title: Clinicopathological importance of Papanicolaou smears for the diagnosis of premalignant and malignant lesions of the cervix.
abstract: BACKGROUND
  Premalignant and malignant lesions are not uncommon in Pakistani women, especially in the older age-groups
  
  
  OBJECTIVE
  This study was conducted to determine the clinicopathological importance of conventional Papanicolaou (Pap) smears for the diagnosis of premalignant and malignant lesions of the cervix.
  
  
  METHODS
  Pap smears of 1000 women were examined from January 2007 to June 2009. Only cases with neoplastic cytology were included.
  
  
  RESULTS
  The overall frequency of normal, inadequate, neoplastic, and infective smears was 50%, 1.8%, 10.2%, and 38.3%, respectively. Most of the patients (67%) were in the postmenopausal age-group, with the mean age being 44.7±15.63 years. The commonest clinical signs/symptoms seen among the 102 patients with neoplastic gynecological lesions were vaginal discharge and abnormal bleeding (93/102;(91.2% and 62/102;60.7%). Of the 102 cases with neoplastic lesions 46 patients (45%) had low-grade squamous cell intraepithelial lesions (LSILs), 22 (21.5%) had high-grade squamous cell intraepithelial lesions (HSILs), 14 (13.7%) had squamous cell carcinoma, and 6 (5.8%) showed features of adenocarcinoma. Ten (9.8%) cases showed cytology of atypical squamous cells of undetermined significance (ASCUS) and four (3.9%) cases had atypical glandular cells of undetermined significance (AGUS).
  
  
  CONCLUSIONS
  We conclude that cervical smear examination is well suited for diagnosing neoplastic disease. It is clear that cervical neoplastic lesions are becoming a problem in Pakistan.
authors.affiliation: Departemnt of Pathology, King Edward Medical University, Lahore, Pakistan.
authors.forename: Mulazim Hussain
authors.initials: MH
authors.lastname: Bukhari
authors.forename: Kanwal
authors.initials: K
authors.lastname: Saba
authors.forename: Samina
authors.initials: S
authors.lastname: Qamar
authors.forename: Muhammad Muddasar
authors.initials: MM
authors.lastname: Majeed
authors.forename: Shahida
authors.initials: S
authors.lastname: Niazi
authors.forename: Samina
authors.initials: S
authors.lastname: Naeem