The cytological pattern of cervical smears of a series of Saudi women in one gynecologic center

OBJECTIVE

Cervical intraepithelial neoplasia (CIN) is a type of abnormal cervical epithelial development that can lead to cervical malignancy. Thus, the purpose of this study was to examine the cytological pattern of cervical smears from a group of Saudi women who visited a single gynecologic center.

PATIENTS AND METHODS

From May 2020 to May 2021, 300 women were referred to the cytopathology laboratory and their cytological materials were collected. Because of gynecologic concerns, the women in the study were referred for Pap smears. As part of the obligatory investigations in conjunction with the clinical assessment, a Pap smear is requested.

RESULTS

CIN of various grades was found in 11% of the women. High-grade Squamous Intraepithelial Lesions (HSIL) were the most detected modifications, followed by Atypical Squamous Cells of Undetermined Significance (ASUS) and Low-grade Squamous Intraepithelial Lesions (LSIL), accounting for 36.4%, 33.3%, and 30.3%, respectively. In 23.7% of the women, inflammatory cell infiltrations were found. Infection with Candida Albicans was identified in 2.3% of the women. In 15.8% of the patients, cytological evidence of bacterial infection was found.

CONCLUSIONS

The prevalence of CIN has been growing in Saudi Arabia in recent years, implying a probable involvement in the spread of HPV. Most CIN cases associated with middle age point to HPV infection at a younger age. There is no link between estrogen and/or progesterone levels and CIN.

Human Papillomavirus genotypes associated with cervical intraepithelial lesions among Saudi women

OBJECTIVE

HPV is responsible for over 90% of cervical cancer worldwide. HPV has numerous subtypes with great variety distribution in different geographical regions. Thus, the present study aimed at assessing Human Papillomavirus (HPV) genotypes associated with cervical intraepithelial lesions among Saudi women.

PATIENTS AND METHODS

The current study collected cervical smears from 300 women transferred to a cytopathology laboratory between May 2020 and May 2021. The studied women were referred to do Pap smear because of gynecologic complaints.

RESULTS

Positive HPV testing was established in 4.7%. Most positive cases were identified in the age range of 14-50 years, followed by 51-60 years, representing 50% and 35.7%, respectively. The risk of HPV infection was significantly high in the age between 40-50 years, the odds ratio (OR), 95% confidence interval (95% CI), OR (95% CI) = 3.0137 (1.0228 to 8.8797), p = 0.0454, z statistic = 2.001. About 57% of the cases of HPV were found with cytological atypia. The risk of HPV in inducing cytological atypia, the OR (95%CI) = 1.8546 (2.9386 to 27.0952), p = 0.0001, z statistic = 3.862. Inflammatory cells infiltrate was identified in 43% of HPV-positive cases. The risk of HPV in inducing inflammatory changes, the OR (95% CI) = 2.6423 (0.8850 to 7.8887), p = 0.0817, z statistic = 1.741.

CONCLUSIONS

The prevalence of High-risk human papillomavirus is relatively low in the AL-Madinah area, Saudi Arabia. Cervical cytological atypia corresponds to the positive HR-HPV findings. HR-HPV infection or cervical cytological atypical changes induce inflammatory cell infiltrates. HR-HPV infection is more common among elderly Saudi women.