Department of Obstetrics and Gynaecology, Federal Medical Centre, Katsina, Nigeria.
Department of Obstetrics and Gynaecology, Bayero University, Kano/Aminu Kano Teaching Hospital, Kano, Nigeria.
Ann Afr Med. 2021 Jul-Sep;20(3):212-221. doi: 10.4103/aam.aam_47_20.
Cervical cancer is the leading cause of death among women in developing countries. It is preventable through effective cervical cancer screening program. However, in Nigeria, screening programs are opportunistic and coverage is insufficient to make an impact.
This study assessed the cervical cytopathological changes among pregnant women at booking using liquid-based cytology (LBC) in Aminu Kano Teaching Hospital (AKTH).
This was a cross-sectional study that was carried out at the antenatal Clinic of AKTH, Kano, Nigeria. A total of 161 pregnant women who fulfilled the criteria and gave their consent were recruited into the study using systematic sampling technique at booking for antenatal care. LBC was employed using standard procedure and samples sent to histopathology department for analysis. Pro forma developed for the study was used to obtain the socio-demographic and reproductive characteristics of the women and the risk factors for abnormal cervical cytology.
Out of the 161 pregnant women that had cervical cytology screening using LBC on their first prenatal visit during the study, 22 had abnormal cervical cytology, giving a prevalence rate of 13.7%. Out of this, six (27.3%) were atypical squamous cells of undetermined significance, 3 (13.6%) were Atypical Squamous Cells, Cannot Rule Out HSIL (ASC-H), 11 (50.0%) were low-grade Squamous Intraepithelial Lesions while 2 (9.1%) were high grade squamous intraepithelial lesions. Negative smears were seen in 104 women (64.6%). Inflammatory and other conditions of the cervix which are technically negative smears made up the remaining 21.7%. There was a statistically significant association between cervical cytology results and advanced age (P < 0.01), increasing number of lifetime sexual partners since coitarche (P < 0.01), high parity (P < 0.01), absent previous Pap test (P < 0.027), previous history of sexually transmitted infections (P < 0.040), and positive HIV status (P < 0.001). Following binary logistic regression, advanced maternal age, increasing number of sexual partners, high parity, and positive HIV status stood out to be independent predictors of premalignant lesions of the cervix in pregnancy in this study.
Advanced maternal age, increasing number of sexual partners, high parity, and positive HIV status stood out to be independent predictors of premalignant lesions of the cervix in the study. Routine cervical cytology screening using LBC should be offered to all antenatal clients in our setting to increase coverage and detection rate of preinvasive lesions of the cervix, and/or pregnant women with increased risk of abnormal cervical cytology from this study.
在发展中国家，宫颈癌是导致女性死亡的主要原因。通过有效的宫颈癌筛查计划可以预防这种疾病。然而，在尼日利亚，筛查计划是偶发性的，覆盖面不足，无法产生影响。
本研究旨在评估使用液基细胞学（LBC）在 Aminu Kano 教学医院（AKTH）对孕妇进行的宫颈细胞学变化。
这是一项横断面研究，在尼日利亚卡诺 AKTH 的产前诊所进行。使用系统抽样技术，在产前保健时对符合条件并同意参加研究的 161 名孕妇进行了招募。使用标准程序进行 LBC，并将样本送到组织病理学部门进行分析。为研究制定的表格用于获取女性的社会人口统计学和生殖特征以及与异常宫颈细胞学相关的风险因素。
在研究期间，161 名孕妇在首次产前就诊时进行了 LBC 宫颈细胞学筛查，其中 22 名孕妇的宫颈细胞学异常，患病率为 13.7%。其中，6 名（27.3%）为非典型鳞状细胞意义不明，3 名（13.6%）为非典型鳞状细胞，不能排除 HSIL（ASC-H），11 名（50.0%）为低级别鳞状上皮内病变，2 名（9.1%）为高级别鳞状上皮内病变。104 名妇女（64.6%）的涂片为阴性。剩下的 21.7%是由于宫颈炎症和其他技术上为阴性的情况。宫颈细胞学结果与年龄较大（P < 0.01）、初潮后性伴侣数量增加（P < 0.01）、多产（P < 0.01）、既往巴氏涂片检查阴性（P < 0.027）、既往性传播感染史（P < 0.040）和 HIV 阳性（P < 0.001）之间存在统计学显著关联。二元逻辑回归后，高龄产妇、性伴侣数量增加、多产和 HIV 阳性是本研究中与妊娠时宫颈癌前病变独立相关的预测因素。
在本研究中，高龄产妇、性伴侣数量增加、多产和 HIV 阳性是与妊娠时宫颈癌前病变相关的独立预测因素。在我们的环境中，应该向所有产前患者提供常规的 LBC 宫颈细胞学筛查，以增加对宫颈上皮内瘤变的检测率，以及/或对本研究中来自高危人群的孕妇进行筛查。
