Role of cytology in screening of cervical lesions along with its histopathological correlation: A study in two-tier city.

Abstract

Background: One of the most common carcinoma amongst Indian women is cervical carcinoma. World Health Organisation (WHO) recommends use of Papanicolaou cytology (Pap smear) as a screening technique in the detection of precancerous lesions.  The lesions were classified based on the Bethesda terminology was correlated with the histopathological findings.

Aim: To compare the cervical pap cytology results with their corresponding histopathological findings received in our institution.

Method: 300 cervical cytology smears from November 2019 to March 2020 were prospectively classified according to the Bethesda system (2014) for reporting of  Cervical Cytology and  compared with its histopathological findings.

Results: Most of the patients were in 3^rd -4^th decade of life. The most common finding was NILM constituting 74% of cases, followed by Atypical squamous cells of undetermined significance (ASC-US) (12%cases),low grade squamous intraepithelial lesion (L-SIL) and high grade squamous intraepithelial lesion (HSIL) both comprised of 6 %cases. Malignancies (squamous cell carcinoma and adenocarcinoma), Atypical glandular cells of undetermined significance (AGUS)constituted about 1% of cases. Histopathological correlation was possible in 113cases.The sensitivity of the present study was 100 %, specificity was 50%. PPV was 39.82%, NPV was 100% and the diagnostic accuracy was 62.43% .

Conclusion: PAP smear is one of the best, easy and cost-effective screening method for cervical lesions. However histopathology being considered as the gold standard test, hence its correlation with cytology pronounces the efficacy of  cervical PAP smears.