Abstract

Objective: Cervical cancer is a preventable disease in the vast majority of woman. Exfoliative cytology still remains the most effective screening tool for preventing various affliaciation of the female genital tract. The aim of present study was to determine the clinicopathological significance of exfoliative cytology in postmenopausal woman.

Materials and Methods: A total of 82 postmenopausal woman, attending in Obstetrics and Gynecology OPD presenting with various gynecological complains of mucoid or mucopurulent vaginal discharge, chronic backache, lower abdominal pain, Irregular vaginal bleeding, post coital bleeding, pain during coitus and dysuria were included in study. All the data regarding  age, religion. Socioeconomic status, parity, locality and presenting complains of the patients were noted. From all the patient pap smear were taken and send for cytological evaluation in our department. All the fixed smears were stained by papanicolaou stain and seen under   microscope.

Result: Out of 82 patient, underwent exfoliative cytology, 67.07% patients were seen in 51-55 years of age, maximum number of patient belonged to Hindu community (60.97%). Low socioeconomic status (56.09%), multiparity (71.95%) and Rural based (63.41%). Majority of patients complained of lower abdominal pain (82.92%), followed by chronic backache (74.39%), vaginal discharge (46.34%) and (25.60%) had Irregular vaginal bleeding. In exfoliative cytological finding maximum patients were (40.24%) found to have Negative for intraepithelial malignancy (NILM), Atypical squamous cell of undetermined significance (ASCUS) was seen in 29.26% of cases, 19.51% patients had Low grade squamous intraepithelial lesion (LSIL), 9.57% patients showed High grade squamous intraepithelial lesion (HSIL) and 1.21% patients were diagnosed as squamous cell carcinoma (SCC). Bacterial vaginosis was the most common infection found in 34.14% of patients followed by fungal (Candida albicans) 9.75% , Protozoa (Trichomonas) in 4.87% of patients and mixed infection in 14.63% of cases. Maximum number of patients had only mild dysplastic charges and were seen in 45-55 year of age groups. In correlation of parity with dysplasia ASCUS was most common in 1-3 children group, LSIL was most common in 4-6 children group and HSIL was noticed mostly in 4-6 children group.

Conclusion: Malignancy is a dreaded disease of mankind involving significant population of the world. Despite breakthrough advances in medical science, mankind is practically helpless against malignancy. The morbidity and mortality caused by malignancy is immense. Even with advanced and expensive therapy we have only been able to postpone the consequences of malignancy. Moreover in a developing country like ours, with major bulk of population below poverty line, only a few get access to such therapy. Therefore simple and economically viable tests like exfoliative cytology were prescribed to detect early cervical cancer.

Keywords: Exfoliative cytology, cervical cancer, postmenopausal woman, screening.