1Assistant Professor, Dept. of Pathology & Laboratory Medicine, AIIMS, Raipur
2Scientist C, NIREH (ICMR), Bhopal
3Associate Professor, SMS Medical College, Jaipur
4PDCC, Dept. of Renal & Transplant Pathology, Apollo, Hyderabad
5Assistant Professor, Dept. of Pathology, TMH, Mumbai
6Ex. Professor, SMS Medical College, Jaipur
*Corresponding Author: Email: ujjawalkhurana@rediffmail.com
Online published on 20 June, 2017.
Cervical cancer is the commonest cancer in women in developing countries. Cost effective screening methods with optimum diagnostic accuracy can help in reducing the global burden.
This prospective study was carried out on 100 patients with suspected lesions of the cervix. Cervical biopsy was taken as gold standard to compare the performance of visual inspection with aceitic acid(VIA) and cytology (Conventional pap smear). Various parameters like age, clinical and sexual history were noted. Genotyping of HPV 16 and 18 of preneoplastic cases was done with real time PCR-based method. All statistical analysis was done at alpha-error 5% and power 80%.
Out of 100 cases, 78 were carcinoma cervix (78%), 19% cervical intraepithelial neoplasia (CIN) (CIN I-8, CIN II-3 and CIN III-8), and 3 had inflammation (3%). Accuracy of cytohistological correlation was highest for Carcinoma cervix (94.64%), 72.72% and 75% each for High grade squamous intraepithelial lesion (HSIL) and Low grade squamous intraepithelial lesion (LSIL). The sensitivity and PPV of VIA came out to be 93.32%, 95% respectively. HPV16 genotype was found in 25% cases of CIN I, 66.66% cases of CIN II and 62.2% cases of CIN III. HPV 18 genotype was detected in only one case (12.5%) of CIN III.
Positive VIA formed a good clinical screening method for picking up Carcinoma Cervix and a promising alternative to Pap smear in precancerous lesions. HPV16 integration status has the potential to be a good marker for risk assessment of CIN progression.
Cancer of Cervix, CIN, HPV, Pap smear, VIA
