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151 Screening for cervical cancer in a tunisian hospital
  1. A Ben Amor1,
  2. D Bacha2,
  3. K Saffar1,
  4. A Halouani1,
  5. A Lahmar2,
  6. S Ben Slama2,
  7. S Bouraoui2 and
  8. T Amel1
  1. 1Mongi Slim Hospital, Gynecology Department, Tunis, Tunisia
  2. 2Mongi Slim Hospital, Pathology Department, Tunis, Tunisia


Objectives To analyze the epidemiological, clinical and cyto-colo-histological data of patients who carried out colposcopy.

Methods Prospective study, conducted during 4 years in the Gynecology department of our institution. We included all patients who had colposcopy, regardless of indication and without gynecological neoplastic pathology.

Results Our study included 110 patients with so many pap smears: atypical squamous cells of undetermined significance (48%), high grade squamous intraepithelial lesions (HSIL) (11%), atypical squamous cells cannot exclude HSIL (22%), low grade squamous intraepithelial lesions (14%), atypical glandular cells (5%). Colposcopy showed atypical transformation: grade 1 (ATG 1) in 34% and grade 2 (ATG 2) in 66% of cases. Cervical biopsy revealed normal cervical squamous mucosa in 8%, cervicitis in 72% and condyloma in 8%. A case of CIN 1 was found in 6%, CIN 2 in 3% and CIN 3 in 2%. Cervical biopsy revealed one squamous cell carcinoma. Coloscopy sensitivity was 77% and specificity of 37%. The positive predictive value was 24% and the negative predictive value was 86%. For high grade dysplasia, colposcopy had a sensitivity of 100%, a specificity of 37%. A conization was performed in nine patients for squamous cell carcinoma or high grade dysplasia. Conization was performed in a patient with cyto-histological discordance. Histological study rebealed an in situ carcinoma in two cases.

Conclusions Our results showed that ATG 1 lesions at colposcopy regardless of the FCU abnormalities are predictive of benign biopsy lesions. We also tend to overestimate the ATG 2 lesions.

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