Evaluation Of Cervical Punch Biopsy In The Diagnosis Of Cervical Cancer

Abstract

Background: Cancer of the cervix uteri is the second leading cause of death in reproductive age women in developing countries. Its early detection and management can reduce the attendant mortality. Aim: To determine the adequacy of cervical punch biopsy technique in the diagnosis of cervical cancer. Methods: A consecutive five year clinico-pathological analysis of two hundred and fourteen cervical punch biopsies in the department of Pathology, Ahmadu Bello University Teaching Hospital, Zaria from January 2001 to December 2005. Results: Two hundred and fourteen (214) cervical punch biopsies were analysed. The age range of the patients was 22 to 85years, with a median age of 46 years and a mean age of 46.8years. Commonest presenting complaints were abnormal vaginal bleeding and offensive vaginal discharge. Out of the 214 biopsies, histological diagnosis was made in 190 (88.8%) cases. The spectrum of diagnosis comprised malignant tumours 164 (76.6%), cervical intraepithelial neoplasia (CIN)10 (4.7%), chronic cervicitis 9 (4.2%) and others 7(3.3%) including nabothian cysts, leiomyoma and a case of tuberculosis. The malignant tumours comprised predominantly squamous cell carcinoma 153(71.5%) with the large cell keratinizing histologic subtype accounting for 144 (99.1%), cervical Adenocarcinoma 5(2.3%), Adenosquamous 4 (1.9%), Leiomyosarcoma 1(0.5%) and malignant lymphoma 1(0.5%). Of the CIN cases, 7 had prior abnormal cervical smear cytology. 24 (11.2%) biopsies were considered inadequate for histological opinion due to extensive necrosis, obscuring haemorrhage and or scanty tissue. Conclusion: Cervical punch biopsy technique is an adequate procedure in the diagnosis of cervical cancer. Squamous cell carcinoma is the commonest histologic type and late presentation is the norm in our setting. Keywords : Punch Biopsy, Cancer Cervix, Cytology Highland Medical Research Journal Vol. 5 (1) 2007 pp. 33-37