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ORIGINAL ARTICLE
Year : 2016  |  Volume : 53  |  Issue : 1  |  Page : 61-62
 

Spectrum of cervical lesions observed in 500 cases: Carcinoma cervix the leading cause of death in females


Department of Pathology, Prathima Institute of Medical Sciences, Karimnagar, Telangana, India

Date of Web Publication28-Apr-2016

Correspondence Address:
S Srikanth
Department of Pathology, Prathima Institute of Medical Sciences, Karimnagar, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-509X.180818

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 » Abstract 

Introduction: The present study was done to know the various histopathological variants in cervical lesions, to know the age incidence and to know the preventive measures and early detection of cervical cancer. Materials and Methods: This is a retrospective and prospective study done on all the hysterectomy specimens and on punch biopsy samples sent for histopathology. We studied a total of 500 cases for a period of 3 years. Results: Out of the 500 cases, 395 cases were non-neoplastic and 105 cases were neoplastic lesions. Chronic cervicitis was the most common non-neoplastic lesion and large cell non-keratinizing squamous cell carcinoma was the most common malignant lesion. Conclusion: The main aim of presenting this study is to highlight the various histopthological variants, age incidence and to educate about the preventive measures and early detection of cervical cancer.


Keywords: Chronic cervicitis, dysplasia, large cell non-keratinizing squamous cell carcinoma, adenocarcinoma


How to cite this article:
Srikanth S. Spectrum of cervical lesions observed in 500 cases: Carcinoma cervix the leading cause of death in females. Indian J Cancer 2016;53:61-2

How to cite this URL:
Srikanth S. Spectrum of cervical lesions observed in 500 cases: Carcinoma cervix the leading cause of death in females. Indian J Cancer [serial online] 2016 [cited 2020 Jul 10];53:61-2. Available from: http://www.indianjcancer.com/text.asp?2016/53/1/61/180818



 » Introduction Top


Carcinoma cervix is an important public health problem world-wide, particularly in the developing countries and accounts for 20-25% of all cancers and 80-85% of all the female genital tract malignancies. Majority of the cervical cancer occur in women who are in their 30's and 40's while they are still raising or supporting families. One of the main reasons for the sharply higher occurrence of cervical cancer in developing countries is the lack of effective screening programs aimed at detecting precancerous conditions (dysplasia) and treating them before they progress to invasive cancer. By proper screening procedures, we can reduce the incidence of cervical lesions.


 » Results Top


A total of 500 cervical tissues were studied, among them hysterectomy cases were 219 (43.8%) and biopsies were 281 (56.2%). Among the 500 cases, non-neoplastic lesions contributed 395 cases (79%) and neoplastic lesions contributed 105 cases (21%).

Among the non-neoplastic lesions, chronic non-specific cervicitis with papillary endocervicitis contributed 336 cases (85.06%)[Figure 1]a. [Table 1] showing the various non-neoplastic lesions.
Figure 1: (a) Gross showing fungating growth from the cervix with ulceration. (b) Cut section showing tumor in the cervix extending up to myometrium

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Table 1: Spectrum of non neoplastic lesions

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Among the neoplastic lesions, large cell non-keratinizing squamous cell carcinoma contributed 28 cases (26.66%). Other neoplastic lesions include Adenocarcinoma [Figure 2] and Squamous cell carcinoma [Figure 3]. [Table 2] showing the various neoplastic lesions. [Figure 2], [Figure 4] and [Figure 5].
Figure 2: (a) Section showing tumor tissue arranged in glandular pattern suggestive of adenocarcinoma (H and E, ×40). (b) Section showing adenocarcinoma with mucinous change (H and E, ×40)

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Figure 3: (a) Section showing tumor cells with a keratin pearl (H and E, ×40). (b) Section showing tumor tissue with clear cell change (H and E, ×40)

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Table 2: Spectrum of neoplastic lesions

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Figure 4: (a) Section showing tumor tissue with pleomorphic and hyperchromatic nuclei with loss of basal polarity (H and E, ×40). (b) Section showing tumor arranged in transitional and squamous differentiation in papillary pattern-squamous transitional carcinoma (H and E, ×40)

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Figure 5: (a) Section showing lining ectocervix with underlying stroma showing inflammatory infiltrate–chronic cervicitis (H and E, ×40). (b) Section showing features of condyloma (H and E, ×40)

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 » Discussion Top


The present study is conducted with an aim to detect the various non-neoplastic and neoplastic lesions of the cervix. Data was analyzed to know the relative frequencies of different cervical lesions. The age group between 31 and 40 contributed highest number of cases i.e., 164 cases and age group between 71 and 80 contributed least number of cases i.e., 04 cases. The age group between 41 and 50 years are more prone for malignancies in our study.

Human papilloma viruses (HPVs) have been linked to many types of cervical diseases ranging from the relatively innocuous condyloma acuminatum to the sometimes fatal invasive squamous cell carcinoma. HPV comprise a family of DNA viruses of which more than 60 types have been characterized. The most common being Types 6 and 11.[1] HPV infection of the cervix is transmitted venerally and it has a predilection for the metaplastic squamous epithelium.

The various risk factors for carcinoma cervix include age at first intercourse, increased parity and sexually transmitted diseases-HPV, multiple sex partners, racial factors, socio-economic status, smoking, oral contraceptives, male factors and immunological factors.

Several investigations have shown that cervical cancer is about five times more common among commercial sex workers than in controls. There is a close inter relationship between racial, cultural and religious factors in the development of cervical cancer and this is illustrated by reference to cervical cancer in Jewesses, who have repeatedly been shown to have a low incidence of the disease. The studies are shown that there is a 2-fold risk of invasive and intraepithelial neoplasia of the cervix among current smokers compared with women who never smoked. It has been demonstrated that nicotine and its major metabolite, cotinine are more concentrated in cervical mucus as compared with the serum.[2]

One of the effective methods of early detection of cervical cancer is screening by  Pap smear More Details. With this, we can detect any dysplastic changes and can take early preventive measures.

Cervical intraepithelial neoplasia lesions are most often treated by local ablative methods and invasive carcinoma of the cervix can be treated by surgery or radiation or a combination of both.[3],[4]

Carcinoma cervix is one of the leading causes of mortality in females; by proper screening we can decrease the incidence. It is important to diagnose mucin secreting carcinomas of the uterine cervix because they carry bad prognosis with early metastasis.

The present study helps us to know the various non-neoplastic and neoplastic lesions and to know the age group distribution. Though, the vaccination has been invented to prevent carcinoma cervix, the efficacy has not yet been proved.

 
 » References Top

1.
Ratnam SS, Rao KB, Kumaran SA. Obstetrics and Gynaecology for Post Graduates. 1st ed. 1997. p. 335-63.  Back to cited text no. 1
    
2.
Anderson MC. Systemic Pathology, Female Reproductive System. 3rd ed., Vol. 6. : Churchil Livingstone; p. 47-127.  Back to cited text no. 2
    
3.
Kilgori LC, Soong SJ, Gore H. Analysis of prognosis features in a adenocarcinoma cervix. Principles and Practice of Radiation Oncology. 1988. p. 1744-53.  Back to cited text no. 3
    
4.
Park JJ, Sun D, Quade BJ, Flynn C, Sheets EE, Yang A, et al. Stratified mucin-producing intraepithelial lesions of the cervix: Adenosquamous or columnar cell neoplasia? Am J Surg Pathol 2000;24:1414-9.  Back to cited text no. 4
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]
 
 
    Tables

  [Table 1], [Table 2]



 

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