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

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.

Author(s):  
Ruksana Farooq ◽  
Azhar-un-Nisa Quraishi ◽  
Shahida Mohammad

Background: Cervical cancer is the most common genital cancer in India. In India alone,almost,130000 new cases occur with the death toll of 70000 everywhere. Objective of current study was correlation of pap smear with histopathological diagnosis.Methods: A retrospective study was conducted in tertiary care hospital in 130 sexually active women. Pap smears were taken and histopathological diagnosis was performed in all such patientsResults: From pap smear findings, out of 130 patients, maximum number of cases, 74 (56.9%) were categorized as. Out of epithelial cell abnormality, ASCUS was seen in 25 patients (10.2%), LSIL in 17 patients (13.1%), HSIL in 11 patients (8.5%). SCC was seen in 2 patients (1.5%) and adenocarcinoma in 1 patient (0.8%). From cervical biopsy reports, 51 cases(39.2%) were diagnosed as chronic cervicitis, 34 cases (26.2%) were diagnosed as chronic cervicitis with squamous metaplasia, CIN I in 31 patients (23.8%), CIN II in 8 patients (6.2%) and CIN III in 3 patients (2.3%), squamous cell carcinoma in 2 patients (1.5%) and adenocarcinoma in 1 patient (0.8%). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of pap smear test was 91.1%, 82.4%,73.2%, 94.6% and 85.4%, respectively.Conclusions: Pap smear has excellent correlation with histopathological diagnosis. Therefore it should be encouraged as effective tool for cervical cancer screening program to reduce incidence and mortality caused by cervical cancer. 


2019 ◽  
Vol 9 (1) ◽  
pp. 1475-1479
Author(s):  
Anuj Poudel ◽  
Prahar Dahal

Background: Conventional Cervical Cytology is the most widely used cervical cancer screening test. The incidence of cervical carcinoma is incredibly high in developing countries due to lack of proper knowledge. The extensive use of cervical screening with Papanicolau smears had considerably increased the detection of precancerous and cancerous lesion of uterine cervix. Study was conducted to evaluate cytohistological correlation and to calculate concordance and discordance of Pap smear in detection of precancerous and cancerous lesions of uterine cervix. Materials and Methods: A total of 54 samples reported in Pap smear as cervical intraepithelial lesions and suspicious for invasive malignancies were selected and correlated with corresponding histopathological findings. It was an observational study done for a period of 18 months from November 2016 to May 2018 at UCMS-TH. All the statistical evaluation was done by using SPSS version 20. Results: During the study period 54 cases were evaluated. Atypical Squamous Cell of Undetermined Significance was the common abnormal findings in the Pap smear with frequency of 26 (48.1%). Out of total 54 cases of Pap smears, 30 (55.55%) were concordant while discrepancies occurred in 24(44.44%) cases with cervical biopsy. Conclusions: The study revealed a good correlation between cervical cytology and cervical biopsy. We also concluded that conventional Pap smear is a cost effective test for the early detection of precancerous and cancerous cervical lesions.


Author(s):  
Srilakshmi Yarlagadda ◽  
Rangarao Diddi ◽  
Prasuna J. L. Narra

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.


Author(s):  
Rashmi Saxena ◽  
Alpana Agrawal ◽  
Neelima Agarwal ◽  
Manisha Gupta ◽  
Divya Shubham ◽  
...  

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.


Author(s):  
Jyothi Gandavaram ◽  
Bindu Reddy Pamulapati

Background: Cervical malignancy is ranked second among the malignancies in females with breast carcinoma the first. Screening for cervical cancer by conventional cytology and supported by colposcopy and histopathology can easily identify the premalignant lesions and also other non-invasive inflammatory lesions of the cervix. Objective of this study was to find the correlation of Pap smear, colposcopic findings and colposcopic guide biopsy in evaluation of cervical lesions in women and to analyze the various risk factorsMethods: A prospective study for two years was conducted by department of obstetrics among women aged from 20-60 years. Socio demographic data, clinical history and examination were done and findings noted. Pap smear, colposcopy and colposcopic guided biopsy was done and findings were noted and analyzed foe sensitivity, specificity and compared with Pap smear.Results: In present study sensitivity of Pap smear for detecting lesions above LSIL was 28%, specificity 99.32%, PPV was 93.47%, negative predictive value 76.21% and accuracy of Pap smear was 78%. The sensitivity of colposcopy in detection of low grade lesions and above came out to be 80.2%, specificity 82.14%, positive predictive value 66.78%, negative predictive value 86.78% and accuracy of colposcopy was 84.65%.The incidence of preinvasive lesions (LSIL and HSIL) was 33.6% with LSIL (19.2%) and HSIL (14.4%) and of invasive lesions was 9.6%.Conclusions: This study suggests that accuracy of detection of cervical abnormalities is higher when cytology, colposcopic biopsy and colposcopy are used complimentarily in diagnosis of cervical lesions. Colposcopy eliminates the need for repeated follow up as in Pap smear which has low sensitivity.


2021 ◽  
Vol 29 (2) ◽  
pp. 164-168
Author(s):  
Koustav Mondal ◽  
Chiranjib Das

Introduction Multinodular goitre (MNG) is defined as multiple palpable distinct nodules in the enlarged thyroid gland. MNG can harbour malignancy in 1-10% cases. We undertook the present study to correlate the clinical, radiological and cytological features of MNG with that of final histopathological diagnosis. Materials and Methods A prospective cohort study was done in a tertiary care hospital in northern part of West Bengal from January 2018 to December 2019. Patients aged between 12 years and 75 years, presenting with MNG on clinical examination, were included in the study. We compared the pre-operative ultrasonography (USG) of neck and fine needle aspiration cytology (FNAC) reports with post-operative histopathological examination (HPE) report. Results Among 100 patients 80 were female and 20 were male. Most patients were in 41-50 years age group. For detection of malignancy in MNG, USG had 40% sensitivity, 97.78% specificity, 66.67% positive predictive value (PPV), 93.62% negative predictive value (NPV), and 92% diagnostic accuracy. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of FNAC for detection of malignancy in MNG were 20%, 93.33%, 25%, 91.3% and 86% respectively. When USG features were combined with FNAC features non-diagnostic result decreased from 6% to 2% and diagnostic accuracy for detecting malignancy in MNG increased from 86% to 90%. Conclusion USG and FNAC are complementary to each other in the diagnostic workup of MNG. USG guided FNAC is still better for reaching final diagnosis and exclusion of malignancy.


Author(s):  
Chaitra Krishna ◽  
Savitha Chandraiah ◽  
Chandana Krishna

Background: Cervical cancer is the fourth commonest cancer affecting women worldwide and the second most common cancer in women aged 15-44 years. The Papanicolaou (Pap) smear has been the cornerstone of screening for cervical neoplasm for the last 50 years. Liquid-based cytology (LBC) was introduced in mid-1990s as an alternative technique to process cervical samples has many benefits over Pap. A new second generation technique, Liquiprep was introduced after a decade has the advantage of a much lower cost. However, the information available on second generation liquid based cytology is limited. The objective was to look for the efficacy of LBC and to compare it to that of conventional cytology.Methods: This hospital based comparative study was undertaken 100 women who attended gynaecology OPD during 2017 at a tertiary care hospital in Bengaluru. Two cervical smears were simultaneously prepared from each subject, one for Pap smear and another for LBC followed by colposcopy and biopsy.Results: Among the study subjects, 89% of Pap smear analysis and 100% of smears in LBC showed satisfactory smear. Cytological abnormality was detected in 11% and 21% in pap and LBC, respectively. The present study showed higher sensitivity and specificity of 100% and 75% by LBC when compared to Pap smear (55% and 100% respectively).Conclusions: The present study showed that liquid based cytology is better in detecting cervical lesions when compared to conventional smear. 


2020 ◽  
Vol 11 (4) ◽  
pp. 5860-5866
Author(s):  
Sujata Kumbhar ◽  
Sujata Kanetkar ◽  
Avinash Mane ◽  
Akanksha Gore

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.


2019 ◽  
Vol 4 (1) ◽  
pp. 2-8
Author(s):  
Pragya Gautam Ghimire ◽  
Durga BC Rawat ◽  
Kavita Sinha ◽  
Kamar Jahan ◽  
Richa Shrestha

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.


Sign in / Sign up

Export Citation Format

Share Document