CERVICAL DISEASES

TO COMPARE THE EFFICACIES OF PAP SMEAR CYTOLOGY, COLPOSCOPY AND HISTOPATHOLOGY, IN GYNAECOLOGICAL DIAGNOSIS

Abstract

Objectives: The aim of our study is to compare the efficacies of Pap smear
cytology, colposcopy and histopathology, in diagnosis of cervical diseases. Study Design:
Cross sectional cohort study. Period: One year from June 2013 to June 2014. Setting:
Tertiary care hospital in Karachi, Pakistan. Method: The patient population n=145 consisted
of women ranging from age 18 to 80 years old, who had come to the outpatient clinics for a
variety of symptoms. Pap smear, colposcopy and histopathology was done for women who had
symptoms like recurrent vaginal discharge, postcoital bleeding and other diseases of the cervix.
Findings were noted on a proforma and all the patients signed a duly informed consent. Data
was analyzed using SPSS version 23. Results: The mean age was 45 +/- 9 years (between
24 – 75 years), the parity was 5 +/- 4, normal colposcopy findings were found in n= 66 women,
while abnormal findings were found in n=79 women. In the abnormal colposcopic finding group
n=63 had abnormal histopathology (p<0.001) abnormal histopathology was found in n=11
women who had normal colposcopic findings (16.67% false negative), the calculated sensitivity
and specificity of colposcopy was determined to be 86% and 79%. For pap smear abnormality
was found in n= 49 patients, out of which n=29 had abnormal findings on histopathology as
well. And for colposcopy and pap smear out of n= 78 patients who had abnormal colposcopic
findings, abnormal pap smear was found in only n= 28 patients. And out of those who had
normal colposcopy n= 67, n= 21 had abnormal pap smear (False positivity of 31.34%) similarly
out of those who had normal pap smear n= 96, n= 44 had abnormal histopathology (false
negativity of 45.83%). The calculated sensitivity and specificity of pap smear was 38.8% and
71.8% respectively. Conclusion: We have concluded that there is a strong correlation between
findings of colposcopy and histopathological diagnosis, but when it comes to the diagnosis
made by pap smear and colposcopy and pap smear and histopathology the correlation is weak
and not consistent.