The study of early screening of cytology and diagnostic concordance for uterine cervical carcinoma

Abstract

Introduction: Cervical cancer is one of the leading causes of death for middle-aged women in the developing world, yet it is almost completely preventable if precancerous lesions are identified and treated in a timely manner. The use of the cervical smear (Papanicolaou/Pap) as a screening tool has significantly reduced the incidence of cervical cancer. Cyto-histopathological correlation of Pap smear is a widely accepted method of internal quality assurance and helps in the analysis of various factors leading to discrepant diagnosis. With the above view, the present study has been carried out to evaluate the cyto-histopathological correlation of the various cervical lesions. The study aimed to determine the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of pap smears test in cervical lesions by comparing with histopathology. Quality must be maintained through all aspects of the Materials and methods: The study was prospective cross-sectional hospital-based study carried out over a period six months and cytohistopathological correlation of 192 cases were obtained from NCC of Mongolia in 2015. The reporting of Pap smear was done in Bethesda system and histopathology WHO classification. Results: The overall concordance of the study was 65.6% (n=126). The discordant cases were 34.4% (n=66). Unsatisfactory smears were two. There were 51 cases of LSIL (Low grade squamous intraepithelial lesion) and 26 cases of HSIL (High grade squamous intraepithelial lesion) by cytology and there were 84 cases of LSIL and 39 cases of HSIL by histology. The concordance rate for LSIL was sensitivity 60.8%, positive predictive value 39.2% (k=0.213, p=0.002) and for HSIL was sensitivity 50.0%, positive predictive value 58.0 % (k=0.311, p=0.001) Conclusion: The quality of cervical smears results different between city and rural areas p=0.001) The overall concordance of the study was 65.6%. The discordant cases were 66 (34.4%). The positive predictive value was 40.2% and negative predictive value was 21.1%. Presented the overall concordance by Bethesda classification is different but cyto-histopathological correlation agreement was moderate (k=0.333)