Pradhan B, Pradhan S B, Mital V P
Department of Community Medicine, Duwakot Community Hospital, Kathmandu Medical College, Sinamangal, Nepal.
Kathmandu Univ Med J (KUMJ). 2007 Oct-Dec;5(4):461-7.
Carcinoma of the cervix is the most common cause of the death in Nepal. Cervical carcinoma does not develop suddenly from normal epithelium but is presented by a spectrum of intraepithelial neoplastic changes that are precancerous lesion and were termed as cervical intraepithelial neoplasia (CIN). Cervical cytological screening is designed to detect over 90% of cytological abnormalities. It has also been established that most cervical cancers can be diagnosed at the preinvasive stage with adequate and repetitive cytological screening. Keeping in view of the importance of carcinoma and the precancerous lesion (CIN) of cervix, study of different methods for the early detection of abnormalities in cervix, correlation with the clinical findings and comparison between the techniques was carried out.
Patients with suspicious cervix attending Gynaecology OPD of TUTH and Western regional hospital (Pokhara) who have undergone for pap smear cytology test along with biopsy were selected. Detail history with clinical examination was performed and the findings were correlated.
Unhealthy cervix with discharge was found to be common even in chronic cervicitis however bleeding and tenderness were associated with more advanced lesions. Pap smear test was found to be equally sensitive to histopathological examination for the early detection of different cervical lesions. However, it is advised to perform biopsy if any abnormalities are detected in pap smear for correlation and confirmation.
宫颈癌是尼泊尔最常见的死亡原因。宫颈癌并非由正常上皮突然发展而来，而是呈现出一系列上皮内肿瘤性变化，这些变化是癌前病变，被称为宫颈上皮内瘤变（CIN）。宫颈细胞学筛查旨在检测出超过90%的细胞学异常。还已证实，通过充分且重复的细胞学筛查，大多数宫颈癌可在浸润前期被诊断出来。鉴于宫颈癌及宫颈的癌前病变（CIN）的重要性，开展了关于宫颈异常早期检测的不同方法、与临床发现的相关性以及技术之间比较的研究。
选取在加德满都大学医学院教学医院（TUTH）和西部地区医院（博卡拉）妇科门诊就诊、接受了巴氏涂片细胞学检查及活检的宫颈可疑患者。进行了详细病史询问及临床检查，并将结果进行关联分析。
即使在慢性宫颈炎中，有分泌物的不健康宫颈也很常见，然而出血和压痛与更晚期的病变相关。发现巴氏涂片检查在早期检测不同宫颈病变方面对组织病理学检查同样敏感。然而，如果在巴氏涂片中检测到任何异常，建议进行活检以进行关联和确认。
