scholarly journals Cytohistological Correlation of Cervical PAP Smears - A TwoYear Retrospective Study from Ongole, Andhra Pradesh

2021 ◽  
Vol 8 (21) ◽  
pp. 1659-1663
Author(s):  
Rajavarapu Rajeswari ◽  
Kancharla Sushma Chandulee ◽  
Kona Suneetha ◽  
Boddu Penchala Prasanna
Keyword(s):  
Early Detection ◽  
Pap Smear ◽  
Pap Smears ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Smear Examination ◽  
Number Of Patients ◽  
Study Results ◽  
Intraepithelial Lesion ◽  
Undetermined Significance

BACKGROUND Cervical cancer is one of the most common forms of cancer. In India it is the second most common cancer after breast carcinoma. PAP smear is the best screening method to reveal spectrum of lesions in cervix ranging from inflammatory to the neoplastic process. Because of easy accessibility of cervix, cervical screening is helpful for ready diagnosis of 90 % to 96 % cytological abnormalities even in the pre-invasive stage. We wanted to evaluate the importance of PAP smear examination as a preliminary method accommodating histopathology and assess the spectrum of lesions. METHODS The study was done to identify the target age groups for the early detection of cancerous cervix by PAP smear examination. The study was done on patients who attended government general hospital (GGH), Ongole, from January 2018 to December 2019. Lesions were categorized based on 2014 Bethesda system as negative intraepithelial lesion for malignancy (NILM) / Inflammatory, benign, premalignant, and malignant. The clinicocytological and histopathological examination (HPE) of cervical biopsy of corresponding smears were compared and analysed in the present study. RESULTS Of the 584 cases studied by PAP smear examination, maximum number of patients were between 21 and 60 years of age. Maximum number of patients came with the complaint of white discharge. Highest number of cases reported were NILM / inflammatory (54.18 %), followed by atypical squamous cells of undetermined significance (ASCUS) (20.68 %), high-grade squamous intraepithelial lesion (HSIL) (13.84 %), squamous cell carcinoma (SCC) (6.84 %), low-grade squamous intraepithelial lesion (LSIL) (1.65 %), metaplasia (1.19 %), atypical glandular cells of undetermined significance (AGUS) (0.51 %), adenocarcinoma (0.17 %). CONCLUSIONS Cervical PAP smear screening is simple, cost effective and reliable method for early detection of cervical cancers. Classification of lesions based on Bethesda terminology is most informative and useful. Correlation of PAP smear cervical cytology with gold standard HPE provides greater efficacy in diagnosis. KEYWORDS PAP smears, NILM, ASCUS, AGUS, LSIL, HSIL

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 Cervical pap smear- A prospective study in a tertiary hospital

2015 ◽  
Vol 5 (10) ◽  
pp. 820-823 ◽  
Author(s):  
S Pudasaini ◽  
KBR Prasad ◽  
SK Rauniyar ◽  
R Pathak ◽  
K Pande ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Pap Smear ◽  
Cost Effective ◽  
Tertiary Hospital ◽  
Pap Smears ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Effective Screening ◽  
Intraepithelial Lesion ◽  
A Prospective Study

Background: Cervical cancer is a leading cause of mortality and morbidity among women worldwide and most common gynaecological cancer in developing countries. Papanicolaou smear is a simple and cost effective screening test for cervical cancer. The aim of this study is to evaluate and interpret the cervical pap smear cytology in a tertiary hospital. The interpretation and reporting of the pap smear is based on 2001Bethesda system.Materials and methods: This is a prospective study conducted in a tertiary hospital, Nepal Medical College over a period of two and a half years (January 2013 to June 2015). All cervical pap smears received in the department of Pathology in the study period were included.Results: A total of 4160 cervical pap smears were reported in the study period. Majority of the cases were Negative for Intraepithelial lesion or malignancy (87.9%). Bacterial vaginosis, atrophy and reactive cellular changes associated with inflammation were seen in 5.3%, 2.4% and 1.5% cases respectively.   Epithelial cell abnormalities (0.5%) include Atypical squamous cells of undetermined significance, Low grade squamous intraepithelial lesion and High grade intraepithelial lesion. 88% of Low grade squamous intraepithelial lesion was seen in reproductive age group (20-45 years).Conclusion: Cervical cancer is the most common gynaecological cancer in the developing countries. Pap smear is the simple and cost effective screening tool to detect pre invasive cervical epithelial lesions.

scholarly journals Comparison between Thin Prep® Preparation (Liquid Based Cytology) and Conventional Pap Smears of Cervical Smear Cytology Lesions – A Study from Kanyakumari, Tamilnadu, India

2021 ◽  
Vol 10 (21) ◽  
pp. 1611-1615
Author(s):  
Premalatha A. ◽  
Velayutham Sumathi
Keyword(s):  
Pap Smear ◽  
Cervical Cytology ◽  
Pap Smears ◽  
Low Grade ◽  
Age Group ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Smear ◽  
Intraepithelial Lesion ◽  
Liquid Based Cytology ◽  
Pap Method

BACKGROUND The major cause of mortality among women is cancer of the uterine cervix. It is the second most common cancer worldwide. Pap smear is done as a method of cervical screening to detect precancerous and cancerous lesions of the cervix. Early detection of these lesions prevent the number of deaths from cervical cancer. Liquid based cervical cytology was developed to improve the diagnostic accuracy of pap smears. The main purpose of this study was to compare the profile of distribution of cervical smear cytology lesions obtained by thin prep preparation (liquid based cytology) and conventional pap method among women in the age group of 25 – 60 yrs. METHODS This is a cross sectional study done among 110 women from the outpatient department of Obstetrics and Gynaecology. Conventional and liquid based cytology smears were taken simultaneously from the same women and reported according to the 2001 Bethesda system. RESULTS Majority of the women included in this study fall in the age group of 41 - 50 years [65 (59.1 %)]. Women with a history of persistant vaginal infection were 13 (11.8 %). Out of the 110 pap smears taken by both conventional and liquid based methods, unsatisfactory smears were not detected in liquid based cytology and 6 (5.5 %) unsatisfactory smears were found in conventional pap method. In liquid based cytology, inflammatory smears were detected more (80 %), atrophic smears (2.7 %), smears with features of atypical squamous cells of undetermined significance (ASCUS) were 4.5 %, low-grade squamous intraepithelial lesion (LSIL) were 3.6 %, and smears with high-grade squamous intraepithelial lesion (HSIL) were 0.9 %. Epithelial cell abnormalities were found to be high in liquid based cytology. CONCLUSIONS Abnormal epithelial lesions were detected more in liquid based cytology (thin prep method). The number of unsatisfactory smears were found to be decreased when compared to conventional pap method. KEY WORDS Bethesda Cervical Cytology, Cervical intraepithelial lesion, Conventional Pap Smear, Liquid Based Cytology Smear

scholarly journals Pattern of cervical biopsy results in cases with cervical cytology interpreted as higher than low grade in the background with atrophic cellular changes

CytoJournal ◽  
2020 ◽  
Vol 17 ◽  
pp. 12 ◽  
Author(s):  
Yilan Li ◽  
Olubunmi Shoyele ◽  
Vinod B. Shidham
Keyword(s):  
Pap Smear ◽  
Estrogen Therapy ◽  
False Positives ◽  
Cervical Cytology ◽  
Pap Smears ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Biopsy Material ◽  
Hpv Test ◽  
Intraepithelial Lesion

Objective: The cytomorphological changes associated with atrophic cellular pattern (ACP) in cervical cytology smears may mimic high-grade squamous intraepithelial lesion (HSIL). Due to this, there may be higher chances of cytomorphological overinterpretation in cases with ACP. Estrogen therapy (ET) (topical or systemic) would reverse the changes related to atrophy and repeat Pap smear after ET should correct the false positives. This approach would minimize the unindicated invasive interventions. However, performing immediate biopsies following “higher than low-grade squamous intraepithelial lesion (LSIL) (atypical squamous cells-cannot exclude HSIL, low-grade squamous intraepithelial lesions-cannot exclude HSIL, and HSIL) interpretations” in such cases, is a general trend. Pap smears with “higher than LSIL interpretations” in association with ACP over a period of 10 years were selected. Materials and Methods: A total of 657,871 cases over 10 years were reviewed, of which 188 Pap smears interpreted as higher than LSIL interpretations with ACP were selected randomly for this study. Result: Of these 188 cases, 67 underwent biopsies which were reviewed and compared with 67 biopsies performed for “higher than LSIL interpretation” cases without ACP. The follow-up biopsy material was reviewed including elective p16 immunohistochemistry with other clinical details including high-risk HPV test results as indicated. Conclusion: The findings demonstrated that Pap smears with ACP have higher false positives due to tendency for cytomorphologic overinterpretation as compared to non-ACP group.

scholarly journals Analysis of abnormal epithelial lesions in cervical Pap smears in Mid-Western Nepal

1970 ◽  
Vol 1 (1) ◽  
pp. 30-33 ◽  
Author(s):  
SK Ranabhat ◽  
R Shrestha ◽  
M Tiwari
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Pap Smear ◽  
Pap Smears ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Pap Screening ◽  
Intraepithelial Lesion ◽  
Epithelial Lesions

Background: Like in other developing countries, cancer of cervix is one of the most common malignancies in women in Nepal. Most women never undergo a cervical Pap smear screening. The objective of this study is to determine the prevalence of abnormal cervical epithelial lesions. Materials and Methods: This was a retrospective study of 880 conventional cervical Pap smears reported from the Department of Pathology, Chitwan Medical College in Chitwan, Nepal. The time period was from June 2009 to November 2010. Results: In this study, High-grade Squamous Intraepithelial Lesion was the most common with 6 cases (40%), followed by Low-grade Squamous Intraepithelial Lesion with 3 cases (20%), then Atypical Squamous Epithelial Cells of Undetermined Significance, and atypical Glandular Cells and Squamous cell carcinoma with 2 cases each (13.3%). Eighty per cent of all the abnormal epithelial lesions were found in women above the age of 40 years. Conclusion: At least one Pap screening test of the cervix of all women between the ages of 40-50 years is recommended. Keywords: Pap smear; Cervical Intraepithelial Lesion; Squamous cell carcinoma. DOI: 10.3126/jpn.v1i1.4447Journal of Pathology of Nepal (2011) Vol.1, 30-33

AN INSTITUTION-BASED DETECTION OF ABNORMAL CERVICAL CYTOLOGY IN PAPANICOLAOU SMEARS

2020 ◽  
pp. 3-4
Author(s):  
Devendu Bose ◽  
Ravi Shankar ◽  
Bejoy Chand Banerjee
Keyword(s):  
Pap Smear ◽  
Clinical Signs ◽  
Cervical Cytology ◽  
Pap Smears ◽  
Low Grade ◽  
Severe Dysplasia ◽  
Age Group ◽  
Squamous Intraepithelial Lesion ◽  
Intraepithelial Lesion ◽  
Malignant Lesions

Introduction: Cancer of the cervix is the fourth most common cancer among women in the world. It accounts for 9%-13% of all cancers in females. Cervical cancer is the most common cause of death among women in developing countries. Aim: To study the role of Pap smear in detecting premalignant and malignant lesions of cervix; and to determine the prevalence of various lesions. Materials and Methods: A retrospective study was conducted in pathology department of Shaheed Nirmal Mahato Medical College, Dhanbad, Jharkhand from January 2017 to December 2020 on patients meeting the mentioned inclusion and exclusion criteria. Results: A total of 3591 Pap smears were studied with respect to age group, clinical signs and symptoms, and cytology ndings. Most of the patients were in age group of 31–40 (44.30%) years. The Pap smear ndings revealed 35.90% as mild dysplasia (Low grade squamous intraepithelial lesion- LSIL/CIN-I) , 14.81% as moderate to severe dysplasia (High grade squamous intraepithelial lesion-HSIL/CIN-II,CIN-III), 0.29% as invasive carcinoma(suspected) besides 51% showed Negative for Intraepithelial Lesion or Malignancy ( Inammatory lesion as 44.70% and 6.30% as normal cytology. Mean age of the patients with diagnosis of LSIL was 30.3 years and for HSIL, it was 39.5 years. Conclusion: Premalignant and malignant lesions of cervix are not uncommon in our set up and cervical cytology by Papanicolaou (Pap) smears is an effective means of screening for cervical premalignant and malignant conditions. Nonspecic inammation and Low grade squamous intraepithelial lesion were most common nding among different age groups.

scholarly journals Cervical cytology profile by Papanicolaou smear in a rural setting in mid-Kerala

2020 ◽  
Vol 9 (10) ◽  
pp. 4000
Author(s):  
Megha Jayaprakash ◽  
Sreenija Menon ◽  
Georgy Joy Eralil ◽  
Alok K. P. ◽  
Rajany Jose
Keyword(s):  
Rural Areas ◽  
Pap Smear ◽  
Rural Setting ◽  
Glandular Cell ◽  
Screening Methods ◽  
Low Grade ◽  
Age Group ◽  
Squamous Intraepithelial Lesion ◽  
Intraepithelial Lesion ◽  
Undetermined Significance

Background: With no systematic national screening programme, the rates of cervical epithelial cell abnormalities as reported by various studies range from 1.32% to 25% in India. Majority are epithelial squamous cell abnormalities that include atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LSIL). Worldwide incidence of adenocarcinoma and its precursors have increased over past few decades. Objectives were to study the clinical and cervical cytological profile among women attending camps in rural areas of Thrissur district of Kerala.Methods: A cross sectional study was conducted in 214 women in the 25-65 years age group who attended cancer screening camps in rural areas of Thrissur district. Papanicolaou (Pap) smear was done using standard technique and reported using latest Bethesda classification. Pap smear results were considered as abnormal when the report was ASCUS, atypical glandular cells of undetermined significance, LSIL, high grade squamous intraepithelial lesion or invasive lesion.Results: Of all the smears, 41.6% were negative for intraepithelial lesion or malignancy. Inflammatory smears (nonspecific and specific infection associated) were seen in 57%. Glandular cell abnormality was found in 1.4% and these women were in 31-50 years age group. Among patients with glandular cell abnormality most common symptom was discharge per vaginum.Conclusions: The results of this study may be a pointer to an increase in glandular cytological abnormalities in our population and needs further large-scale studies to confirm. Current screening methods of Pap smear alone may not be adequate to pick up these lesions.

scholarly journals Demographic and Clinical Study on Patients Referred to the National Cancer Research Center for Pap Smears

2019 ◽  
Vol 60 (4) ◽  
pp. 208-214
Author(s):  
Nada A.S. Alwan ◽  
Huda Hameed Alabbody ◽  
Safana A.S. Yaseen
Keyword(s):  
Cancer Research ◽  
Clinical Examination ◽  
Pap Smear ◽  
Research Center ◽  
Pap Smears ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cellular Changes ◽  
Pap Smear Screening ◽  
Intraepithelial Lesion

Background: Cervical cancer ranks the fourth most common cancer among women worldwide and the eighth cancer overall. It is considered as one of the most preventable malignancies, and can be controlled through screening and Pap smears. Objectives: To explore the demographic and clinical characteristics of a sample of Iraqi patients who were referred to the National Cancer Research Center of the University of Baghdad for Pap smear test.        Patients and methods: The study enrolled 175 female participants who were subjected to clinical examination and Pap smear tests. A questionnaire was filled for each patient on which demographic and clinical variables were recorded. Cellular specimens were collected, fixed, stained by Papanicolaou stain and examined cytologically. The corresponding cytological findings were correlated with the studied variables and tabulated accordingly.Results: 60% of the 175 women were housewives, 40% got married before the age of 20 years, 35.4% had used contraceptive pills and 10.3% were nulliparous. The mean ages at marriage, pregnancy and first child birth were 20.2, 22.0 and 23.0 years respectively. On clinical examination, cervical erosions were obviously apparent in 41.7% of the cases and genital warts were noted in only one case (0.6%), while koilocytotic cellular atypia was observed in 4.0%. Pap smears revealed infections with Moniliasis and Trichomonas Vaginalis in 16.5% and 1.1% respectively. Atypical metaplastic changes, AGUS (atypical glandular cells of uncertain significance) and ASCUS (atypical squamous cells of undetermined significance) were displayed in 21.1%, 5.7% and 22.3% respectively. Diagnoses of CIN I (LSIL) (cervical squamous intraepithelial neoplasia 1 - low-grade squamous intraepithelial lesion), CIN II and CIN III (HSIL) (high-grade squamous intraepithelial lesion) were reported in 26.8% and 2.3% respectively. Among patients with cervical erosions, the Pap smear findings illustrated more pronounced cellular changes consistent with atypical squamous metaplasia, AGUS and ASCUS (43.8%, 19.2% and 45.2% respectively). On the other hand, LSIL, kiolocytotic atypia and HSIL in these cases were registered in 15.1%, 6.8% and 1.3% respectively. Conclusions: The demonstrated young ages at marriage, pregnancy and childbirth of the examined patients, reflecting the early onset of sexual reproductive activities, and the associated cellular changes urge the necessity for promoting public awareness on the significance of Pap smear screening among Iraqi females. The Bethesda system facilitates easier interpretation of the results; thus fostering the communications between the examining pathologists and the gynecologists.

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