Clinical correlation of CC screening using Pap smear test

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Yasamin Hamza Sharif


Cervical Pap smear, abnormal smear, Human papilloma virus, PCR.



Background and objectives: The cervical cancer (CC) has its long pre-invasive stage, which allows for a preventive detection and possible cure. In this study, this stage was a target stage to investigate women with precancerous lesions by applying the Papanicolaou (Pap) smear test and perform a correlation study.

Patients and methods: A two-year cross sectional study was conducted, in which 200 married women (21-60 years old) were participated in the investigation, which included women with Pap-test abnormal results (atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), and high-grade squamous intraepithelial lesions (HSIL)), which were sent to perform a polymerase chain reaction (PCR) test to detect the presence of human papillomavirus (HPV) of (6 and 11), a low-risk type, and (16 and 18), a high-risk type, with colposcopy examination and colposcopy-guided biopsy, if needed for women with abnormal colposcopy outcomes. The treatment, per severity and disease stage, was applied.

Results: The clinical presentation and pap smear results of women enrolled in the study were asymptomatic 82.5%, postcoital bleeding (PCB) was seen in (17.0 %) and intermenstrual bleeding (IMB) was seen in a single case (0.5 %). History of sexually transmitted diseases (STD) was seen in (2.5 %). Pap smear results were as following: No remarkable pathology seen in (36.0 %), Inflammatory evidence seen in (32.0 %), ASCUS was seen in (19.0 %), LSIL seen in (7.5 %) and HSIL seen in (5.5 %). Regarding human papilloma virus infection was negative in (95.0 %), low risk virus strains were seen in (1.5 %) and high risk viruses were seen in (3.5 %). Low risk HPV included 6, 11 and 42, whereas, high risk group included 5 cases of HPV16 and 2 cases of HPV 18.

Conclusions: The present work presents the Pap smear test as a highly useful, easy, technically safe, and cost-effective tool for detecting the cervical epithelial precancerous lesions, which can be used as a routine screening technique for better treatment outcomes and reducing mortality rates. The power of detection of these lesions can be potentiated when using the Pap test and HPV-PCR test together.

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