The Significance of the Papanicolaou Smears in Diagnosis of Squamous Intraepithelial Lesion. A Cyto Histopathological Study

摘要

OBJECTIVE: To assess the frequency of intraepithelial lesion in Pap smear and to correlate between thecytopathological and histopathological findings this study were done.STUDY DESIGN: A prospective observational study.PLACE & DURATION: From September 2008 to June 2010 at Azadi Teaching Hospital Duhok City.METHODOLOGY: Cytopathological and histopathological analysis of 136 specimens of cervix diagnosedbetween 2008 and 2010 at Azadi teaching hospital in Duhok city. Initial cytopathological interpretation wasperformed based on the Bethesda 2001 criteria. Formalin-fixed, paraffin-embedded tissues were reviewedfor confirming histopathological diagnosis, presence of atypia, koilocytosis and changes relatedintraepithelial lesion.RESULTS: The mean age was 36 years. Out of the 136 cases analyzed. Cytologically includes (n=8) 6%cases of high grade squamous intraepithelial lesion (HSIL), (n=17) 12.5% were low grade squamousintraepithelial lesion(LSIL), (n=77) 56.5% were atypical squamous cells of undetermined significance(ASCUS), (n=34) 25% were negative for intraepithelial lesion and malignancy (NILM) . Histopathologically 2were squamous carcinoma, 6 were CIN2 and CIN3, (n=37) 27.3% were CIN1 and (n= 91) 66.9% werenegative for neoplasia. Koilocytosis was observed in 49.CONCLUSIONS: Women with a Pap diagnosis of NILM, ASCUS and LSIL appear to be less likely to harbora high-grade lesion than those diagnosed with HSIL alone.The association between cytological (NILM & ASCUS) and histopathological findings is variable and doesnot show that compatibility. This study showed the high frequency of koilocytosis in both cytology and biopsywhich may reflects the high incidence of HPV infection.