrophied cervix and only 9.1% had normal cervix. It was found that PAP -smear has a sensitivity of 33.33%, specificity of 92.59%, accuracy of 68.89%, positive predictive value of 75% and negative predictive value of 67.57%. Test parameters calculated for colposcopy revealed that it has sensitivity of 73.33%, specificity of 92%, PPV of 64.7%, NPV of 94.52% and accuracy of 88.89%.Conclusions: The results from the current study conclude that it is better to use cytology and colposcopy together as part of routine screening for cervical cancer rather than pap smear alone in order to detect maximum number of lesions.

Sequential Screening with Cytology and Colposcopy in Detection of Cervical Neoplasia

2009 ◽  
Vol 1 (3) ◽  
pp. 45-48 ◽  
Author(s):  
BR Desai ◽  
PR Malur ◽  
Dalal Anita ◽  
Durdi Geeta ◽  
Sherigar Bhavana ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Pap Smear ◽  
Cross Sectional Study ◽  
Diagnostic Efficacy ◽  
Cross Sectional ◽  
Sequential Screening ◽  
Sensitivity Specificity

ABSTRACT Background Pap smear is the most commonly used screening test for cervical cancer, however it has disadvantage of having low sensitivity. Colposcopy has higher sensitivity as compared to Pap smear but low specificity. Sequential screening with both Pap smear and colposcopy can overcome these problems. Aim The study was aimed to find out the diagnostic efficacy of both Pap smear and colposcopy. It was also intended to find out the advantages of sequential use of Pap smear and colposcopy in screening for cervical cancer. Design It was a cross-sectional study conducted in colposcopy clinic of KLE's Dr. Prabhakar Kore Hospital and MRC, Belgaum from November 2006 to September 2008. Material and methods A total of 190 patients with complaints of postcoital bleeding, intermenstrual bleeding, postmenopausal bleeding, persistent vaginal discharge or those found to have an unhealthy cervix on per speculum examination were included in the study. In all the 190 cases Pap smear, colposcopic evaluation and colposcopic directed biopsy were performed. Statistical analysis Sensitivity, specificity, positive predictive value, negative predictive value of both Pap smear and colposcopy were calculated with histopathology as a gold standard, keeping LSIL as a disease threshold for test positivity. Results Pap smear was positive in 14.21% (27/190) cases, colposcopy was positive in 37.89% (72/190) cases. Biopsy confirmed LSIL and higher lesions in 31.57% cases. The sensitivity, specificity, positive predictive value and negative predictive value of Pap smear were 41.66%, 96.92%, 86.21% and 78.26% respectively and 80%, 81.54%, 66.66% and 89.83% respectively for colposcopy. Combined colposcopy and Pap smear could accurately diagnose 53/60 biopsy confirmed cases of LSIL and higher lesions with an accuracy of 88.33%. Conclusion Sequential use of Pap smear and colposcopy in screening for cervical cancer increases the accuracy of the test.

scholarly journals The study of co-relation of pap smear with colposcopy and histopathology in sexually active woman with unhealthy cervix

2021 ◽  
Vol 10 (9) ◽  
pp. 3366
Author(s):  
Vandana Dhama ◽  
Tulika Minz ◽  
Rachna Chaudhary ◽  
Shakun Singh
Keyword(s):  
Cervical Cancer ◽  
Predictive Value ◽  
Pap Smear ◽  
Primary Objective ◽  
P Value ◽  
Sexually Active ◽  
Cervical Lesions ◽  
Dysplastic Lesion ◽  
Active Woman ◽  
Early Primary

Background: Unhealthy cervix is a group of cervical lesions, mostly chronic. Cervical cancer is the second most frequent cancer worldwide in women after breast carcinoma cervical cancer is a preventable and curable malignancy if identified and managed early. Primary objective was to study pap smear, colposcopy and histopathology in unhealthy cervix in sexually active woman with secondary objective to screen woman who have abnormal unhealthy, foul smelling cervical discharge.Methods: The present study was conducted in the department of obstetrics and gynecology L.L.R.M. medical College and associated SVBP hospital, Meerut from June 2019 to May 2020 with sample size of 70. Participant who fit the inclusion criteria were included in the study after taking a written and informed consent. The colposcopy finding was correlated with histopath findings of cervical biopsy that was undertaken.Results: Co relation of pap smear with colposcopy had sensitivity of 78% and specificity of 92% with positive predictive value of 52%and negative predictive value of 97%, p value less than 0.0001. The pattern of distribution of histopathological assessment with respect to the pap smear findings was significant statistically (p<0.0001). The proportion of patients with NILM on pap smear was significantly higher in the VILI negative category compared to the VILI Positive category (94.12% vs 77.78%, p=0.0525). In the present study, prevalence of CIN of any grade was detected in 8 (11.4%) cases. With CIN 1 in 5 (7.14%) and CIN2 in 2 (2.86%) and CIN3 in 1 (1.43%) case were seen.Conclusions: Several screening modalities are available of which pap smear is most widely used. colposcopy has been proven very useful to identify and guide the biopsy of dysplastic lesion.

Diagnostic Value of Pap Smear and Colposcopy in Non-benign Cervical Lesions

2018 ◽  
Vol 7 (2) ◽  
pp. 211-215
Author(s):  
Manizheh Sayyah-Melli ◽  
Vahideh Rahmani ◽  
Elaheh Ouladsahebmadarek ◽  
Mehri Jafari-Shobeiri ◽  
Parvin Mostafa Gharabaghi ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Pap Smear ◽  
Screening Tests ◽  
Specific Method ◽  
Diagnostic Utility ◽  
Cervical Lesions ◽  
Sensitivity Specificity

Objectives: Cervical cancer is a very common and lethal condition; however, owing to longstanding premalignant lesions, it is possible to prevent morbidity and mortality by screening tests. Pap smear, colposcopy, and biopsy are among the main modalities in this regard, however there is no consensus on the diagnostic utility of the first 2 methods. This study sought to examine the diagnostic utility of Pap smear, colposcopy, and cytology in evaluating the non-benign cervical lesions. Materials and Methods: A cross-sectional study was carried out between 2014 and 2016 in an out-patient setting at Alzahra teaching hospital of Tabriz University of Medical Sciences. After obtaining informed consent, all 315 participants with abnormal Pap test underwent colposcopy and biopsy from the abnormal areas. Cervical biopsy was considered as a gold standard and the diagnostic values of Pap smear and colposcopy were individually compared by calculating sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratio. Results: The mean age of patients was 38.49±10.31 years (17-68 years). On the basis of biopsy findings, non-benign cervical lesions were present in 31 cases (9.8%). Accordingly, the sensitivity, specificity, positive predictive value, negative predictive value, and positive likelihood ratio of Pap smear in revealing non-benign cervical lesions were 77.4%, 69.7%, 21.8%, 95.6%, 70.7%, and 2.55%, and for colposcopy, were 90.3%, 90.9%, 51.9%, 98.9%, 90.8%, and 99.2%, respectively. Conclusions: Based on our results, the colposcopy is a sensitive and specific method in differentiating benign cervical lesions from non-benign cervical lesions. The accuracy of Pap smear is intermediate in this regard, and the utility is limited. Therefore, this method should not be considered as the main criterion for decision making.

scholarly journals A Clinicopathological study of uterine cervical lesions in a Tertiary Care Centre

2020 ◽  
Vol 11 (4) ◽  
pp. 5860-5866
Author(s):  
Sujata Kumbhar ◽  
Sujata Kanetkar ◽  
Avinash Mane ◽  
Akanksha Gore
Keyword(s):  
Predictive Value ◽  
Pap Smear ◽  
Early Stage ◽  
Tertiary Care ◽  
Screening Method ◽  
Pap Test ◽  
Cervical Lesions ◽  
Tertiary Care Centre ◽  
Sensitivity Specificity ◽  
Histopathological Results

Pap test is a simple yet effective screening method to detect cervical cancer in its early stage, and thus it helps to reduce morbidity and mortality from cancer. A total of 430 cases were studied after taking ethical clearance. The cytological diagnoses were made by Cytopathologist using Bethesda 2014 system for categorization of cervical smears. Cytological results were correlated with clinical features and histopathological results wherever biopsy was available. The total of the 430 cases studied 24 (5.58%) were inadequate to report, excluding these, of the total 406 cases 260 (64.04%) cases were symptomatic, and 146 (35.96%) were asymptomatic. Cytologic diagnoses were NILM –normal- 140 (55.23%)with a mean age of 38.48 years, NILM- inflammatory 128 (47.76%) with a mean age of 35.96 years, ASC-US 36 (8.86%) with a mean age of 36.69 years, ASC-H 18 (4.43%) with a mean age of 45 years, LSIL 42 (10.34%) with a mean age of 41.90, HSIL 22 (5.42%) with a mean age of 51.22 years, and invasive cancer 20 (4.92%) with a mean age of 61.8 years. Sensitivity, specificity, and positive predictive value, negative predictive value and accuracy of Pap test were 89.79%, 95.34%, and 95.65%, 89.13% and 83.33% respectively. Pap smear test is a simple, rapid, economical, still practical screening test to detect cervical intraepithelial lesions and cancer.

Comparison of Papanicolaou Test With Visual Detection Tests in Screening for Cervical Cancer and Developing the Optimal Strategy for Low Resource Settings

2010 ◽  
Vol 20 (5) ◽  
pp. 862-868 ◽  
Author(s):  
Pakhee Aggarwal ◽  
Swaraj Batra ◽  
Gauri Gandhi ◽  
Vijay Zutshi
Keyword(s):  
Cervical Cancer ◽  
Predictive Value ◽  
Visual Inspection ◽  
Visual Detection ◽  
Alternative Methods ◽  
Papanicolaou Test ◽  
Low Resource Settings ◽  
Low Resource ◽  
The Mean ◽  
Sensitivity Specificity

Objectives:To compare the sensitivity, specificity, positive and negative predictive values, and accuracy of Papanicolaou test with visual inspection with acetic acid (VIA)/VIA using magnification devices (VIAM) and develop the best strategy for screening in low resource settings.Materials and Methods:This is a prospective cross-sectional study on 408 symptomatic multiparous women in the reproductive age group, sequentially using the Papanicolaou test, the VIA, and the VIAM for screening. Women with a positive screening test underwent guided biopsy and endocervical curettage. The site of biopsy was recorded. Histopathological findings were taken as the "gold" standard in comparing the methods.Results:The mean (SD) age was 32.3 (6.8) years (range, 15-49 years), whereas the mean (SD) parity was 2.9 (1.2) (range, 1-9). Abnormal cytological findings were detected in 2.9% patients, whereas the remaining smears were negative for any intraepithelial lesion or malignancy. A total of 113 cases were screened positive by one/all methods. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the Papanicolaou test, the VIA, and the VIAM were 24, 98, 42, 96, and 94%; 95, 78, 19, 99, and 79%; and 95, 78, 19, 99, and 79%, respectively, for high-grade lesions.Conclusions:The Papanicolaou test had low sensitivity but high specificity, whereas visual detection methods had a high sensitivity in addition to being cheaper. Alternative methods of screening such as VIA/VIAM can be a valuable alternative to the Papanicolaou test for cervical cancer screening in low resource settings. Visual inspection using magnification devices may be of benefit over VIA in doubtful cases.

scholarly journals Fecal Calprotectin in Combination With Standard Blood Tests in the Diagnosis of Inflammatory Bowel Disease in Children

2021 ◽  
Vol 8 ◽  
Author(s):  
Shaun S. C. Ho ◽  
Michael Ross ◽  
Jacqueline I. Keenan ◽  
Andrew S. Day
Keyword(s):  
Inflammatory Bowel Disease ◽  
Platelet Count ◽  
Bowel Disease ◽  
Predictive Value ◽  
Screening Test ◽  
Fecal Calprotectin ◽  
Non Invasive ◽  
Blood Tests ◽  
Inflammatory Bowel ◽  
Sensitivity Specificity

Introduction: Fecal calprotectin (FC) is a useful non-invasive screening test but elevated levels are not specific to inflammatory bowel disease (IBD). The study aimed to evaluate the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FC alone or FC in combination with other standard blood tests in the diagnosis of IBD.Methods: Children aged &lt;17 years who had FC (normal range &lt;50 μg/g) measured and underwent endoscopy over 33 months in Christchurch, New Zealand were identified retrospectively (consecutive sampling). Medical records were reviewed for patient final diagnoses.Results: One hundred and two children were included; mean age was 12.3 years and 53 were male. Fifty-eight (57%) of the 102 children were diagnosed with IBD: 49 with Crohn's disease, eight with ulcerative colitis and one with IBD-unclassified. FC of 50 μg/g threshold provided a sensitivity of 96.6% [95% confident interval (CI) 88.3–99.4%] and PPV of 72.7% (95% CI 61.9–81.4%) in diagnosing IBD. Two children with IBD however were found to have FC &lt;50 μg/g. Sensitivity in diagnosing IBD was further improved to 98.3% (95% CI 90.7–99.1%) when including FC &gt;50 μg/g or elevated platelet count. Furthermore, PPVs in diagnosing IBD improved when FC at various thresholds was combined with either low albumin or high platelet count.Conclusion: Although FC alone is a useful screening test for IBD, a normal FC alone does not exclude IBD. Extending FC to include albumin or platelet count may improve sensitivity, specificity, PPV and NPV in diagnosing IBD. However, prospective studies are required to validate this conclusion.

Sign in / Sign up

Export Citation Format

Share Document