Role of Conventional Pap’s Smear in Diagnosis of Atypical Squamous Cell-Indeterminate Significance (ASC-US) and Low-Grade Squamous Intraepithelial Lesion (LSIL) in Comparison with Human Papillomavirus PCR Test

Abstract

Human papillomavirus (HPV) infection is most common etiological agent of carcinoma cervix. Most prevalent carcinogenic HPV types are 16 and 18. Cervical lesion can be detected by conventional Pap’s smears and polymerase chain reaction (PCR). Molecular techniques are costly and not available everywhere. The aim of study was to evaluate efficacy of conventional Pap’s smear in comparison with HPV PCR for diagnosis of ASC-US (atypical squamous cell-indeterminate significance) and LSIL (low-grade squamous intraepithelial lesion). We prospectively collected data of conventional Pap’s smears from May 2017 to September 2017. Pap’s smears showing epithelial cell abnormality were sent for HPV DNA PCR as per Bethesda guidelines 2014. Total 252 Pap’s smears were collected. Age range of affected women was 21–45 years. Chief complaints of patients were discharges, pain, and bleeding per vagina. Out of 252 Pap’s smears, 47 Pap’s smears showed epithelial cell abnormalities. The abnormalities included ASC-US in 59.5%, LSIL in 17.0%, ASC-H (cannot exclude HSIL) in 10.6%, HSIL (high-grade squamous intraepithelial lesion) and AGC in 4.2% each, adenocarcinoma in situ and squamous cell carcinoma in 2.1% each. Out of 36 ASC-US and LSIL abnormal Pap’s smears, six patient’s (five ASC-US and one LSIL) samples were sent for HPV DNA PCR. All six patients were negative for HPV DNA on PCR. Early-stage lesions of cervix may be detected by Pap’s smear even in PCR-negative cases. Conventional Pap’s smear is cost-effective method for detection of cervical lesions like ASC-US and LSIL.