Neoplastic Lesions Of Cervix Research Articles

Cytomorphological study of pap smear and its efficacy to detect various cervical lesions

: Cervical lesions require screening for early diagnosis to differentiate between non-neoplastic and neoplastic lesions of cervix. The present research aimed to evaluate the prevalence of various cervical lesions and detect the efficacy as a screening test of pap smear for early diagnosis of cervical lesions. : The current retrospective study was conducted in the Department of Pathology, SSMC, Rewa, M.P. Total 658 cervical pap smears were retrieved, re-examined and re-classified according to the revised Bethesda system for reporting of cervical cytology, 2014. Out of 658 pap smears, 234 biopsies were available, which were re-examined histopathologically and correlation was done with their corresponding cytological findings.: Out of 658 pap smears, negative for intraepithelial lesion or malignancy (NILM) was found in 74.47% smears, while the prevalence of epithelial cell abnormalities (ECA) was 24.32%. Amongst ECA, most common (11.86%) cervical lesion was low-grade squamous intraepithelial lesion (LSIL). Diagnostic sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy for the diagnosis of pre-invasive and invasive cervical lesions was found 70.54%, 81.9%, 82.72%, 69.35% and 75.6% respectively.: The current study showed that pap smear cytology is able to detect various cervical lesions with a diagnostic accuracy of 75.6%. So, women belonging to reproductive or postmenopausal age-group should be routinely screened for cervical lesions by non-invasive pap smear method. Conclusively, early diagnosis of cervical lesions is possible, thus reducing the incidence of invasive cervical carcinoma.

ANALYSIS OF CERVICAL PAP SMEARS AS PER BETHESDA SYSTEM IN A TERTIARY CARE CENTRE.

Background: The value of exfoliative cervical cytology is undisputed today. Most studies focus on the application of pap smears to detect precancerous and cancerous lesions but pap smears are also significant in detecting inflammatory lesions and etiology wherever possible which can help the clinician in the management and prevent further dysplasias.
 Aim & Objectives: To find out the prevalence of various non-neoplastic and neoplastic lesions of cervix as per the Bethesda system 2014 and to find out the etiology of inflammation wherever possible.
 Methodology: This study was conducted over a period of one year from January 2017 to January 2018. 1518 pap smears received in the Department of Cytology were stained with pap stain & reported according to 'The 2014 Bethesda System for reporting cervical cytology'.
 Results: 1518 pap smears were screened in which 28 (1.8%) smears were unsatisfactory for evaluation and 1490 (98.2%) were satisfactory. NILM was the predominant finding seen in 1473(98.86%) smears. Among the specific infections, the most common was bacterial vaginosis in 128 (8.59%) smears, trichomonas vaginalis in 10 (0.67%), candida infection in 7 (0.47%) smears and 26 (1.75%) smears showed reactive changes associated with inflammation. Atrophic changes were found in 50 (3.36%) cases. Epithelial cell abnormalities were seen in 17 (1.17%) cases in which 9 (0.6%) cases were reported as ASCUS, 2 (0.13%) cases as LSIL and HSIL was seen in 1 (0.07%) case. Squamous cell carcinoma (SCC) was diagnosed in 4 (0.27%) cases and Adenocarcinoma in 1 (0.07%) case.
 Conclusion: Cervical cytology is a simple and cost effective test and should be established as a routine diagnostic aid.
 Keywords: Atypical squamous cells of undetermined significance (ASCUS), Bethesda System, High grade squamous intraepithelial lesion (HSIL), Low grade squamous intraepithelial lesion (LSIL), Negative for intraepithelial lesion or malignancy (NILM), Papanicolaou smears.

Histopathological evaluation of Non-Neoplastic and Neoplastic Lesions of Uterine Cervix at tertiary care centre

Background: Uterine cervix is common specimen from gynecological department with non-neoplastic and neoplastic lesions. Most cervical cancers can be detected at pre-invasive state with an adequate screening and treated appropriately thus preventing overt progression to full blown cancer and hence decreasing morbidity and mortality. Carcinoma of cervix is a preventable tumor and if good effort given in detecting preinvasive lesion one can give definite treatment at earliest. Objectives: To evaluate the histopathological diagnosis of a biopsy of cervix in women with unhealthy cervix. Also, to study the agerelated, incidence and the incidence of various nonneoplastic and neoplastic lesions of the cervix. Methodology: It is a cross sectional study. Institutional Ethics committee permission was taken prior to start of the study. Pertinent clinical history like age, significant family and personal history, history of other diseases was taken. Cervical biopsy specimens collected from histopathology section and grading of cervical lesions was done based on the proportion of stained cells and the intensity of staining. Statistical analysis was done. The data were tabulated and frequencies and percentages were calculated. Observations: The common age group was 41-50 years (37.50%) followed by 31-40 years of age (26.25%). The symptoms with which patients presented were vaginal bleeding (52.50%) followed by white discharge per vagina (16.25%) and menorrhagia (12.50%). The premalignant lesions were seen in 12 cases (15.0%) and malignant lesions in 68 cases (85.0%). Among them 64 malignant tumours were epithelial in origin. As per microscopic examinations squamous cell carcinoma was diagnosed in 61 cases (93.75%), followed by 2 cases (3.13%) of adenocarcinoma, and 1 case (1.58%) of adenosquamous carcinoma and 1 case (1.54%) of rhabdomyosarcoma. Conclusion: Cervical cancer continues to be the most common cancer of females in developing countries. One of the most significant advances in the management of cervical neoplasms has been the realization that cervical intraepithelial lesions behave as progressive stages of a biologic continuum towards the development of invasive cancer.

Prevalence of altered cervical cytological pattern: Aretrospective study in females visiting tertiary care hospital

Background: Cervical cancer is one of the major causes of morbidity and mortality in India. Pap smear is a simple, non-invasive, cost-effective and sensitive tool to detect various non-neoplastic and neoplastic lesions of cervix. The objective of this study was to estimate the prevalence of cervical cytological pattern in a tertiary care centre; by using conventional Papanicolaou (Pap) smears for the screening of inflammatory, premalignant and malignant lesions of the cervix. Methods: This cross-sectional study is based on 574 patients who attended the out‑patient Department of Obstetrics and Gynecology, during the period between Jan 2015 to Feb 2017. Pap smears were prepared from patients presenting with complaints like vaginal discharge, post‑coital bleeding, inter‑menstrual bleeding, dyspareunia, and pain in lower abdomen. Conventional Papanicolaoustained smears were classified as per Bethesda 2001 nomenclature. Results: Prevalence of altered cervical cytological pattern was 75.59% amongst females visiting hospital. A total of 574 cervical pap smears were studied, out of which 66 were inadequate. Out of 508 cases, 448 cases were of NILM [including 324 (63.78%) inflammatory lesions and 124 (24.41%) normal smears] and 60 (11.81%) cases of epithelial lesions. The epithelial lesions prevalence rate was ASCUS (5.7%), LSIL (1.4%) and HSIL (1.4%), AGUS (0.78%), SCC (0.6%) and endometrial carcinoma (0.2%). Conclusions: This study shows relatively high prevalence of epithelial abnormalities with increasing age, parity, women with clinical lesions on per speculum findings. Malignancy was more common in sixth and seventh decade and intraepithelial lesions/dysplasia was seen mostly in fourth and fifth decade. Inflammatory lesions were more common in younger age group. Pap smear should be advised as a routine screening procedure; as it is a simple, cheap, safe and practical diagnostic tool for early detection of cervical cancer in high risk group population. It also helps in diagnosis of inflammatory lesions including the identification of causative organism and atrophic changes.

Histopathological Evaluation of Non-Neoplastic and Neoplastic Lesions of Cervix

Histopathological Evaluation of Non-Neoplastic and Neoplastic Lesions of Cervix

Detection Of Abnormal Cervical Cytology In Papanicolaou Smears At A Tertiary Care Hospital

Objective: After breast cancer, cervical cancer is the second most common cancer in women worldwide.In developing countries it happens to bea leading cause of death by cancer. It is one of the most preventable and curable of all cancers. Most women due to lack of awareness never undergo a cervical Pap smear screening. The Objective here is to study the role of Pap smear in detecting premalignant and malignant lesions as well as non- neoplastic lesions of cervix. Methods: This retrospective study of 1058 women with age group 20 to 90 years was carried out over 4 years from 2012 to 2015 at cytology section of pathology department, Tripura Medical College, Hapania.Pap smears were prepared and after fixation and staining, each smear was carefully examined. Results: In this study, Low-grade squamous intraepithelial lesions was the most common with 86 cases (8.1%) followed by High-grade squamous intraepithelial lesions with 52 cases (4.9%). Squamous cell carcinoma 35 cases (3.3%), ASCUS 12 cases (1.1%). Conclusion: Pap smear happens to be an elementary, economical, safe and pragmatic diagnostic tool for early detection of cervical cancer, so it should be established as a routine screening procedure. A routine pap screening cytology of uterine cervix of all the women aged 40 to 50 years should be encouraged by the medical fraternity.

Significance of mast cells in non-neoplastic and neoplastic lesions of uterine cervix

Background: Mast cells are involved in multiple biological events. The significance of mast cells in non-neoplastic and neoplastic lesions of cervix has been studied with conflicting results. Its presence in tumor has been described as evidence of host immunologic antitumor response, angiogenesis and tumor invasion. Aims/Objectives: To study mast cell density in various cervical lesions using Toluidine blue stain; To compare the sections studied with conventional Toluidine blue staining and Toluidine blue staining by reducing the pH. Methodology: Cervical biopsy/hysterectomy specimens from archives of Department of Pathology were considered for the study. The sections were studied for histomorphology and mast cell density. The mast cell density was assessed by Toluidine blue staining by conventional method and another method by reducing pH using weak HCL. The stained slides were reviewed for mast cell density under 10 high power field and statistically analysed. Results: Total of 100 cases were studied. Normal cervix 7 cases with mean age of 44.29 and mast cell density (mean) of 45.43. Chronic cervicitis and polypoidal Endocervicitis were 26 and 28 cases, mean age of 45.38 years and 39.14 years and mean mast cell count of 48.38 and 66.96 respectively. Intraepithelial lesions and malignancy were 23 and 16 cases, mean age of 43.56 years and 52.26 years and mean mast cell of 34.47and 34.6 respectively. Maximum number of mast cells was seen in polypoidal Endocervicitis and least number in Squamous cell carcinoma of cervix. Conclusion: The role of mast cell differs in inflammatory and neoplastic lesions of cervix. Mast cells has active role in inflammatory lesions.

Cervical Neoplasia-Cyto-Histological Correlation (Bethesda System) A Study of 276 Cases

Carcinoma uterine cervix is one of the leading causes of cancer death among women worldwide. To detect this widely prevalent cancer at an early stage, the simplest test has been a pap smear. Reporting of pap smears is done by using The Bethesda System 2001 prior to which many classification systems were developed [1,2,3,4]. To check the sensitivity and specificity of Bethesda system, the cytological findings have to be correlated with histology considering histopathology as gold standard. In our study, we have correlated cytological findings (pap smears) with corresponding histology after follow up of the symptomatic patients in the age range of 20 to 80 years. The main objectives were to study usefulness of cytology in detecting various preneoplastic and neoplastic lesions of cervix, to evaluate and to interpret the cases of epithelial lesions according to The Bethesda 2001 classification system [5] and correlation of cytological findings with follow-up histology sections. Analysis of different factors causing discrepancies was done. Aims: The study was conducted to study usefulness of cervical cytology by PAP smear and the application of the Bethesda 2001 system in classifying different preneoplastic and neoplastic lesions of cervix. Setting and design: With the use of PAP test and applying the BETHESDA 2001 classification 5, in the present study we have examined cervical smears of symptomatic patients in the age group ranging from 25 to 70 years. Inflammatory & unsatisfactory smears were excluded. The remaining cases showing epithelial abnormalities were followed up and biopsy slides were studied. Cytohistological correlation was done in those cases and results were obtained.