Cytomorphological patterns of cervical Papanicolaou smear abnormalities based on 2014 Bethesda System in North Karnataka region

Abstract

Introduction: Cervical PAP smears are a cost effective, out-patient procedure to screen patients for cervical pathology. Objectives: To utilize cervical PAP smear examination in categorizing lesions according to the 2014 Bethesda System for cervical cytology, to analyse the spectrum of lesions andto evaluate its effectiveness as a screening procedure for detection of epithelial abnormalities in a teaching hospital in North Karnataka. Methods: A prospective one year study was carried on all conventional PAP smears received in the Department of Pathology, Navodaya Medical College, Raichur. Reporting was done in accordance with the 2014 Bethesda System for reporting cervical cytology. Correlation was done with the clinical findings. Results: A total of 578 cases were included in the study. The most common presenting complaint was abdominal pain (28.5%). The most frequent examination finding was white discharge per vaginum, WDPV (38.9%). 90.8% of PAP smears were categorized as ‘Negative for intraepithelial Lesion or Malignancy’. Specific infections were seen in 8.1%, squamous metaplasia in 15.5% and atrophic changes in 3.2%. Epithelial cell abnormalities comprised 9.2% of cases, of which Atypical Squamous Cells of Undetermined Significance (ASC-US) was 3.2%, Low grade Squamous Intraepithelial Lesion (LSIL) was 3.6%, High grade Squamous Intraepithelial Lesion (HSIL) was 1.9%, Squamous Cell Carcinoma (SCC) was 0.2% and Atypical Glandular Cells– Not Otherwise Specified (AGC-NOS) was 0.9%. Conclusion: The overall prevalence of epithelial cell abnormalities concurred with studies done in other parts of India and constituted9.2% of the total smears screened, LSIL being the most common lesion.