A correlation study of cervical cytology on pap smear with cervical biopsy in a tertiary care hospital (1 Year Study)

Abstract

Introduction: Cervical cancer is the second most common cancer in women worldwide after breast cancer, and in developing countries, the leading cause of death by cancer. It is one of the most preventable and curable of all cancers. The Pap smear is the standard screening tool used to test for the presence of abnormal cells that could become cancerous. A regular Pap smear provides an opportunity to detect pre-cancerous cells in the cervix. The simplicity, effectiveness and versatility of Pap test have made it an integral part of routine clinical examination and large chunk of workload in gynaecological and pathological practice is due to this test. Aims and Objectives: To establish usefulness of pap smears examination as a diagnostic tool for detection of cervical lesions. Material and Method: In present study results of 400 PAP smears are analysed, which had been examined in cytology section (Department Of Pathology, M.P. Shah Medical College, Jamnagar) during 1 years (July 2021 to July 2022). Out of 400 pap smear 250 patients were undergone cervical biopsy or hysterectomy. So the final sample size is 250. The conventional cervical smears were fixed by 100% methanol and stained by Pap method (RAPID-PAP). The cytological smears were reported using Bethesda System 2001. The cervical biopsies or hysterectomy specimens received from the same patients were fixed in 10% neutral buffered formalin solution and processed with embedding in paraffin blocks and stained with haematoxylin and eosin (H and E) stain. The histopathological findings and Pap smear findings were correlated and histopathological diagnosis of biopsies were taken as the gold standard. Result: In present study most common complain was irregular menstrual bleeding followed by lower abdominal pain. Out of 250 pap smears maximum patient belong to 41-50 years and were multipara. Maximum cases were reported as NILM (60%), followed by ASCUS (15.2%), LSIL (12%), HSIL (8%), squamous cell carcinoma (4.8%). On histopathology, 47.6% cases were diagnosed as chronic cervicitis, 23.2% cases as chronic cervicitis with squamous metaplasia, CIN I (17.2%), CIN II (4.4%), CIN III (2.8%), squamous cell carcinoma (4.8%). Overall sensitivity, specificity, positive predictive value and negative predictive value is 95.8%, 83%, 70%, 98% respectively. Conclusion: Pap smear is a simple cheap safe and practical diagnostic tool for early detection of cervical cancer in high risk group population and therefore should be established as a routine screening procedure.