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 OF LIQUID-BASED CYTOLOGY AND CONVENTIONAL CYTOLOGY FOR EVALUATION OF CERVICAL PAP SMEARS

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Dr. Bipin Gandhi
Keyword(s):  
Cervical Cancer ◽  
Epithelial Cell ◽  
Pap Smear ◽  
Developed Countries ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Conventional Cytology ◽  
Resource Setting ◽  
Intraepithelial Lesion ◽  
Liquid Based Cytology

INTRODUCTION: This high mortality rate from cervical cancer globally can be reduced by an approach that includes prevention, early diagnosis, effective screening and treatment programmes. There are currently vaccines that protect against common cancer-causing types of human papilloma virus and can significantly reduce the risk of cervical cancer. in low socioeconomic or developing countries where screening programmes are not available, diagnosing cervical cancer at an early stage and providing access to effective treatment can significantly improve the likelihood of survival. Liquid-based cytology (LBC) was introduced at around mid-1990s as an alternative technique to process the cervical samples. After that most of the developed countries has switched from conventional Pap smear to LBC. LBC has been proposed to be beneficial than Pap smear because of less number of unsatisfactory smears MATERIAL AND METHODS: This study comprises of 287 cervical samples from women visiting the Department of Obstetrics and Gynaecology over a period of 1 year.  Samples were taken and divided into two parts by split-sample technique.  Material was taken from the fornix, portio, and endocervix from all women. Slides for conventional cytology and LBC were stained according to the Pap method. LBC was considered representative if the slide contained >5000 epithelial cells. Endocervical cells were considered present if the slide contained ≥2 groups of glandular/metaplastic cells with ≥5 cells each or if the slide contained ≥10 dissociated glandular/metaplastic cells RESULTS: 287 patients were included in the study. Epithelial cell abnormality was observed in 10 cases in conventional smear while in LBC it was 11. In conventional smear pap report of Unsatisfactory, normal, atrophic, altered flora and candida was in 21,193, 21, 46 and 10 cases respectively. In LBC pap report Unsatisfactory, normal, atrophic, altered flora and candida was in 15,214, 22, 44 and 13 cases respectively. Epithelial cell abnormality was seen in 10 (3.5%) cases by both the methods. Of these 10 cases low grade squamous intraepithelial lesion was observed in 2 cases, High grade squamous intraepithelial lesion in one case, Squamous cell carcinoma in one case and atypical squamous cells of undetermined significance in 6 cases. CONCLUSION: There was a similar detection rate of epithelial abnormalities and infections in both the methods. US rate of CPS was 7.3% and 5.2% for LBC. Thus LBC can be a superior test as compared to conventional pap smear but has to reconsidered in the low-resource setting.

scholarly journals Cervical Cancer screening in a tertiary care centre by Pap smear and its clinical correlation

2019 ◽  
Vol 2 (3) ◽  
pp. 154-158 ◽  
Author(s):  
Gir Dhari Sharma ◽  
Rajesh Adhikari ◽  
Shyam Sundar Parajuly ◽  
Kalpana Gautam Adhikari
Keyword(s):  
Cervical Cancer ◽  
Pap Smear ◽  
Screening Tool ◽  
Precancerous Lesion ◽  
Early Marriage ◽  
Low Grade ◽  
Major Public Health Problem ◽  
Squamous Intraepithelial Lesion ◽  
Carcinoma Cervix ◽  
Intraepithelial Lesion

Introduction: Cervical cancer is one of the common cancers in women and is a major public health problem all over the world. It has significant contribution to high mortality and morbidity. Preinvasive lesions spontaneously regress to normal, remain stable for a long time or progress to higher degree of dysplasia followed by carcinoma cervix. Materials and Method This was a hospital based retrospective study where 456 patients’ records were reviewed. Pap smear was used as the screening tool for the detection of precancerous lesion among the women visiting Western Regional Hospital (WRH), Department of obstetrics and gynecology. Results: Among 456 patients screened, most of them were in the age group of 30-39 years (42.8%) and were of parity 3 (42.8%). Most of them had no risk factors for carcinoma cervix (54.4%). Early marriage accounted for the highest risk of developing precancerous lesion (32.7%). There were no carcinoma detected by Pap smear. The test was negative in 68.9%, Low-grade Squamous Intraepithelial Lesion (LSIL) was detected in 5.9% and 2.9% had High-grade Squamous Intraepithelial Lesion (HSIL). Pap smear was sent for screening purpose in asymptomatic women (37.1%) and among the symptomatic patients vaginal discharge was the most common indication of pap test (34.6%). Conclusion: A Pap smear is reliable, simple, non-invasive, cost effective, and easy screening tool for detection of precancerous lesions in a woman.  

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 Correlation of Epithelial Cell Abnormality in Cervical Cytology with Cervical Histology

2020 ◽  
Vol 18 (1) ◽  
pp. 40-43
Author(s):  
Richa Shrestha ◽  
Kavita Sinha ◽  
Nirmala Sharma ◽  
Anil Shrestha
Keyword(s):  
Epithelial Cell ◽  
Pap Smear ◽  
College Teaching ◽  
Cervical Cytology ◽  
Internal Quality ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Abnormal Finding ◽  
Common Cancer ◽  
Intraepithelial Lesion

Introduction: Cervical cancer is the second most common cancer in females worldwide and third most common cancer in Nepal. Conventional Pap smear is the most widely used screening tool for detecting premalignant and malignant lesions of cervix. Cytohistological correlation of Pap smear is a widely accepted method for analysis of various factors leading to discrepancies in diagnosis and internal quality assurance. Aims: To study the cytohistological correlation of epithelial cell abnormality in Pap smear in Nepalgunj Medical College Teaching Hospital, Kohalpur, Banke, Nepal. Methods: This is a hospital based prospective cross sectional study carried out at Department of Pathology, NGMC, Kohalpur, Nepal from August 2018 to January 2020. The study included 137 cases of Pap smear with epithelial cell abnormality and correlated with corresponding histopathological findings. Results: The age of patients ranged from 20-80 years with the number of cases seen in the range of 30-39 years (n=44; 32.1%). Whitish discharge per vaginum was most common presenting symptom.  High grade squamous intraepithelial lesion (HSIL) was the most common abnormal finding in Pap smear with a frequency of 40 (29.1%) cases. Out of 137 cases of Pap smear 57 (41.6%) cases showed discrepancies in cervical biopsy. All cases of Squamous Cell Carcinoma (SCC) were correctly diagnosed by Pap smear. The overall sensitivity of smear test was 84%. After evaluating cytohistological correlation, the Positive Predictive Value (PPV) was found to be 100% for SCC, 52% for HSIL and 59% for Low grade squamous intraepithelial lesion (LSIL). Conclusion: The current study revealed a good correlation between cervical cytology and biopsy in Pap smear showing epithelial cell abnormalities. Thus, cytology and histology are complementary to each other and helps to reduce discrepancies.

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 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 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

scholarly journals ThinPrep Pap Test for Diagnosis of Cervical Cancer in Early Stages

2019 ◽  
Vol 4 (4) ◽  
pp. 141-144
Author(s):  
Siamak Sabour ◽  
Ommolbanin Abbasnezhad ◽  
Ali Dastranj Tabrizi ◽  
Amir Vahedi ◽  
Elmira Mostafidi
Keyword(s):  
Cervical Cancer ◽  
Screening Test ◽  
Pap Smear ◽  
Pap Test ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Papanicolaou Test ◽  
Observer Reliability ◽  
Early Stages ◽  
Intraepithelial Lesion

Background: Cervical cancer is one of the world’s deadliest forms of cancer and Pap smear is the most popular screening test for diagnosis in early stages. The aim of our study was to assess potential screening rule of ThinPrep Pap test. Methods: In this cross sectional, study Cervical samples were collected from all women who referred to a pathology center for Papanicolaou test and all samples were prepared with ThinPrep process. To assess validity, biopsy was selected as gold standard. 131 women who had ThinPrep Pap test and biopsy were considered for the analysis. The participants were selected purposeful. Three thresholds were used to define test positivity: 1) Atypical squamous cells of undetermined significance (Asc-us) 2) Low grade squamous intraepithelial lesion (LSIL) 3) High grade squamous intraepithelial lesion (HSIL) and worse. Inter and intra observer reliability were evaluated using kappa (simple and weighted) as well as Fleiss kappa and validity were assessed by the well-known validity estimates for qualitative variables. Results: Intra observer reliability was moderate for pathologists with low and moderate experience (kappa was 0.44 and 0.46 respectively) and was good for experienced pathologist [kappa (WK) = 0.64]; however, inter observer reliability was poor (Fliess kappa=0.12). For diagnosis of ASCUS and worse, the sensitivity was 96.3% and for diagnosis of HSIL and worse the sensitivity and specificity were 86.6% and 95.1%, respectively.Conclusion: ThinPrep pap is an acceptable screening test for diagnosis of cervical cancer in early stages. However, experience and specialty have effect on reliability’s results.

scholarly journals Conventional Pap Smear Cytology in a Tertiary Care Center

2021 ◽  
Vol 17 (2) ◽  
pp. 117-123
Author(s):  
Tika Kumari Gurung ◽  
Shree Prasad Adhikari ◽  
Ayushma Adhikari ◽  
Reecha Shrestha ◽  
Chum Maya Pun ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Pap Smear ◽  
Tertiary Care ◽  
Pap Test ◽  
Low Grade ◽  
Test Results ◽  
Pap Tests ◽  
Intraepithelial Lesion ◽  
Bethesda System

Abstract: Background: Cervical cancer is the fourth most common cancer in women with high mortality. Since it is a preventable cancer, screening for cervical cancer with Papanicolaou test (Pap Test) is considered as the stepping stone in its cure by detecting  at its premalignant state. The two methods of acquiring the sample for cytology are Conventional method and liquid based cytology. Methods:  The Pap test  results of the patients who visited the outpatient clinic of the Gynecologic Department of Gandaki Medical College and Teaching Hospital from January 2012 to December 2017 were reviewed and analyzed from the medical records. The findings of Pap test results were tabulated and categorized as per Bethesda system of classification (2001). Results:  A total of 2004 Pap tests were taken. All of the patients in the study were married with mean age of 39.7±10.3 years. A total of 1291(64.42%) Pap tests were normal or negative for intraepithelial lesion whereas 578(28.84%) were inflammatory smears while 37(1.85%) were inadequate for evaluation. There was a presence of low grade intraepithelial lesion in 4(0.2%)  and high grade intraepithelial lesion in 15(0.75%). Atypical squamous cell of undetermined significance (ASCUS) was noted in 11(0.55%) and frank malignancy was noted in 1(0.05%) of total Pap test samples. Conclusion: In a developing country like Nepal, Pap test is still the preferred cervical cancer screening tool. All women should undergo the screening test for cervical cancer with any feasible available test. Key words: Bethesda system; cervical cancer; HPV; Pap Test.

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