Abstract

EVALUATION OF UNHEALTHY CERVIX IN KASHMIRI WOMEN BY COLPOSCOPY, LIQUID BASED CYTOLOGY AND HISTOPATHOLOGY-A TERTIARY CARE HOSPITAL BASED STUDY

Dr. Maraj Ud Din, Dr. Sahilanazir, Dr. Arshiandleeb, Dr. Syed Basit and Dr. Javid*

Abstract

Objectives: (1) To evaluate the various causes of unhealthy cervix in Kashmiri women. (2) To assess the utility of colposcopy and cytology in detecting the various causes of unhealthy cervix. (3) To correlate the findings of cytology and colposcopy with each otherand with histopathology. Methodology: 200 women attending gynecology OPD with clinicallyunhealthy cervix were subjected to evaluation by liquidbased cytology, colposcopy and directed biopsyand the findings were noted. Results: Majority of women were in the age group of 30-39 years. Commonest complaint was vaginaldischarge in 50% cases followed by menorrhagia in 19.5% women18% had abnormal discharge in 50% cases followed by menorrhagia in 19.5% women, 18% had abnormal LBC findings with 11% women had LSIL, 5.5% had HSIL, and 1.5% had squamous cellcarcinoma (SCC). 32.5% had abnormal women had LSIL, 5.5% had HSIL, and 1.5% had squamous cell carcinoma (SCC). 32.5% had abnormal colposcopic findings, 21% had low grade lesion and 11.5% had high grade lesion. In our study, on correlating LBC findings with histopathology, out of 8.5% women with ASCUS on LBC, 4% had positive histopathological findings. Out of 5% patients with LSIL on LBC, 3.5% were having positive histopathologicalfindings. Out of 3% patients with HSIL on LBC, 1.5% were positive on histopathological examination. On correlating colposcopic findings with histopathology, 5.5% patients which appeared normal on colposcopic evaluation had dysplasia on histopathology, 15.5% women with low grade lesion on colposcopy had negative histopathological findings. Out of 21% patients with low grade lesion, 3.5% had LSIL and 1.5% had HSIL on histopathology. 4.5% women with high grade lesion on colposcopy were negative histopathologically. 7% out of 11.5% women with high grade lesion had positive histopathological findings. Sensitivity and specificity of LBC was 58.3% and 91.5% respectively. Sensitivity and specificity of colposcopy was 69.4% and 75.6% respectively. Conclusion: Though, the study was conducted in a tertiary care hospital which is not representative of the general population but still we had significant numbergeneral population but still we had significant number of cases withpremalignant and malignant cervical lesions. Therefore, all women with complaints of suspicious looking cervix should be examined and screened in a single visit by LBC, colposcopy and directed biopsy to helpin detecting cases in premalignant state which may otherwise be missed.

Keywords: LBC, Colposcopy, LSIL, HSIL, Cervical Cancer.