TITLE - TO STUDY THE INTRAEPITHELIAL LESIONS OF CERVICAL SMEARS IN A TERTIARY CARE CENTRE

Pathology(Medicine)

Abstract Aims and objectives: 1.To study the epidemiological factors, symptoms of women and per speculum examination findings. 2.To study the epithelial cell abnormality and compare it with other studies. 3.To compare the exfoliative cytology in detecting LSIL(Low Grade Squamous Intraepithelial Lesion), HSIL(High Grade Squamous Intraepithelial Lesion),SCC(Squamous Cell Carcinoma) and compare it with histopathological report wherever available. Materials and Methods: The present retrospective observational study was conducted in the department of pathology at Dr. Vasantrao Pawar Medical College, Nashik. A total of 1660 women who were more than 15 years were enrolled in the study. PAP smear was used as a method of screening for cervical cancer. The smear was obtained using an Ayre spatula and is spread over a marked glass slide, which was placed in 95% ethyl alcohol and sent to the department of pathology for cytopathological examination. Results: A total of 1660 cases were studied for the age ranging from 25 to 80 years. NILM(negative for intraepithelial lesion or malignancy) were seen in the age ranging from 20 to 65 year, Inflammatory smear from 25 to 75 year, LSIL(Low grade squamous intraepithelial lesion) from 40 to 45 year, HSIL(High grade squamous intraepithelial lesion) from 41 to 70year, ASCUS(Atypical squamous cells of undetermined significance) from 25 to 65 year, AGUS(Atypical glandular cells of undetermined significance) from 35 to 40 year, SCC(Squamous cell carcinoma) from 43 to 61 year. Most of the women with LSIL, HSIL or Carcinoma generally had three or more children. This indicates that multiparity is a significant risk factor. Most of the women in the study were Hindu. Most women belongs to Rural Communities. 3.6% women had history of oral contraceptive use. Copper T insertion was done in 6.4% of female. No female had history of retroviral disease. 55% of women were illiterate. White vaginal discharge was the most common symptom found in 37.95%, followed by abdominal pain in 26.08% and irregular cycle in 12.71%.On per speculum examination white discharge was commonly found in 35.54% followed by healthy looking cervix in 26.50% and cervical erosion in 19.87%. Unsatisfactory sampling occurred for 8.42% , while remainder had adequate sample for reporting. Of the total cases studied 51.35% were NILM, 47.1% were inflammatory, 1.01% were ASCUS, 0.12% were AGUS,0.06% were LSIL, 0.18% were HSIL and squamous cell carcinoma was seen in 0.18%.

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