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 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 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 Liquid Based Cytology for the Detection of Cervical Intraepithelial Lesion among Women in Jimma town, Ethiopia

2019 ◽  
Author(s):  
Getnet Tesfaw ◽  
Yesuf Ahmed ◽  
Lealem Gedefaw ◽  
Lamessa Dube ◽  
Samson Godu ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cervical Dysplasia ◽  
Screening Tests ◽  
Cancer Case ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Kappa Value ◽  
Intraepithelial Lesion ◽  
Liquid Based Cytology

Abstract BackgroundCervical cancer is the second leading type of female cancer in Ethiopia and screening is based on visual inspection with 5% acetic acid (VIA). Liquid-based cytology (LBC) has not yet been used. MethodWomen aged 21-65 years were enrolled. Liquid based cytology and VIA were done for the detection of cervical dysplasia. Logistic regression analysis were conducted to identify factors associated. Finally Cohen’s K was done to test agreement between the methods of diagnostics.ResultsFrom the total 448 participants, (296, 66%) were 35-65 years old. Four hundred nineteen (93.5 %) were screened using LBC of which, 97 (23.2%) had low grade squamous intraepithelial lesion (LSIL) and 17 (4.1%) had high grade squamous intraepithelial lesion (HSIL). Among women with LSIL, 84(86.6%) women as well as all those HSIL were 35-65 years old and women aged 35-65 years old had 4.7 times higher odds of having intraepithelial lesions (P=0.00). A total of 294/448 (65.6%) women underwent VIA examination, of these 18 (6.1%) were found positive. Two hundred seventy two (60.7%) women screened using both LBC and VIA. Of this 6 (2.2%) were positive with both LBC and VIA screening tests. The level of agreement between the two methods was weak and statistically significant (kappa value=0.155, p=0.006). ConclusionPrevalence of cervical lesions is higher among older women. There is high variability in LBC and VIA results. Though more expensive and requiring equipment, using LBC where possible would increase cervical cancer case detection.

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 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 Multiple Adaptive Neuro-Fuzzy Inference System with Automatic Features Extraction Algorithm for Cervical Cancer Recognition

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Mohammad Subhi Al-batah ◽  
Nor Ashidi Mat Isa ◽  
Mohammad Fadel Klaib ◽  
Mohammed Azmi Al-Betar
Keyword(s):  
Cervical Cancer ◽  
Fuzzy Inference System ◽  
Pap Smear ◽  
Fuzzy Inference ◽  
Features Extraction ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Inference System ◽  
Neuro Fuzzy ◽  
Intraepithelial Lesion

To date, cancer of uterine cervix is still a leading cause of cancer-related deaths in women worldwide. The current methods (i.e., Pap smear and liquid-based cytology (LBC)) to screen for cervical cancer are time-consuming and dependent on the skill of the cytopathologist and thus are rather subjective. Therefore, this paper presents an intelligent computer vision system to assist pathologists in overcoming these problems and, consequently, produce more accurate results. The developed system consists of two stages. In the first stage, the automatic features extraction (AFE) algorithm is performed. In the second stage, a neuro-fuzzy model called multiple adaptive neuro-fuzzy inference system (MANFIS) is proposed for recognition process. The MANFIS contains a set of ANFIS models which are arranged in parallel combination to produce a model with multi-input-multioutput structure. The system is capable of classifying cervical cell image into three groups, namely, normal, low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL). The experimental results prove the capability of the AFE algorithm to be as effective as the manual extraction by human experts, while the proposed MANFIS produces a good classification performance with 94.2% accuracy.

scholarly journals Detection of Cervical Cytological Abnormalities by Pap smears Method among Women Attending the Screening Clinic of Nsambya Hospital

2019 ◽  
pp. 1-4
Author(s):  
Mwesigwa Boaz ◽  
◽  
Andrew Livex Okwi Okwi ◽  
Othieno Emmanuel ◽  
◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Pap Smear ◽  
Public Health Problem ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Squamous Cells ◽  
Cytological Abnormalities ◽  
Intraepithelial Lesion ◽  
Intraepithelial Lesions

Background: Cervical cancer is an important public health problem. In Uganda, it ranks the most frequent cause of cancer among women aged between 15 to 44 years of age. Early detection and eradication of cervical cancer and its precursor lesions is the mainstay for control of this disease. The Pap smear method is the most cost-effective means of screening cervical pre-malignant, malignant processes and non-neoplastic lesions. Aim: To describe the cervical cytological abnormalities as detected byPap smear method and to determine the prevalence of such abnormalities Methodology: This was a prospective study, in which a total of 175 women were recruited from May to June, 2016. Cervical samples were collected from these women and stained according to the papanicolaou staining protocol. Results were reported using the 2014 Bethesda reporting system. Results: Out of 175 cases, 163 (93.1%) were reported as negative for intraepithelial lesion or malignancy [NILM]. Cervical intraepithelial lesions were reported in 12 (6.9%) cases which included atypical squamous cells of undetermined significance [ASCUS] in 4(2.3%) cases, atypical squamous cells cannot exclude high grade squamous intraepithelial lesions [ASCH] in 1(0.6%) case, low-grade squamous intraepithelial lesion [LSIL] in 5 (2.9%) cases, high-grade squamous intraepithelial lesion [HSIL] in 1(0.6%) case and atypical glandular cells [AGC] in 1(0.6%) case. Conclusion: Cervical cytology by Pap smear method should be used to screen women routinely because it is an effective method in detecting pre-malignant and malignant lesions of the cervix.

scholarly journals Liquid-based Cytology for the Detection of Cervical Intraepithelial Lesions in Jimma Town, Ethiopia

2020 ◽  
Author(s):  
Getnet Tesfaw ◽  
Yesuf Ahmed ◽  
Lealem Gedefaw ◽  
Lamessa Dube ◽  
Samson Godu ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cervical Dysplasia ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Kappa Test ◽  
Intraepithelial Lesion ◽  
Liquid Based Cytology ◽  
Epithelial Lesions ◽  
Intraepithelial Lesions

Abstract Background: Cervical cancer is the second leading type of female cancer in Ethiopia. Screening for cervical cancer is primarily conducted using visual inspection with 5% acetic acid (VIA). Liquid-based cytology (LBC) is not yet widely used in Ethiopia. Method: Women aged 21-65 years were tested using LBC and VIA to detect cervical dysplasia. Logistic regression analysis was conducted to identify associated factors. Cohen’s Kappa test was conducted to test agreement between LBC and VIA. Results: Forty-two percent (n=188) of 448 participants were 31 to 40 years of age and only two participants were above 60. Of the 448 participants, 419 (93.5%) were tested with LBC, 294 (65.6%) VIA and 272 (60.7%) with both LBC and VIA. Among women screened using LBC, 305 (72.8%) were negative for intraepithelial lesion or malignancy (NILM), 97 (23.2%) had low-grade squamous intraepithelial lesion (LSIL) and 17 (4.1%) had high-grade squamous intraepithelial lesion (HSIL). Presence of cervical lesions was generally lower in younger and older women. Majority, 39 (40%) of women with LSIL and 10 (59%) with HSIL were 41-50 years of age. Women aged 51-60 were more likely to have abnormal intraepithelial lesions compared to women aged 21-30 (AOR= 20.9, 95% CI=[7.2-60.9], p=0.00). Out of 47 (10.8%) HIV-positive women, 14 (32.56%) had intraepithelial lesions of which 10 (23.3%) and 4 (9.3%) had LSIL and HSIL, respectively. Among women screened with VIA, 18 (6.1%) were positive; among the 272 (60.7%) women screened using both LBC and VIA, 6 (2.2%) were positive on both LBC and VIA tests. The level of agreement between the two tests was weak at a statistically significant level (kappa value=0.155, p=0.006). Conclusion: LBC demonstrated high rates of cervical squamous intra-epithelial lesions in our study. VIA was a less reliable predictor of cervical squamous intra-epithelial lesions than LBC. Evaluating diagnostic accuracy of both LBC and VIA against a histological endpoint should be completed before adopting either or both screening modalities.

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