Cytohistopathological Correlation of Cervical Lesions

Background: Conventional cervical cytology is the most widely used ervical cancer screening test in the world. Squamous intraepithelial neoplasia (SIL) and cervical cancer remain important health problems for women worldwide. Aim and Objective: To study various types of cervical lesions with relevant factors such as age, parity, to classify cervical lesions into malignant& benign groups and to correlate the cytological with histopathological findings. Materials and Methods: This study was conducted on 1065 cases of Pap smears and cervical biopsies, along with resected specimens. After fixation and staining, smears and cervical biopsies were processed and examined under microscope. Results: Maximum number of patients was more than 60 years in age (36.50%)The mean age among cancer cases (51.94�12.30 years) was higher than in cases (39.53�9.66 years) who did not have cervical cancer. Association between age group of cancerous patients and non-cancerous patients were highly significant with pvalueless than0.001. Maximum no. of malignancy cases reported in parity 3 (284 cases) followed by parity 4 (212 cases) and minimum cases of cervical cancer were found in parity 1 (40 cases) Maximum number of patients (72%) presented within 1 year of presentation of clinical symptoms consistent with cervical lesions followed by 1-3 years (14%). Majority of patients (60%) presented with abdominal pain followed by vaginal discharge (58%) followed by irregular vaginal bleeding (47%). On cytological examination 50% cases among study population were inflammatory smears and frank malignancy was reported in 17.5% cases, LSIL and HSIL was reported in 8% and 11% respectively. Maximum number of cases on biopsy were those of infections (60.50%), Squamous intraepithelial lesions were seen in 17% patients. Similar cases were those of frank malignancy with benign lesions comprising of only 5% in study population. Out of 605 inflammatory lesions maximum cases were those of chronic cervicitis (94.21% cases) and minimum cases were that of chronic cervicitis with squamous metaplasia (2.47% cases). Most common diagnosis being infection which came out to be 450 cases on cytological examination and 605 cases on histopathological examination, which came out to be non significant with p-value of 0.012, invasive squamous cell carcinoma (17.5%) in both cytological and histopathological findings was also found to be non-significant with the p-value of 0.954. Benign lesions accounted for 325 cases in cytology while 220 cases were diagnosed as benign in histopathology. Which were significant with a p-value of 0.001. Conclusion: Pap smear followed by cervical biopsy is an effective method for detection of pre-cancerous, cancerous and non-cancerous changes in the cervix.