Cervical Cancer Screening Using Liquid-based Cytology and its Histopathological Correlation
Background: Cervical cancer is one of the leading causes of cancer-related deaths in women. It is the fourth most common cancer in women. The Papanicolaou test is a screening test that has been used traditionally to detect premalignant and malignant lesions of the cervix. Aim: To study the frequency...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Jaypee Brothers Medical Publisher
2025-06-01
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| Series: | Journal of Medical Academics |
| Subjects: | |
| Online Access: | https://www.jmaacms.com/doi/JOMA/pdf/10.5005/jp-journals-11003-0157 |
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| Summary: | Background: Cervical cancer is one of the leading causes of cancer-related deaths in women. It is the fourth most common cancer in women. The Papanicolaou test is a screening test that has been used traditionally to detect premalignant and malignant lesions of the cervix.
Aim: To study the frequency of premalignant and malignant lesions of the cervix and the cyto-histopathological pattern of Pap smears with cervical biopsies done in atypical smears.
Materials and methods: This is a retrospective study conducted at the Army College of Medical Sciences and Base Hospital, a tertiary care hospital of the Army, between September 2023 and August 2024 using liquid-based cytology (LBC). For evaluating the Pap smears, the Bethesda system (2014) for reporting cervical cytology was used. Patients with atypical findings were further followed up with cervical biopsy, and statistical analysis was done.
Results: In our present study, a total of 2,850 patients who had symptoms of heavy menstrual bleeding, vaginal discharge, postcoital bleeding, etc., were analyzed with LBC during the abovementioned period. The age of women ranged from 20 to 67 years. It was observed that 114 patients (4.00%) had unsatisfactory smears, 2,506 patients (93.22%) had negative for intraepithelial lesion or malignancy (NILM), and 48 patients (1.68%) had abnormal results. Out of these 48 abnormal Pap smears, atypical squamous cells of undetermined significance (ASCUS) were seen in 23 (47.91%), low-grade squamous intraepithelial lesions (LSIL) in 14 (29.16%), high-grade squamous intraepithelial lesions (HSIL) in 8 (16.66%), and atypical glandular cells (AGC) in 3 (6.25%) patients. A total of 34 patients underwent cervical punch biopsy, loop electrosurgical excision procedure (LEEP), or cone biopsy. The cyto-histopathological correlation was evaluated. The Pap smear had a sensitivity of 63.63%, specificity of 78.26%, positive predictive value (PPV) of 58.33%, negative predictive value (NPV) of 81.81%, and diagnostic accuracy of 73.52% in diagnosing LSIL. It had a sensitivity of 85.71%, specificity of 92.59%, PPV of 75.0%, NPV of 96.15%, and diagnostic accuracy of 91.17% in diagnosing HSIL. The overall concordance rate was 76.47%.
Conclusion: It was found that the Pap smear was very useful in diagnosing the premalignant conditions of the cervix. |
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| ISSN: | 2581-8279 |