TITLE:
Cervical Cancer in Women with Inflammatory Pap Smears
AUTHORS:
Mongia Achour, Dorra Zeghal
KEYWORDS:
Pap Smear; Inflammatory; Cervical Cancer; Human Papillomavirus
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.5 No.1,
January
17,
2014
ABSTRACT:
In spite of preventive measures such as Papanicolaou cervical cytological
analysis and, more recently, vaccination against HPV infection, cancer of the
uterine cervix continues to be one of the most frequent causes of mortality
among women worldwide, particularly in developing countries. In this
prospective study, sixty patients with inflammatory Pap smears had a colposcopy
with directed biopsies. The average age of our patients was 42 years. Results
showed that colposcopy is normal in 10% of women. It showed normal
transformations, ectropion, a colpotis and polyp at 8.33%, 21.66%, 13.33% and
5% respectively. It was able to detect changes with Grade I atypical
transformations (28.33%), and Grade II atypical transformations in 13.33% of
cases. The biopsies were objectified dysplasia and carcinoma in 24.13% of cases
with carcinoma in situ, micro
invasive squamous cell carcinoma and invasive carcinoma glandular. Moreover, we
detected HPV-specific antibodies in sera of these patients. Results showed that
six patients (10%) showed a positive reactivity to at least one of the HPV-16
or HPV-18 antigens and sera showed different reactivity to the different
antigens with the following percentages: 5%, 3%, 2%, 3% and 3% for L1 HPV-16,
E6 HPV-16, E7 HPV-16, E6 HPV-18 and E7 HPV-18 respectively. Among patients having positive antibody response, 83.33% were cases of
dysplasia and carcinoma. We concluded that the Pap smear, examination of key
screening for cervical cancer, is a screening test without diagnostic value and
more specifically any inflammatory Pap smear should be considered a positive
test and led to further investigations. Moreover, colposcopy is an exam that is
performed on an outpatient basis; it allows a detailed study of the cervix and
reduces the negative rate of cytology. In addition, early detection of HPV
antibodies could help the follow-up of patients.