Cytohistological correlation of conventional Papanicolaou smears in cervical neoplasia at a tertiary care hospital of Nepal

Dahal, Prahar

doi:10.3126/jpn.v9i1.23372

Cited by 5 publications

(4 citation statements)

References 14 publications

(20 reference statements)

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“…The number of cases with a diagnosis of atypical squamous cells, both ASCUS and ASC‐H, is lower (20%) in our study than in studies by Hemalatha et al (52%) 17 and Poudel et al (48%) 18 from similar population groups. The most frequent lesion in the former study was ASC‐H (29%), and, in the latter study, ASCUS (48%).…”

Section: Discussioncontrasting

confidence: 80%

“…For many of the significant number of ASCUS diagnoses examined in our study, the biopsy showed reactive inflammatory changes; a similar observation was made by Meenai et al 22 There was no discordance in the ASC‐H, LSIL or SCC categories in the present study. The concordance rate was 95.7% in our study, which is much higher than that of other, similar studies, which reported rates of 68.57%, 55.55% and 70.7% 18,21,22 . The slides were reviewed for all cases of discrepant CHC, and a note regarding the review was included in the handwritten backup copy of the case notes.…”

Section: Discussioncontrasting

confidence: 50%

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Quality metrics in cervical cytopathology: A single institutional study

Kumar

Ravikumar

2021

Cytopathology

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Objectives Implementation of quality control measures ensures acceptable performance by a laboratory. This study aims to assess the quality of cervical cytopathology reporting using quality metrics like atypical squamous cells (which include both atypical squamous cells of undetermined significance and atypical squamous cell ‐cannot rule out high grade squamous intraepithelial lesion)/squamous intraepithelial lesion (ASC/SIL), cytohistological correlation (CHC) and positive predictive value (PPV) of Papanicolaou (Pap) smears for squamous lesions of cervix. Methods A retrospective study of Pap smears from 2015 to 2020 was performed. The quality metrics analysed include diagnoses of ASCUS, ASC‐H and ASCUS/SIL ratio, CHC and PPV. Cases with cervical biopsies/hysterectomy were included for CHC, and discrepancy was defined as discordance in diagnostic category between cytology and histology in the CHC. Results A total of 22,695 cervical cytology smears were reported. Unsatisfactory smears (n = 290) were excluded. Squamous lesions were reported in 233 smears, and the Bethesda system of nomenclature was followed. A definitive diagnosis (SILs and SCC) was given in 74% of cases. ASCUS and ASC‐H were reported in 47 and 14 cases, respectively. The most common lesion on Pap smear was high‐grade squamous intraepithelial lesion (HSIL; n = 92), followed by low‐grade squamous intraepithelial lesion (LSIL; n = 64), and two were ungradable SIL. Squamous cell carcinoma (SCC) was reported in 14 smears. The ASC/SIL ratio was 0.38. CHC (n = 139) was 100% for ASC‐H, LSIL, SCC and 84.7% for HSIL. A review of discrepant cases suggested sampling and interpretational discrepancy in five and one cases, respectively. The PPV of Pap smear for squamous lesions was 96.4%. Conclusion It is essential to have good quality cytopathology reports for early identification, which enables appropriate management. The most commonly used quality indicator for cytopathology is the ASCUS/SIL ratio. This study suggests the inclusion of the CHC and PPV values as quality metrics for Pap smear, since these are easily measurable and serve as a good indicator of quality in cervical cytopathology reporting.

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Section: Discussioncontrasting

confidence: 80%

Section: Discussioncontrasting

confidence: 50%

Quality metrics in cervical cytopathology: A single institutional study

Kumar

Ravikumar

2021

Cytopathology

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“…3,14,18,[20][21][22] All 10 cases of SCC on PAP smear were diagnosed as invasive SCC in histopathology. Similar observation was made by Fathima NK et al 14, Joshi C et al 18 , Abali R et al 20 and Poudel A et al 21 We found nonneoplastic changes in 8 cases, CIN I in 16 cases, CIN II in 4 cases and CIN III in 2 cases of total 30 ASC-US cases. The total rate of CIN among cases with an ASC-US smear result was 73%.…”

Section: Discussionmentioning

confidence: 99%

Correlation of Epithelial Cell Abnormality in Cervical Cytology with Cervical Histology

Shrestha

Sinha

Sharma

et al. 2020

J. Nepalgunj Med. College

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Introduction: Cervical cancer is the second most common cancer in females worldwide and third most common cancer in Nepal. Conventional Pap smear is the most widely used screening tool for detecting premalignant and malignant lesions of cervix. Cytohistological correlation of Pap smear is a widely accepted method for analysis of various factors leading to discrepancies in diagnosis and internal quality assurance. Aims: To study the cytohistological correlation of epithelial cell abnormality in Pap smear in Nepalgunj Medical College Teaching Hospital, Kohalpur, Banke, Nepal. Methods: This is a hospital based prospective cross sectional study carried out at Department of Pathology, NGMC, Kohalpur, Nepal from August 2018 to January 2020. The study included 137 cases of Pap smear with epithelial cell abnormality and correlated with corresponding histopathological findings. Results: The age of patients ranged from 20-80 years with the number of cases seen in the range of 30-39 years (n=44; 32.1%). Whitish discharge per vaginum was most common presenting symptom. High grade squamous intraepithelial lesion (HSIL) was the most common abnormal finding in Pap smear with a frequency of 40 (29.1%) cases. Out of 137 cases of Pap smear 57 (41.6%) cases showed discrepancies in cervical biopsy. All cases of Squamous Cell Carcinoma (SCC) were correctly diagnosed by Pap smear. The overall sensitivity of smear test was 84%. After evaluating cytohistological correlation, the Positive Predictive Value (PPV) was found to be 100% for SCC, 52% for HSIL and 59% for Low grade squamous intraepithelial lesion (LSIL). Conclusion: The current study revealed a good correlation between cervical cytology and biopsy in Pap smear showing epithelial cell abnormalities. Thus, cytology and histology are complementary to each other and helps to reduce discrepancies.

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“…A Pap smear test, which is the main screening test for the identification of precancerous intraepithelial cervical neoplasia and the early stage of invasive cervical cancer, may recognize early cervical epithelial changes. [10], [12]…”

Section: Introductionmentioning

confidence: 99%

Abnormal Finding of Pap Smear Among Women Hospital Visitors in City of Mosul, Iraq

Rajab

Elias

Saeed

et al. 2020

Int. J. Res. Granthaalayah

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Objective: The research aims to test the use of the Pap smear screening system to identify precancerous lesions among women in City of Mosul, Iraq. Methods: This prospective study was carried out over 1 year at the Department of Obstetrics and Gynaecology in Mosul Teaching Hospital, city of Mosul, Iraq. We screened 100 sexually active women who were more than 21 years of age. Women with different complaints, including vaginal discharge, blood‑mixed discharge, foul-smelling discharge, postcoital bleeding, intermenstrual bleeding, postmenopausal bleeding, abdominal pain, infertility, and secondary amenorrhea, were included in this study. The glass slides had been sent for cytopathological review to the pathology department. The laboratory results have been reported by the new Bethesda Cervical Cytology Reporting System 2014. The device divided the lesions narrowly into certain negative ones for intraepithelial neoplasia and with epithelial cell abnormalities (ECA) that involve squamous and glandular cells. Upon pap smear, the patient was treated accordingly. Results: The study had enrolled a total of 100 cases. All of these patients had an abnormal Pap smear finding that fell according to TBS-2014 criteria in the category of Epithelial Cell abnormality. We interviewed all patients in Detail by proforma. The data reported were statistically analyzed and were collected following observations and tests. Among the study subject, the most common abnormal findings (68.9%) were negative findings. Inflammatory constitute (15.4), and Atypical squamous cells of undetermined significance (7%) followed by LSIL (5.9) and HSIL (2.9). Conclusion: Pap smear is an effective method for screening for Cervical Lesions Precancerous and cancerous. Nevertheless, a cervical biopsy must be performed which Is gold standard if any epithelial defects are found to be confirmed in cervical cytology.

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Cytohistological correlation of conventional Papanicolaou smears in cervical neoplasia at a tertiary care hospital of Nepal

Cited by 5 publications

References 14 publications

Quality metrics in cervical cytopathology: A single institutional study

Quality metrics in cervical cytopathology: A single institutional study

Correlation of Epithelial Cell Abnormality in Cervical Cytology with Cervical Histology

Abnormal Finding of Pap Smear Among Women Hospital Visitors in City of Mosul, Iraq

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