Cytomorphological study of cervical Pap smear based on the Bethesda system 2014

Abstract

: The Papanicolaou (Pap) smear used worldwide for cervical screening was developed by Dr George Papanicolaou in 1940s. The Pap smear is a simple, safe and effective test to detect cervical cancer at an early stage.: To study the spectrum of lesions in cervical Pap smear based on The Bethesda System(TBS) 2014 and to determine frequency of premalignant and malignant lesions.: The present prospective study included 200 cases above 20 years of age. The cytological interpretation of smears were made according to TBS 2014. When there was difficulty in differentiating HSIL from other lesions p16 immunostaining was done and evaluated according to the criteria proposed by Wentzensen et al. : Chi – square test was used to see the association between different attributes. Statistical analysis was performed using SPSS version 22. P value <0.05 was considered significant.: The most common lesion was NILM with 175 cases (87.5%) followed by 7(3.5%) SCC, 4(2%) HSIL, 2(1%) cases each of ASCUS, AGC-NOS, LSIL and 1(0.5%) case of ASC-H. Among 200, 7(3.5%) cases were unsatisfactory for evaluation. The subjects were not uniformly distributed (P <0.001). The p16 marker was used in 6(3%) doubtful cases of HSIL among which 2(33.33%) cases were positive. Cervical Pap smear is a useful technique to detect the inflammatory, premalignant and malignant lesions of cervix which helps the clinician to plan further management.

Evaluation of pap smears with cyto-histopathological correlation–our experience at a tertiary care hospital in Telangana

“…12 In the study conducted by Sinchana et al, 18 cases (9%) were reported as ECA, which were in line with this study, where 53 cases (9%) were also reported as ECA. 11 In a study conducted by Sharma et al, in 2021, the total number of ASCUS cases was 15 (3.3%), which was in line with this study where 21 cases (3.74%) were reported as such. 14 The same study reported five cases (1.2%) as LSIL, whereas in our study, two cases (0.32%) were reported as LSIL.…”

“…In a study conducted by Sinchana et al, two cases (1%) were reported as AGCs (NOS), which was in line with this study where seven cases (0.97%) were also reported as AGCs (NOS). 11 In this study, one case was reported as poorly differentiated malignancy on pap smear, whereas no such cases were reported in the comparative studies. 11,12,14 Histopathological examination was advised for all ECA category cases and for those cases that were clinically suspicious though unsatisfactory on cytology.…”

“…11 In this study, one case was reported as poorly differentiated malignancy on pap smear, whereas no such cases were reported in the comparative studies. 11,12,14 Histopathological examination was advised for all ECA category cases and for those cases that were clinically suspicious though unsatisfactory on cytology. Fifty-four cervical biopsies were done.…”

“…In a study conducted by Sinchana et al, in 2022, there were seven unsatisfactory cases (3.5%) while in this study the number of unsatisfactory smears was 37 (6%). 11 This can be due to improper collection techniques or lack of proper transport. Associated clinical symptoms at the time of collection like bleeding per vaginum or lack of co-operation of the patients during the collection procedure may be one of the contributory factors to unsatisfactory smears.…”

“…12 In the study conducted by Sinchana et al, 139 cases (69.5%) were smears associated with inflammation, whereas in this study, 353 cases (57.4%) were inflammatory smears. 11 Cases with persistent inflammation must be further evaluated and treated appropriately as they may slowly transform into pre-malignant lesions. 13 In the study conducted by Pandey et al, 79 cases (3.7%) were atrophic smears, which was in line with this study, where 23 cases were (3.9%) atrophic smears.…”