Study of Cervical Cytology and its correlation with Histopathology in diagnosis of Precancerous and Cancerous Lesions of Cervix

Abstract

Background:The Pap smear is the screening test in which in case of detection of any abnormality, a cervical biopsy is advised for confirming diagnosis and correlation. The present study is carried out to evaluate the pattern of cervical Pap smear cytology at a tertiary care teaching hospital and to correlate it with histopathological findings. Objectives:To assess The Bethesda system (TBS 2014) as a reporting system for cervico-vaginal cytology in detection of abnormal cervical cytology diagnostic categories. To compare the results of individual diagnostic cervical cytology categories with histopathological equivalents in available biopsies of cervix.Material & Methods: The present study is a Retrospective study conducted in tertiary care rural teaching hospital. The study was conducted in the period from January 2015 to January 2020. A total of 3596 patients underwent cervical cytology by Ayres wooden disposable spatula at Sharda Hospital during this period. The number of Negative for Intra Epithelial Lesion (NILM) and Abnormal cervical cytology (ACC) Cases was noted. The cytomorphology in each diagnostic category for their frequent and common feature was observed. The available biopsies of the cervix from the NILM cases and cases of abnormal cervical cytology of the study were processed by the conventional method of tissue processing. These biopsies were stained by H & E Stain.The assessment of the each category diagnosed by TBS 2014 was compared with the histopathological diagnosis in the available biopsies of the cervix. The values of comparison of TBS 2014 was bought out considering histopathology as a gold standard of diagnosis.Results & Conclusion: In a total of 3,596 patients, who underwent the cervical cytology during the study period, total number of cases selected for the study were 199. A total of 99 cases were diagnosed as abnormal cervical cytology and 100 patients were picked up as age match control which were diagnosed as Negative for Intra Epithelial Lesion or Malignancy on Pap smear cytology. The percentile prevalence of abnormal cervical cytology was 2.75% in total of 3,596 cervical cytology performed during the period of study. The categories of TBS 2014 appeared to correlate in all its categories except for ASC-H where in two cases showed the higher lesion. There were no false reporting of the higher lesions (False Positive) when TBS 2014 was applied in the present study. However there were 4 cases in ASC-H category where under reporting of higher lesions has occurred (3 cases of CIN 1, 1 case of CIN 2). No case diagnosed as NILM by TBS 2014 in present study turned to carry higher lesion on the biopsy. The TBS 2014 epithelial cell abnormalities and its categories correlate well with biopsy diagnosis