Document Type : Research Article
Aim: To investigate the use of cytology in detecting various pre-neoplastic and neoplastic cervix lesions.
Methodology: This was a prospective study that took place in the Department of Obstetrics and Gynecology from November 2019 to September 2021. There were 100 ladies who met the criterion for inclusion. A total of 100 women were chosen at random from the Gynecology OP patients. After proper counselling, all of the cases had colposcopy, Pap smears, and biopsies performed.
Results: In the present study, Majority 38% (38/100) of CIN occurred in the age group of 21- 30years.mean age-37.8%. 42% (42/100) with CIN were Para 2, 34% (34/100) with CIN were Para 3 and 21% (21/100) with CIN were greater than Para 4 showing high incidence of CIN in multiparity. The incidence of CIN was found to be high among the middle income groups 76% I,e,. (76/100). 63% (63/100) of women with CIN were found to be illiterate. 99% (99/100) of women with CIN were found to be in rural area. 35% (35/100) of women were married for more than 20 years and 24% (24/100) of women married for 11 to 15 years had CIN. Among women who were diagnosed to have CIN, 83% (83/100) Complained of excessive vaginal discharge, 9% (9/100) of women had post coital bleeding, 18% (18/100) of women had intermenstrual bleeding. 90% (90/100) women among the study group had hypertrophied erosion cervix, 52% (52/100) bleeds on touch on speculum examination. Out of 27 cases of neoplastic lesions studied cytologically, 4 were squamous cell carcinomas, 12were HSIL and 11were LSIL. Out of 100 cases studied histologically, 28 were neoplastic and 72were non neoplastic. Out of 28neoplastic lesions studied histopathological, 7 were squamous cell carcinomas, forming 7% of neoplastic lesions. There were 6 cases of HSIL and15 cases of LSIL, forming 6%, 15%respectively. Diagnostic accuracy of cytology for carcinoma, HSIL and LSIL were 91, 86%, 87.78% and 86.00% respectively. Sensitivity and specificity for cervical cytology was 88.89% and 87.32% respectively. There were 6 false positive diagnoses, giving a false positive rate of 7.01% and three false negative giving a false negative rate of 0.13%. Positive predictive value and negative predictive value were 72, 73%% and 95.38% respectively.
Conclusion: Regular Pap smear screening is a cost-effective strategy for early diagnosis of premalignant and malignant cervical lesions, as well as down staging of cervical carcinoma. The operation is straightforward and affordable, and it can be completed in the outpatient setting. As a result, it should be frequently suggested as a means of promoting reproductive health.