Evaluation and Significance of Cervical Cytology in the Detection of Cervical Intraepithelial Lesions Using the Bethesda System in Classification
Background : Cancer of the cervix uteri remains fourth most common cancer and a significant cause of women mortality in many developed countries; the incidence of cervical cancer was comparatively low in Iraq like most Muslim countries. The Bethesda System goes back almost 3 decades and it is the latest and the more recent medical terminology system with aim to standardize the cervical cytology report.
Objective: Is to emphasize the role of cervical cytopathology smear in the detection of various cervical intraepithelial lesions that may predispose to cancer and to evaluate The Bethesda System in reporting these lesions.
Patients & methods: This retrospective study was carried out in Al-Yarmouk , Baghdad medical city teaching laboratories ,and Karbala gynecology hospital Lab on 91 women aged 25 & above, for the period from June 2016 to March 2017, all were married, non-pregnant, the cervical smears of these women were stained by the Pap technique and reevaluated, reassessed using The Bethesda System (TBS).
Result: According to The Bethesda System the cytological findings of epithelial cells abnormalities revealed: (5.9%) of cases .Minimal cervical smear abnormalities were the high grade squamous intraepithelial lesions (3.3%), Atypical squamous cells, as a single entity was representing (47.1% of abnormal cervical smears, 26.4 % of total group study). While low grade squamous intraepithelial lesions & atypical glandular cells represented (43.1%), (3.9%) of abnormal cervical smears respectively.
Conclusion: Pap smear or cervical smear is a simple, easy test and well established efficiency. The Bethesda System is of validity in providing a uniform formula for cervicovaginal cytopathology report & it reflects important advances in biological understanding of cervical neoplasia & cervical screening technology.
Keywords: Pap smear, cervical cytology, Minimal cervical smear abnormalities, HGSIL, LGSIL &Percent of Clinical Presentation.