DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20211902

Combined use of cytological, visual and colposcopic examination for evaluation of unhealthy cervix and their histopathological correlation

Deepak Patil, B. Pathak

Abstract


Background: Unhealthy cervix can be a presentation of a broad spectrum of clinical conditions with diverse pathologies like infective, inflammatory, reactive and neoplastic etc. Cervical cancer, having a multifactorial causation, is the second most common cancer in female population. Because of a prolonged preinvasive phase, the cancer can be diagnosed at an earlier stage. Early diagnosis makes it amenable to treatment.

Methods: A total 100 ladies attending gynaecology OPD of a tertiary care teaching hospital with unhealthy cervix were evaluated. It involved history taking, cytological assessment by Pap smear, examination of cervix after acetic acid application (VIA), colposcopic assessment and biopsy for histopathological evaluation.

Results: Correlation of all these modalities to rule out neoplastic aetiology showed a high specificity of 91.9%. The positive predictive value of combined approach was found to be 65% whereas negative predictive value approached 100%.

Conclusions: Combined approach with VIA, Colposcopy, Pap smear and Directed biopsy provide a comprehensive evaluation of unhealthy cervix.


Keywords


Unhealthy cervix, Colposcopy, Histopathology, Pap smear

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References


Cohen PA, Jhingran A, Oaknin A, Denny L. Review Cervical Cancer. The Lancet. 2019;393(10167):169-82.

Singh V, Sehgal A, Satyanarayana L, Gupta MM, Parashari A, Chattopadhya D. Clinical presentation of gynecologic infections among Indian women.Obstet Gynecol 1995;85(2):215-9.

Pimple SA, Mishra GA. Global strategies for cervical cancer prevention and screening. Minerva Ginecologica. 2019;71(4):313-20.

Screening for cervical cancer: Recommendation statement. US Preventive Services Task Force. American Family Physician. 2019;99:4.

Naga Ch, Gurram L, Chopra S, Mahantshetty U. The management of locally advanced cervical cancer. Current opinion in Oncology. 2018;30(5):323-9.

Nkwabong E, Laure I, Badjan B, Sando Z. Pap smear accuracy for the diagnosis of cervical precancerous lesions. Trop Doct. 2019;49(1):34-9.

Akhter S, Bari A, Hayat Z. Variability study between Pap smear, Colposcopy and Cervical Histopathology Findings. Journal of Pakistan Medical Association. 2015;65(12).

Koss LG. Editorial. The attack on annual Pap smear. Acta Cytologica. 2017;61:338-44.

Pankaj S. Comparison of conventional Pap smear and liquid based cytology: A study of cervical cancer screening at a tertiary care centre in Bihar. Indian J Cancer. 2018; 55(1):80-3.

Dasari P, Rajathi S, Kumar SV. Colposcopic evaluation of cervix with persistent inflammatory Pap smear: A prospective analytical study. Cytojournal. 2010;5(7):16.

Michelle J. ASCCP Colposcopy standards: Role of Colposcopy, Benefits, Potential Harms and Terminology for colposcopic Practice. J Low Genital Tract Dis. 2017;21(4):223-9.

Luesley D, Downey G. Value of normal colposcopy after an abnormal cervical smear report. J Low Genit Tract Dis. 2009;13(1):33-7.

Hegde D, Shetty H, Shetty PK, Rai S. Diagnostic value of acetic acid comparing with conventional Pap smear in the detection of colposcopic biopsy proved CIN. J Cancer Res Ther. 2011;7(4):454-8.

Ahmed M, Noohet, El-Sayed M, Mohamed, El-Alfy Y. Visual Inspection of Cervix with Acetic Acid as a screening modality for cervical cancer. J Low Genit Tract Dis. 2015;19(4):340-4.

Vahedpoor Z, Behrashi M, Khamehchian T, Abedzadeh-Kalahroudi M, Moravveji A, Mohmadi-Kartalayi M. Comparison of the diagnostic value of the VIA and Pap smear in cervical cancer screening. Taiwan J Obstet Gynecol. 2019;58(3):345-8.