Clinico-Cytological Correlation of Cervical Pap Abnormality

Background: Few studies reported in Iraq about the clinicopathological correlation of Pap Smear results, and non was reported about this correlation among private clinic patient, as the knowledge of the authors. Therefore, this study was developed to study the clinic-pathological correlation of the Pap smear cytology results and the clinical presentation of the private clinic patients.

Patient and Method: Cross sectional study of (144) patients presented to the privet clinic, during the period 1st January-1st September 2018. Information regarding age, job parity, marital status symptoms and patient complain and clinical examination of the patient was obtained via a structured questionnaire. The presenting signs & symptoms were compared with the Pap-smear findings and other factors. Cytological study done by cytopathology specialist. Conventional pap smear were used. Cytology was reported using Bethesda system. A single combined smear, was done for each patient by sampling the endocervix, first to obtain the cell sample. Scraping the ectocervix with the spatula and spreading the material rapidly onto the upper end of the slide. Spreading the endocervical material through the ectocervical material to the end of the slide. This procedure Performed quickly to prevent drying artifacts. Fixation of the slide done using spray fix by thoroughly soaking the cellular sample while holding the spray fixative container about 6-8 inches from the slide. Then allowing spray fixative to evaporate.

Results: NILM (negative for intraepithelial lesion or malignancy) found among 21(14.6%) of the patients 20 (13.9%) had cervicitis, and 1(0.7%) had atrophic changes in the cervix), Atypical Squamous Cell Undetermined Significant (ASCUS) 73(50.7%), followed by Low-grade squamous intra-epithelial lesion (LSIL) 39(27.1%), and High-grade squamous intra-epithelial lesions (HSIL) 9(6.3%). Squamous cell carcinoma was found among 2(1.4%) of the cases.

Conclusion: Iraqi women attending the priate clinic had high level of intraepithelial abnormality, even if it lower than other countries but it in need to be controlled by cervical cancer screening program, the common presenting symptom with increased rate of with various stages of intraepithelial lesion were post coital bleeding, and Irregular vaginal bleeding.