Original Research Article
Year: 2016 | Month: November | Volume: 6 | Issue: 11 | Pages: 80-85
Cytodiagnostic Study of Cervical Lesions Using the Bethesda System with Histopathological Correlation
Tahera1*, Navya BN2**, Paramesh3**, Kariappa TM3**
1Pathologist, 2Associate Professor, 3Professor,4Professor and HOD of Pathology.
*Gokula Metropolis, M. S. Ramaiah Memorial Hospital, Bangalore, Karnataka, India-560054.
*KVG Medical College and Hospital, Sullia, DK District, Karnataka, India-574327.
Corresponding Author: Tahera
Background: The histogenesis and progression of cervical carcinoma is well documented. It is possible to prevent the development of invasive carcinoma by identifying and treating pre invasive lesions. The objectives of the study were to study the usefulness of cytology in detecting various cervical lesions, to evaluate and interpret the cases of epithelial lesions according to The Bethesda 2001 classification System and to correlate cytology diagnosis with histopathology diagnosis. The sensitivity, specificity and positive predictive value of Pap smears were calculated and compared.
Materials and Methods: The study was performed on 100 cases on women between the age group of 18 to 70 years, presenting with complaints of white discharge per vaginum, pain abdomen and menstrual irregularities. Pap smears were obtained and stained with Papanicolaou stain. The conventional Pap smears were interpreted according to The Bethesda System 2001.
Results: The median age was 34 years (range 18-70). The cytological evaluation of 100 Pap smears revealed majority of cases (52%) as benign/inflammatory lesions, NILM (15%), organisms (10%) and neoplastic lesions (23%). On histopathological evaluation, 85 cases were reported as non neoplastic lesions and 15 cases as neoplastic ones. The overall concordance rate was 76.1% and discordant cases were 23.8%. The sensitivity of cytology in detecting cervical lesions was 71.4% and specificity was 89.8%.
Conclusion: The Pap smear has good sensitivity and specificity and positive predictive value in detecting high grade lesions and malignancy. The discrepancy can be minimized by following The Bethesda system for adequacy of sampling.
Key words: The Bethesda system, Pap smears, NILM, Squamous intraepithelial lesions, Squamous cell carcinoma.