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Abstract
Background: To determine the frequency of
abnormal cytological findings in pap smears of
women in a local population in Pakistan.
Methods: In this observational study conventional
PAP smear was collected, from squamocolumnar
junction, using an Ayer’s spatula in clockwise
direction for 3600 after exposing the cervix by a
Cusco speculum. The endocervical smears were
made by rotating the endocervical brush. The
samples collected were transferred to glass slide and
then slides were fixed in 95% ethyl alcohol. The
slides were then sent to pathology laboratory for
histopathological examination . The adequacy and
reporting of pap smears was based on 2001 Bethesda
system.
Results: Majority of the patients in the
reproductive age group (18- 38 years). Most of the
patients (49.6%) had no cervical complaint and they
underwent the procedure for screening. In
symptomatic patients common presenting
complaints were cervicitis (17.1%) and vaginal
discharge (11.3%).Out of the total 1984 pap smears,
99.1% were negative for intraepithelial lesion or
malignancy. The precursor neoplastic lesions were
observed in 0.8%, which included Atypical
Squamous Cells of Uncertain Significance (ASCUS)
(0.6%), Atypical Glandular Cells of Uncertain
Significance (AGUS) (0.2%) and High Grade
Squamous Intraepithelial Lesion (HSIL)(0.1%).
ASCUS was seen mostly in young age group that is
18- 38 years while HSIL and AGC were identified in
patients more than 50 years of age. Non-specific
inflammatory pattern was seen in 17.6%. Atrophic
pattern was observed in 2.5% smears.
Conclusion- A significant number of abnormal
pap smears were negative for intraepithelial lesion
or malignancy.Epithelial cell abnormalities, though
less prevalent were also seen.