Cytohistopathological Study of Cervical Lesions

Introduction: Carcinoma of cervix is the third most common malignancy encountered among women globally. About 80% of these cases occur in the developing countries. With the effectiveness of the papanicolaou (PAP) cytologic test in the early detection of precancerous state and accessibility of cervix for a biopsy the mortality rate due to carcinoma of cervix has declined statistically. The present study was undertaken to correlate premalignant and malignant smears with histopathological findings observe the spectrum of lesions in cervical smears and the clinical findings in the same. Materials and Methods: The cervical cytological smears and biopsies received incessantly in the Department of Pathology, SDMCMSH Dharwad over a period of 2 years were stained with the criterion PAP and hemotoxylin and Eosin stains respectively in the present analytical study. Results: A total number of 5559 smears studied included inflammatory changes 4413 (79.38%), normal 983 (17.68%), precancerous and malignant 123 (2.2%), and inadequate 40 (0.7%). 123 smears showing atypical and malignancy included atypical squamous cells of undetermined significance (ASCUS) 59 (47.96%), atypical glandular cells of undetermined significance (AGUS) 7 (5.69%), low-grade squamous intraepithelial lesion (LSIL) 20 (16.2%), high-grade squamous intraepithelial lesion (HSIL) 15 (12.18%), positivity for malignant cells 5 (4%), squamous cell carcinoma 16 (13%), and adenocarcinoma 1 (0.8%). Biopsies showed 100% accuracy in malignant lesions. 3 (11.11%) of 27 biopsied cases of ASCUS and 4 (44.44%) of 9 biopsied cases of HSIL were malignant. In cases of AGUS and LSIL, all biopsies showed nonmalignant features. Conclusion: PAP smear test is found to be a sensitive and highly effective method for the detection of cervical neoplastic changes.