Distribution of cervical epithelial lesions in a conventional Pap smear

Aim: In this study, we aimed to examine the distribution of cervical epithelial lesions in conventional pap smear screening. Material and Methods: The smear results of 4500 patients aged 25-65 years who applied to the Istanbul training and research hospital between 2010 and 2011 for conventional smears were analyzed retrospectively. The smear results of the patients were recorded from their files. Smears taken from all patients using plastic brushes were evaluated according to the Bethesda system. The smears were classified by an experienced pathologist according to the following epithelial abnormalities: ASCUS: Atypical squamous cells of undetermined significance, AGUS: atypical glandular cells of undetermined significance, LGSIL: Low grade squamous intraepithelial lesion, HGSIL=High grade squamous intraepithelial lesion, Squamous cell carcinoma and other rare abnormalities. After the smear was stained with the Papanicolaou method, it was evaluated under light microscopy. ASCUS, AGUS, LGSIL and HGSIL are epithelial anomalies in cervical cells and are diagnosed using light microscopy. Results: The normal smear rate was found to be 14%. The most common epithelial anomaly was recorded as chronic cervicitis with a rate of 60%. While the rate of smears containing atrophic cells was 9%, the rate of smears containing insufficient cells was 8%. A smear containing squamous cells was detected in 5.2% of the cases. Atypical squamous cells of undetermined significance were detected in 2% of cases, while atypical glandular cells of undetermined significance were found in 0.2%. While low-grade squamous intraepithelial lesion was 0.8%, high grade squamous intraepithelial lesion was found to be 0.3%. Cervical cancer was not detected in 4500 cases. Considering the number of patients who underwent smear screening, it can be considered normal not to detect cervical cancer. Discussion: A large proportion of cervical epithelial lesions can be accurately detected with conventional pap smear screening.