Comparative Analysis of Cytological and Histopathological Findings in Cervical Lesions among VIA-positive Patients and Their Correlation with High-Risk Human Papillomavirus Infection Regarding Cervical Carcinoma

Author(s): Mahmuda Naznin, Zahid Hossain, Farzana Ashrafi Neela

Background: The accuracy of VIA (Visual Inspection with Acetic Acid) in detecting cervical abnormalities varies, necessitating cytology and histopathology. High-risk human papillomavirus (HPV) types are strongly linked to cervical cancer, enhancing diagnostic accuracy and risk assessment when correlated with cytological and histopathological findings. The study aimed to compare cytological and histopathological findings in cervical lesions among VIA-positive patients and to correlate these findings with high-risk human papillomavirus infection status.

Methods: This cross-sectional descriptive study took place at the Department of Pathology, Rajshahi Medical College, and the Department of Gynaecology and Obstetrics, Rajshahi Medical College Hospital, Rajshahi, Bangladesh, spanning from July 2019 to June 2022. A total of 1000 VIA test-positive cases of cervical lesions, were purposively enrolled as study subjects. Cytological, histopathological, and HPV DNA test results were collected and analyzed by using the SPSS version 23.0 program.

Results: According to histopathological findings, out of 1000 participants, 31.0% had either cervical carcinoma (5.3%), Cervical Intraepithelial Neoplasia-I (CIN-1), CIN-II, or CIN-III. According to cytological findings, 25.3% had either cervical carcinoma (4.6%), Low-grade Squamous Intraepithelial Lesion (LSIL), or High-grade Squamous Intraepithelial Lesion (HSIL). The frequency of HPV-positive cases was 24%. The correlation of cervical carcinoma detection between histopathological and HPV-DNA tests and between cytological and HPV-DNA tests was found statistically significant.

Conclusion: There are significant relationships between HPV DNA test results and histopathological and cytological diagnoses. However, none of the testing methods alone are suitable. Therefore, a combination of cytology, histopathology, and HPV DNA typing would ultimately be more useful in assessing cervical lesions or carcinoma.