Author(s): Anitha B1, Satheeshkumar B2
BACKGROUND: Invasive squamous cell carcinoma of cervix remains the most common malignant neoplasm of the female genital tract in many countries. The Papanicolaou stained cervical smear is an excellent and effective method in the diagnosis of invasive carcinoma and precancerous lesions of the cervix. This study was conducted to assess the value of Feulgen stained cervical smears in elucidating nuclear features helpful in the diagnosis of malignancy over conventional Pap stained smears and also to look for micronucleated cells in suspected cases of carcinoma of cervix. AIM: To analyse the distribution of cases of invasive squamous cell carcinoma and intraepithelial neoplasia (squamous intraepithelial lesion) of cervix over a period of 3 years, to elucidate additional nuclear features helpful in diagnosis of carcinoma using Feulgen stained cervical smears and to study the distribution of micronuclei in Feulgen stained smears from suspected cases of Carcinoma cervix.
MATERIALS AND METHODS: A three year analysis of all cases of dysplasia and invasive carcinoma of cervix was done by reviewing Papanicolaou stained cervical smears from all the diagnosed cases of invasive carcinoma and precancerous lesions of the cervix. Cervical smears from sixty clinically suspected cases of carcinoma of cervix and smears from 10 normal women collected during a period of 12 months were studied in detail using Papanicolaou stained and Feulgen Stained Smears and micronuclei analysis (MN analysis) was done.
RESULTS: A total of 24343 cervical smears were screened during the 3 year period of study. Out of these 24343 cases there were 267(1.09%) cases of cervical intraepithelial neoplasia and 144(0.592%) cases of invasive squamous cell carcinoma. Micronuclei analysis done using Feulgen Stained Smears demonstrated a consistent increase in micronucleated cells proportional to the increase in severity of the lesion from normal to invasive carcinoma.
CONCLUSION: This study analysed the distribution of intraepithelial neoplasia and invasive carcinoma of cervix with particular reference to age distribution. This study also demonstrated the superiority of Feulgen stain over conventional Papanicolaou stain in elucidating nuclear features and micronuclei analysis showed a consistent increase in micronucleated cells proportional to the increase in severity of the lesions. So it is suggested that micronuclei analysis may be used as a marker of a greater potential for disease progression.