Correlation among Clinical Presentation, Staging and Histopathological Findings in Carcinoma Cervix

Abstract

Introduction: Cervical cancer is a malignant neoplasm arising mainly in the transformation zone of the cervix. Cervical cancer is the second most common cancer among women worldwide after breast cancer. Squamous cell carcinoma and adenocarcinoma constitute the greatest burden, globally as well as in Bangladesh. Most patients in developing countries including Bangladesh present at advanced stage. Histopathological types of cervical cancer influence the treatment outcome when treated by radiation therapy. To reduce mortality from cervical cancer and improve survival, it is necessary to correlation of clinical presentation, staging and histopathological findings. Objectives: To find the correlation among clinical presentation, clinical staging and histopathological findings in patients with carcinoma cervix. Materials and Methods: This cross-sectional study was conducted in the Gynaecologic division of the Department of Obstetrics & Gynaecology, Bangabandhu Sheikh Mujib Medical University Hospital, Dhaka over a period 6 months between October 2013 to March 2014. A total of 50 patients with histologically confirmed carcinoma cervix were consecutively included in the study. Clinical presentation, staging and histopathological grading were done to see the correlations among them. All information was recorded in data collection sheet. Data were analyzed by SPSS. Data were compared and correlated among groups and presented by tables and figures. Results: Over two-thirds (70%) of the patients were of age 50 or > 50 years with mean age being 51.8 ± 7.7 years indicating that carcinoma cervix is disease of late middle aged or elderly women. In the present study patients were predominantly at menopausal stage (76%). Vaginal discharge was the predominant complaints (66%) followed by irregular bleeding (54%), postcoital bleeding (34%) and foul smelling discharge per vagina. Seventy percent of the cases were clinically categorised as stage IB1 followed by IB2 (16%), IA (6%), IIB2 (4%) and IIIA (4%). Histopathologically majority of the cases was ranked as Grade-II (90%) and typed as squamous-cell carcinoma (94%). Based of clinical symptoms, 42% of the carcinoma cervix were predicted as having advanced disease, but based on clinical staging and histopathological 8% and 6% of the cases respectively were considered having advanced. Conclusion: Present study concluded that clinical staging well-correlates with histopathological grading, but prediction of the status of the disease with mere clinical symptoms may be misleading.