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Research Paper | Pathology | India | Volume 11 Issue 10, October 2022
Cytomorphological Evaluation and Clinical Correlation of Epithelial Cells Abnormalities in Gynaecology Pap Smears
Dr. Romali Deshmukh | Dr. Vaishali Anand | Dr. Hansa Goswami [15]
Abstract: As per Globocon2020, Cervical cancer accounted for 9.4% of all cancers and 18.3% of new cases in 2020 in India. Cervical cancer was being 2nd leading cause of cancer-related deaths in women in India with crude mortality rate of 10.3% in 2020. Pap test (or cervical Pap smear) is the time tested screening method for cervical precancerous lesions. The aim of the present study was to evaluate women for precancerous cervical lesions, categories them according The 2014 Bethesda System for reporting cervical cytology and investigate the clinical correlation. Materials & Methods: A prospective study was carried out on all the PAP smears received during period of 8 months from January 2022 to August 2022. All PAP smears which were satisfactory for evaluation based on the 2014 Bethesda System for cervical cytology were included in the study. Patients who had repeat PAP smears and those which were unsatisfactory for evaluation were excluded. Result: Out of 292 smears received during study period, 12.67% (37) cases are found to be unsatisfactory for evaluation thus excluded. Among 255 Pap smears which were found to be satisfactory, 210 were reported as ?Negative for intra-epithelial lesion or malignancy? (i.e. Non-neoplastic) and 45 were reported as having Epithelial cell abnormalities. Out of all abnormal pap smears, Atypical squamous cell with undetermined significance (ASC-US) was more common finding accounting for 55.55% followed by Low grade intra-epithelial lesion (LSIL) accounting for 17.77%. Glandular cell abnormalities are observed in 8.88 % cases of epithelial cell abnormalities. Most common age-group observed to be involved in study was 31-40 year. The mean age for non-neoplastic lesions was 36.05 years while that for suspected neoplastic lesions was 46.9 years. Discharge per vagina was found as most common presenting complaint accounting for 51.37% of all cases in study followed by Abdominal pain (17.25%). Regarding per speculum examination, Normal cervix was seen in 37.64 % of all cases followed by cervical erosion in 33.72 % of all cases. However, Epithelial cell abnormalities was seem to be more associated with Erosion of cervix which is seen in 44.44% of cases with abnormal pap smears. Conclusion: While reviewing all the results, it is concluded that premalignant and malignant lesions of cervix are not uncommon in our set up. Cervical cytology by Pap smear is a simple, safe and effective test to detect premalignant and malignant lesions of cervix at an early stage, and thus help the clinicians in early and more efficient management of the patients. The information obtained from this study could help the institution to know about the prevalence of various abnormal smears in this area and accordingly screening programs can be emphasized and can further be used for various other research purposes.
Keywords: Bethesda, Pap smear, Epithelial cell abnormalities
Edition: Volume 11 Issue 10, October 2022,
Pages: 1073 - 1078