A Comparative Study of Pap Smear Cytology and Histopathology of Cervix Biopsy

Abstract

ntroduction: Carcinoma cervix is one of the leading causes of death of the female population in developing countries. By virtue of its accessibility, cancer of the cervix can be readily diagnosed even in its preinvasive stage. If treated in the earlier stages the patient can often be cured of the disease. Carcinoma of the cervix is the fourth most frequent cancer in women worldwide and the leading cause of death from cancer in several developing countries including India. The use of cervical smear (Papanicolaou/Pap) as a screening tool has signicantly reduced the incidence of cervical cancer. Materials and Methods: Out of 100,000 Pap smears, a total number of 75 eligible women with atypical glandular cells (AGCs) referred to gynaecology clinics in Isfahan, Iran, and seventy women were selected to undergo Pap smear test, colposcopic examination and ECC. EMC was performed in women older than 35. Pap smear test results were classied as normal, inammation, AGCs and necrosis. Colposcopy, ECC and EMC ndings were classied as normal, benign and malignant pathologic lesions. Results: Majority of the women were between 31-40 years (59.6%).On PAP smear, ASC-US was found in 5.8% of women, ASC-H in 1.4% of women, LSIL in 6.7% of women and HSIL in 6.2% of women. On colposcopy, LSIL was seen in 26.4% of women and HSIL in 17.8% of women. On histopathological examination, CIN I was seen in 16.8% of women followed by CIN II(8.2%)and CIN III(5.8%).Sensitivity and specicity of PAP smear was 29.7% and 94.4%.Sensitivity and specicity of colposcopy was 85.9% and 74.3%. Conclusion: Pap smear had a poor sensitivity compared to colposcopy but a better specicity than colposcopy .Hence, it may be better to utilise both tests in screening of premalignant lesions of cervix as they complement each other.