scholarly journals Comparative study of papanicolaou smear and colposcopy in the evaluation of cervical lesions

2019 ◽  
Vol 8 (6) ◽  
pp. 2400
Author(s):  
Priyanka Mohan ◽  
Lakshmidevi M. ◽  
Shreedhar Venkatesh
Keyword(s):  
Pap Smear ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Research Centre ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Cross Sectional ◽  
Intraepithelial Lesion ◽  
Punctate Pattern

Background: Cervical cancer is the third most common type of cancer among females. Study aims to critically evaluate the sensitivity and specificity of colposcopy versus papanicolaou (Pap) smear in the early detection of dysplasias. Its secondary objective to correlate the findings in the evaluation of unhealthy cervix by cytology, colposcopy and colposcopy guided biopsy.Methods: This was a tertiary care teaching hospital based, prospective, cross sectional study done in Department of Obstetrics and Gynaecology, at Vydehi Institute of Medical Sciences and Research Centre, Bangalore, conducted on 200 women attending Gynaecology OPD.Results: PAP smear was taken for all 200 patients. 73% of smear was found to be normal, 11% showed inflammatory atypia, 9% showed low grade squamous intraepithelial lesion (LSIL), 3.5% showed atypical squamous cells of undetermined significance (ASCUS) and 3.5% showed High Grade Squamous Intraepithelial Lesion (HSIL). Among the 200 cases studied, 38% (76/200) were diagnosed as colposcopically abnormal. Among the abnormal cases, AW areas were diagnosed in 4%. Punctate pattern of vessels was seen in 5% of women. Normal findings was present in 62%, Erosion cervix in 6%, inflammatory changes were seen in 6% and polyps were diagnosed in 7.5%, leucoplakia was found in 2% and unsatisfactory colposcopy finding was seen in 4% and underwent endocervical curettage. 32 cases out of 200 women were positive on Pap smear. 66 out of 200 women were positive on Biopsy. Pap smear was positive in 22 out of 66 biopsy proven positive cases.Conclusions: The commonest presenting complaint was vaginal discharge (182/200; 91% of the patients. the PAP smear  is found to have sensitivity of 33.33%  and specificity of 92.54%. colposcopy is found to have sensitivity of 81.82%  and specificity of 82.84%.

scholarly journals Prevalence of Human Papilloma virus in women with Abnormal Cervical Smears from Sarawak, Malaysia

2021 ◽  
pp. 2729-2734
Author(s):  
Myat San Yi ◽  
Tan Cheng Siang ◽  
Soe Lwin ◽  
Kay Thi Myint ◽  
Khin Than Yee ◽  
...  
Keyword(s):  
High Risk ◽  
Hpv Vaccination ◽  
Hpv Infection ◽  
Cross Sectional Study ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Cross Sectional ◽  
Incidence And Mortality ◽  
Intraepithelial Lesion

Introduction: Cervical cancer is common cancer and ranked in fourth place in both incidence and mortality worldwide. It is 3rd most common female cancer in Malaysia with a lifetime risk of 1 in 116. Infection with high-risk oncogenic human papillomavirus (HPV) is recognized as one of the substantial risk factors for the development of cervical cancers. Methods: It was a cross-sectional study conducted to determine the prevalence of HPV infection and its subtypes among women with various degrees of abnormal smears, who were seen in the colposcopy clinic of Sarawak General Hospital within six months’ period from January to June 2018. We recruited 56 participants. There were 23 each for an atypical squamous cell of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesion (LSIL) and 10 high- grade squamous intraepithelial lesion (HSIL). DNA was extracted, and HPV genotypes were determined via polymerase chain reaction (PCR) using two primer pairs MY09/MY11 and GP5+/GP6+. Results: The age ranged from 23 to 56 years, with a mean age of 42.96 years. HPV was detected in 20 out of 56 (35.7%). There were 6 high-risk oncogenic HPVs (18, 51, 52, 56, 58, 68) detected in participants and the most prevalent subtypes were 18, 52, and 58 (20% each). Four low-risk HPVs detected were 6, 53, 70, and 84. There was a significant association between the severity of cervical lesions and HPV positivity (P < 0.004). HSIL had the highest positive predictive value to have HPV infection as 70% compared to 43.4% of LSIL and 9.3% of ASC-US. Conclusion: Distribution of HPV subtypes from women with abnormal smears from Sarawak indicated a high prevalence of HPV 18, 52, and 58. We also identified HPV 70, which has never been reported in West Malaysia. These findings could contribute valuable information for HPV vaccination strategies, particularly for Sarawakian women.

scholarly journals Separation of Normal and Premalignant Cervical Epithelial Cells Using Confocal Light Absorption and Scattering Spectroscopic MicroscopyEx Vivo

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Ling Yang ◽  
Wen-Tao Liu ◽  
Hao Wu ◽  
Cheng Wang ◽  
Bo Ping ◽  
...  
Keyword(s):  
Light Absorption ◽  
Pap Smear ◽  
Precancerous Lesions ◽  
Scattered Light ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Pap Smear Test ◽  
Intraepithelial Lesion ◽  
Cervical Squamous Intraepithelial Lesion

Confocal light absorption and scattering spectroscopic (CLASS) microscopy can detect changes in biochemicals and the morphology of cells. It is therefore used to detect high-grade cervical squamous intraepithelial lesion (HSIL) cells in the diagnosis of premalignant cervical lesions. Forty cervical samples from women with abnormal Pap smear test results were collected, and twenty cases were diagnosed as HSIL; the rest were normal or low-grade cervical squamous intraepithelial lesion (LSIL). The enlarged and condensed nuclei of HSIL cells as viewed under CLASS microscopy were much brighter and bigger than those of non-HSIL cells. Cytological elastic scattered light data was then collected at wavelengths between 400 and 1000 nm. Between 600 nm to 800 nm, the relative elastic scattered light intensity of HSIL cells was higher than that of the non-HSIL. Relative intensity peaks occurred at 700 nm and 800 nm. CLASS sensitivity and specificity results for HSIL and non-HSIL compared to cytology diagnoses were 80% and 90%, respectively. This study demonstrated that CLASS microscopy could effectively detect cervical precancerous lesions. Further study will verify this conclusion before the method is used in clinic for early detection of cervical cancer.

scholarly journals Spectrum of cytological patterns in cervical PAP smears in a tertiary care center of Western region of Nepal

2019 ◽  
Vol 4 (1) ◽  
pp. 2-8
Author(s):  
Pragya Gautam Ghimire ◽  
Durga BC Rawat ◽  
Kavita Sinha ◽  
Kamar Jahan ◽  
Richa Shrestha
Keyword(s):  
Cervical Cancer ◽  
Epithelial Cell ◽  
Pap Smear ◽  
Statistical Significance ◽  
Care Center ◽  
Tertiary Care ◽  
Pap Smears ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Intraepithelial Lesion

Introduction: Cervical cancer is a common health problem in Nepal. There is paucity of data regarding the spectrum of findings in cervical Pap in western Nepal. This study was aimed to study the cytological patterns in cervical Pap smears in patients in a tertiary hospital of Nepal. Methods: This is a prospective, cross sectional, hospital based study. Clinical features of patients who had presented with Pap smear was noted in a structured proforma. Pap smears were studied by a senior pathologist and reported based on revised Bethesda system (2014). Results: Most of the cases belonged to 31-40 years 399 (42.8%). Unsatisfactory/ inadequate sample was present in 133(14.05%) with obscuration due to inflammatory exudate being most common cause. Negative for intraepithelial lesion or malignancy rate was noted in 798 (85.54%) with 477(51.2%) being normal findings. Epithelial cell abnormalities were noted in 116 (14.5 %) smears. Low-grade squamous intraepithelial lesion constituted 321(34.5%), High grade squamous intraepithelial lesion 273(29.3 %) and Atypical squamous cells of undetermined significance 153(16.4%) of epithelial cell abnormalities. Squamous cell carcinoma was present in 9(1%) of all reviewed smears. There was no statistical significance between the age and abnormalities of Pap smear (p=0.9). Conclusions: Pap smear is pivotal in cervical cancer screening in developing countries. It also identifies various inflammatory, infective, benign and malignant pathologies at the earliest thereby decreasing the morbidity and mortality.

scholarly journals Negative Histology in Cervical Specimens Obtained With the “see and Treat” Method in Women at a Referral Center in Rio De Janeiro, Brazil – A Cross-sectional Study

2020 ◽  
Author(s):  
Renata Pereira Teodoro ◽  
Danielle Scherrer ◽  
Maria José de Camargo ◽  
Ana Costa ◽  
Cecília Vianna de Andrade ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Low Grade ◽  
Statistical Association ◽  
Sectional Study ◽  
Squamous Intraepithelial Lesion ◽  
Cross Sectional ◽  
Significant Downward Trend ◽  
Intraepithelial Lesion ◽  
Preinvasive Lesion ◽  
Over Time

Abstract Background According to the Brazilian Guidelines on Cervical Cancer Screening, women with cytopathologic diagnosis of high-grade intraepithelial lesion, abnormal colposcopic findings, fully visible squamocolumnar junction, and age 25 years or older should be treated at the first visit (“see and treat – S&T”). The main limitation to this approach is the risk of overtreatment, identified by histology without preinvasive lesion. This study aimed to measure the negative histology rate in women submitted to S&T according to the Brazilian Guidelines. Methods This was a cross-sectional study that analyzed records from a database with 616 women submitted to S&T from 1996 to 2017. Negative histology was defined as the following histopathologic results: HPV without CIN, inflammatory, low-grade squamous intraepithelial lesion (LSIL), and CIN 1. Results Of the 616 women, there were 52 (8.44% − 95%CI 6.25–10.64%) with a histopathologic report without preinvasive cervical lesion. No statistical association was found between this outcome and younger ages or a significant downward trend over time. Conclusion The overtreatment rate in this study can be considered low and consistent with the acceptable rates reported in the literature, reinforcing the prevailing Brazilian guideline, in which the benefits of immediate treatment outweigh the risk of losses following biopsy.

scholarly journals Performance of OncoE6TMCervical Test in detecting cervical precancer lesions in HIV-positive women attending an HIV clinic in Bujumbura, Burundi: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e029088
Author(s):  
Zacharie Ndizeye ◽  
Sonia Menon ◽  
Jean-Pierre Van Geertruyden ◽  
Catherine Sauvaget ◽  
Y Jacquemyn ◽  
...  
Keyword(s):  
Low Income ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Low Grade ◽  
Sectional Study ◽  
Squamous Intraepithelial Lesion ◽  
Cross Sectional ◽  
Predictive Values ◽  
Hiv Positive Women ◽  
Intraepithelial Lesion

ObjectiveNew rapid and low-cost molecular tests for cervical cancer screening, such as the OncoE6 Cervical Test, are emerging and could be alternatives for low-income and middle-income countries. To this end, we evaluated the clinical performance of the OncoE6 Cervical Test in detecting cervical intraepithelial neoplasia (CIN) among HIV-infected women in Bujumbura, Burundi.MethodsFrom June to December 2017, a cross-sectional study was conducted in 680 HIV-positive women at the University Hospital. Women aged 25–65 years who declared having had vaginal intercourse were consecutively recruited, and cervical specimens for OncoE6, liquid-based cytology and human papillomavirus (HPV) genotyping were obtained and visual inspection with acetic acid performed. Thereafter, participants underwent a colposcopic examination. The sensitivity, specificity, and positive and negative predictive values of the different tests were calculated with reference to ‘colposcopic-histological’ diagnoses, and areas under the receiver operating curves of OncoE6 and cytology tests were compared.ResultsThe prevalence of CIN was 4.9%, and OncoE6 positivity was 3.1%. OncoE6 sensitivity varied from poor to low with increasing disease severity (42.1%, 95% CI 19.9% to 64.3% at CIN2+ threshold; and 58.3%, 95% CI 30.4% to 86.2% at CIN3+ threshold). OncoE6 had the highest specificity compared with all other tests used together. The performance of the OncoE6 test was significantly lower compared with cytology at atypical squamous cell of undetermined significance (ASCUS+) cut-off (AUC=0.68 vs 0.85, p=0.03) and low-grade squamous intraepithelial lesion (LSIL+) cut-off (AUC=0.68 vs 0.83, p=0.04) for CIN2+ diagnoses. However, the performance of the OncoE6 test was similar to that of cytology at high-grade squamous intraepithelial lesion (HSIL+) cut-off (AUC=0.68 vs 0.76; p=0.30) for CIN2+ diagnoses and was also similar to that of cytology at all cut-offs (ASCUS+, LSIL+ and HSIL+) for CIN3+ diagnoses (p1=0.76, p2=0.95 and p3=0.50, respectively).ConclusionThe current OncoE6 test proved to be a point-of-care test. However, given its poor performance for CIN2+ diagnoses, we do not recommend it for primary screening. We recommend to enrich it with more oncogenic HPV types, which may improve the performance of the test akin to that of cytology.

scholarly journals Analysis of Cervical Cancer Screening at Patan Hospital Nepal

2018 ◽  
Vol 8 (1) ◽  
pp. 1-4
Author(s):  
Laxmi RC ◽  
Prashanti Shrestha ◽  
Binita Pradhan
Keyword(s):  
Cervical Cancer ◽  
Pap Smear ◽  
Lower Abdominal Pain ◽  
Population Based ◽  
Cross Sectional Study ◽  
Low Grade ◽  
Cross Sectional ◽  
Pap Smear Screening ◽  
Glandular Cells ◽  
Intraepithelial Lesion

Background: Cervical cancer is among the most common cancer in women of Nepal. This disease undergoes a state of prolong premalignant state during which it can be detected and treated effectively. Papanicolaou (pap) smear is an effective method of identifying premalignant disease and with this there has been more than 90 percent decrease in the incidence of cervical cancer. The objective of this study was to analyse the pattern of Pap smear screening at Patan hospital. Methods: This is a population based retrospective cross-sectional study conducted at Patan hospital, Lagankhel. The study population includes women with gynaecological symptoms who required Pap smear screening over a period of two years. The pap smear data were collected and statistical analysis was done. Results: Among 1993 smear studied, only 89 reports had some form of intraepithelial lesion. The most prevalent lesion was low grade intraepithelial lesion (49.43%) whereas the least common was Atypical glandular cells (1.12%). The highest number of respondent were in the age of 30 – 40 years whereas the lowest was in the group of age less than 20 years. The patient who had abnormal epi­thelial lesions had multiple symptoms like vaginal discharge, vulval itching and lower abdominal pain. Conclusions: Pap smear screening should be started by the age of 21 and should be done in all women with any gynaecological symptoms.

scholarly journals Prevalence and factors associated to cervical changes in units from the Single Health System

2021 ◽  
Vol 42 ◽  
Author(s):  
Indianara Carlotto Treco ◽  
Valquíria Kulig Vieira ◽  
Janaína Carla da Silva ◽  
Fernando Rodrigo Treco ◽  
Lirane Elize Defante Ferreto ◽  
...  
Keyword(s):  
Health System ◽  
Oral Contraceptives ◽  
Pap Smear ◽  
Cross Sectional Study ◽  
Low Grade ◽  
Cross Sectional ◽  
Factors Associated ◽  
Unified Health System ◽  
Cervical Intraepithelial Lesion ◽  
Intraepithelial Lesion

ABSTRACT Objective: To estimate the prevalence and risk factors associated with cytopathological changes in the uterine cervix of women treated by the Unified Health System. Method: This is a cross-sectional study carried out with 350 women, between 14 and 79 years old who underwent pap smear tests in heath units in Francisco Beltrão, Paraná. Cervical cytopathological analyses and a questionnaire were applied to obtain socioeconomic information, as well as data on sexual behavior, gynecological aspects, and life habits. Chi-square test and logistic regression with p <0.05 were applied for statistical analysis. Results: The prevalence of cervical changes was 3.4% and the main categories found were low-grade cervical intraepithelial lesion, high-grade cervical intraepithelial lesion, and atypical cells of undetermined significance. From these, the first were present in 16.6% of women under 25 years old. The multivariate analysis pointed at associations between previous results of the cytopathology test (OR = 25.693), smoking (OR = 7.576), and oral contraceptives (OR = 5.265) and the outcome. Conclusion: Women with a history of previous cervical cytopathological abnormality, use of oral contraceptives, and smokers were more likely to have an abnormal result in the pap smear test.

scholarly journals Clinical response to glycyrrhizinic acid in genital infection due to human papillomavirus and low-grade squamous intraepithelial lesion

2011 ◽  
Vol 1 (4) ◽  
pp. 93 ◽  
Author(s):  
Marcelino Hernandez Valencia ◽  
Adia Carrillo Pacheco ◽  
Tomás Hernández Quijano ◽  
Antonio Vargas Girón ◽  
Carlos Vargas López
Keyword(s):  
Pap Smear ◽  
Hpv Infection ◽  
The Body ◽  
Reproductive Age ◽  
New Drugs ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Glycyrrhizinic Acid ◽  
Intraepithelial Lesion

Human papilloma virus (HPV) can infect any of the mucosal areas of the body and cause cervical cancer. Until recently, no specific treatments were available for this condition; therefore, any damaged tissue had to be removed or destroyed, which may have presented obstetrical repercussions for some women. Recently, new drugs have been developed that have shown to be effective for the cure of HPV infection. Glycyrrhizinic acid (GA) has shown fewer side effects and its systemic use makes it possible to reach difficultto- treat lesions. The purpose of this study was to evaluate the clinical outcome of GA to eliminate the epithelial lesion and HPV. We carried out a longitudinal, descriptive study that included women of reproductive age who were diagnosed with HPV associated with low-grade squamous intraepithelial lesion (LSIL). Subjects began treatment based on GA using two routes of administration - systemic (oral) and topical (spray) - with assessments every month to determine the clinical changes of the lesions through colposcopy and Papanicolaou (Pap) smear. Simple statistics were used along with two-tailed Student’s t-test; P&lt;0.05 was considered statistically significant before and after treatment. There were 70 eligible patients, of whom 62 fulfilled the inclusion criteria. Age of subjects was 27.8±9.5 years. At the time of the study, 100% of the patients had HPV infection, 40% were associated with LSIL, and only 16% used a barrier contraceptive (condom) method. Resolution was achieved in all patients from 4 weeks of treatment initiation and improvement was achieved in the majority of patients at 12 weeks (74%) (P&lt;0.001). However, there was persistence of LSIL in 27.7% of patients and only one patient progressed to cervical intraepithelial neoplasia (CIN) II. The use of GA proved to be effective in resolving clinical HPV lesions. For cervical lesions with epithelial changes (LSIL), treatment may be required for a longer period as with other drugs used for this infection, as well as monitoring for at least 1 year according to the natural evolution of the disease.

Low Utility in Colposcopy-directed Biopsies for Non-high Grade Cytological Abnormalities on PAP Smear

2020 ◽  
Vol 16 (1) ◽  
pp. 18-22
Author(s):  
Eronmwon E. Gbinigie ◽  
Joshua Fogel ◽  
Maggie Tetrokalashvili
Keyword(s):  
Pap Smear ◽  
Multinomial Logistic Regression ◽  
Cervical Dysplasia ◽  
Outcome Variable ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Intraepithelial Lesion ◽  
Cytologic Abnormalities ◽  
Cytology Screening

Background: Clinicians commonly perform colposcopy directed biopsies on patients with low grade squamous intraepithelial lesion (LSIL) on PAP cytology even when not consistent with clinical guidelines. Objective: We study the association of PAP cytology screening results with cervical intra-epithelia neoplasia (CIN) 2-3 high-grade dysplasia, as confirmed by colposcopy-directed biopsy. Methods: A retrospective study of 263 women with an abnormality on the PAP smear. Multinomial logistic regression was performed with predictors of PAP cytology screening results with the outcome variable of colposcopy-directed biopsy. Results: High grade squamous intraepithelial lesion (HSIL) had significantly increased relative risk for CIN 2-3 (RR: 9.85, 95% CI: 1.84, 52.79, p=0.008). LSIL was not significantly associated with CIN 2-3. In the comparisons of negative with CIN-1, both HSIL and LSIL were not significantly associated with a negative biopsy. Conclusion: HSIL is associated with cervical dysplasia of CIN 2-3 while LSIL is not associated with cervical dysplasia of CIN 2-3. We do not recommend routine biopsies in patients with LSIL cytologic abnormalities unless additional compelling factors exist.

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