DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20193911

Utility of Papanicolaou’s smears in the diagnosis of premalignant and malignant lesions of the cervix in a tertiary care centre of South Gujarat, India

Shivangi S. Gandhi, Pinal C. Shah

Abstract


Background: "Preventable but not prevented", this is the reality of cervical cancer today, at least in developing countries. 80% of all the cases of cervical cancer occur in these developing countries. In India, cervical cancer is the leading cause of cancer related deaths in women. The Papanicolaou test is simple, quick, and painless. It is capable of detecting cervical cancer at an early stage and is used widely in developed countries, where it has decreased both the incidence and mortality of cervical cancer. Objective of the study was conducted to determine the importance of conventional Pap smears for the diagnosis of inflammatory, premalignant and malignant lesions of the cervix.

Methods: This cross-sectional study was conducted from January 2017 to June 2018 on 2000 women coming for a Pap smear examination in Government Medical College attached to New Civil Hospital, Surat. After doing Pap stain, all cases were reported as per the 2014 Bethesda system.

Results: A total of 2000 cases of Pap smears were received out of which 1914(95.7%) cases were satisfactory for evaluation, 86(4.3%) cases were unsatisfactory. The frequency of epithelial abnormalities was 3.66%. The age group of 51-60 years showed the highest epithelial abnormalities. The frequency of epithelial abnormalities in asymptomatic women was 2.3%. Out of the 1844 cases, 103(5.6%) showed changes of atrophy, 1011(54.8%) cases showed inflammatory/reactive changes, whereas organisms were seen in 558(30.3%) cases.

Conclusions: Pap smear happens to be an economical, safe and pragmatic diagnostic tool for early detection of cervical cancer.


Keywords


Bethesda system, Cervical cancer, Epithelial abnormality, Pap smear

Full Text:

PDF

References


Nikumbh DB, Nikumbh RD, Dombale VD, Jagtap SV, Desai SR. Cervicovaginal cytology: clinicopathological and social aspect of cervical cancer screening in rural (Maharashtra) India. Int J Heal Sci Res. 2012;1:125-32.

Sreedevi A, Javed R, Dinesh A. Epidemiology of cervical cancer with special focus on India. Int J Women's Heal. 2015;7:405.

Bukhari MH, Saba K, Qamar S, Majeed MM, Niazi S, Naeem S. Clinicopathological importance of Papanicolaou smears for the diagnosis of premalignant and malignant lesions of the cervix. J Cytol/Ind Acad Cytol. 2012;29(1):20.

Chakraborty DR, Chakraborty DD, Majumder DH. Detection of abnormal cervical cytology in papanicolaou smears at a tertiary care hospital. IOSR J Dent Med Sci ;2016;15(10):20-4.

Sherwani RK, Khan T, Akhtar K, Zeba A, Siddiqui FA, Rahman K, et al. Conventional Pap smear and liquid based cytology for cervical cancer screening-A comparative study. J Cytol. 2007;24(4):167.

Bhojani KR, Garg R. Cytopathological study of cervical smears and correlation of findings with risk factors. Int J Biol Med Res. 2011;2(3):757-61.

Sankaranarayanan R, Thara S, Sharma A, Roy C, Shastri S, Mahe C, et al. Multicentre study group on cervical cancer early detection in india. accuracy of conventional cytology: results from a multicentre screening study in India. J Med screening. 2004;11(2):77-84.

Ranabhat SK, Shrestha R, Tiwari M. Analysis of abnormal epithelial lesions in cervical Pap smears in Mid-Western Nepal. J Pathol Nepal. 2011;1(1):30-3.

Saha D, Ghosh S, Nath S, Islam H. Utility of Pap smear screening for prevention of cervical cancer-A 3 years study from rural Tripura-a northeastern state of India. Int J Med Dent Sci. 2017;6(2):1456-61.

Bodal VK, Brar RK, Bal MS. Pap smear and histopathological study of cervical lesions. Glob J Med Res. 2014:17.

Heselmeyer K, Schröck E, Du Manoir S, Blegen H, Shah K, Steinbeck R, et al. Gain of chromosome 3q defines the transition from severe dysplasia to invasive carcinoma of the uterine cervix. Proceed National Acad Sci. 1996;93(1):479-84.

Khasnabish S, Chakraborty R, Chakraborty D, Hati GC. Study of cervical pap smear study and its utility in cancer screening: an experience in a tertiary care hospital of Tripura, North Eastern state of India. J Evid Based Med Heal. 2017;4:2936-9.

Manoli N, Manoli N. Recent Concepts in Cytology for Early detection of Cervical cancer. Cerv Cancer Recent Res Rev Stud. 2016;1-33.

Panickar SA, Sulhyan KR. Role of Papinicolaou Smears in the diagnosis of premalignant and malignant lesions of the cervix. Ind Med Gaz. 2014;(5):176-9.

Dhaubhadel P, Vaidya A, Choudhary P. Early detection of precursors of cervical cancer with cervical cytology and visual inspection of cervix with acetic Acid. JNMA. 2008;47(170):71-6.

Bisht M, Agarwal S, Upadhyay D. Utility of Papanicolaou test in diagnosis of cervical lesions: a study in a tertiary care centre of western Uttar Pradesh. Int J Res in Med Sci. 2015;3(5):1070.

Aggarwal R, Gupta S, Nijhawan R, Suri V, Kaur A, Bhasin V, et al. Prevalence of high-risk human papillomavirus infections in women with benign cervical cytology: a hospital based study from North India. Ind J Cancer. 2006;43(3):110.

Misra SJ, Das V, Singh U, Singh M, Misra JS, Khand V, et al. Comparative risk assessment of age and parity in cervical carcinogenesis The Journal of Obstetrics and Gynecology of India. J Obs Gynecol India. 2007;57(5):422-5.

Khattak ST, Khattak I, Naheed T, Akhtar S, Jamal T. Detection of abnormal cervical cytology by pap smears. Gomal J Med Sci. 2006;4(2):74.

Gupta K, Malik NP, Sharma VK, Verma N, Gupta A. Prevalence of cervical dysplasia in western Uttar Pradesh. J Cytol/Ind Acad Cytolog. 2013;30(4):257.

Kalyani R, Sharief N SS. A study of PAP smear in tertiary hospital in South India. J Cancer Biol Res. 2016;4(3):1084.

Neelima T, Navyaa VR. Utility of pap smear in the diagnosis of various neoplastic and non-neoplastic lesion of cervix. Int J Pharmaceut Res Bio-Sci. 2012;1:379-89.

Bajpai M Raina A et al. A study of Pap smears in a tertiary care hospital. IOSR J Dent Med Sci. 2016;15(2):93-5.

Mulay K, Swain M, Patra S, Gowrishankar S. A comparative study of cervical smears in an urban Hospital in India and a population-based screening program in Mauritius. Ind J Pathol Microbiol. 2009;52(1):34.

Das D, Kar A, Rath S, Baliarsingh SK, Prusty D, Dash AK. Cytological pattern of papanicolaou smears and detection of cervical cancers: An experience from a tertiary care center of eastern zone of India. Oncol J Ind. 2018;2(2):25.

Patel M, Pandya A. Cervical pap smear study and its utility in cancer screening. Natl J Community Med. 2011;2(1):49–51.

Ferlay J, Pisani P, Parkin DM. Cancer Incidence, Mortality and Prevalence worldwide, Version 1.0, Lyon: Intern Agency Res cancer. 2000;55;74-108.

Bolla C, Rao AR, V Phani Madhavi K, P Ravikumar B, Padala A. Study of cervical cytology in menopausal women-in a maternity and general hospital, Hyderabad, Andhra Pradesh. J Evol Med Dent Sci. 2013;2:6824-30.

Bhavani K, Sheela VP, Vani I. Study of cervical cytology in papanicolaou smears in a tertiary care center. Int Arch Integr Med. 2017;4:172-6.

Malpani G, Agrawal P, Varma AV, Khandelwal N, Tignath G. Cervical Pap smear study and detection of abnormal epithelial lesions and determination of its accuracy by cytohistological correlation in patients of tertiary care teaching hospital in central India. Int J Reprod Contracept Obstet Gynecol. 2017;5:2312-6.

Gidwani RK, Goswami F. Prevalence of altered cervical cytological pattern: a retrospective study in females visiting tertiary care hospital. Pathol Updat Trop J Pathol Microbiol. 2018;4(2):188–94.

Khan MS, Raja FY, Ishfaq G, Tahir F, Subhan F, Kazi BM. Pap smear screening for pre-cancerous conditions of the cervical cancer. Pak J Med Res. 2005;44(3):111-3

Patel K, Champaneria N, Shah S. Histopathological Vs. cytological findings in cervical lesions (Bethesda System 2001): a comparative study. Int J Biomed Adv Res. 2016;7(11):530-3.