الفهرس 
Material and methodsOnly 14 pages are availabe for public view
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Abstract
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SU1WJARY .AIm CONCLUSION
nte commonestsite of malignancy in the female
genital tract is the cervix. Dysplasia and carcinoma in
situ are the final stages of developmentthrough which
cervical carcinoma must pass.
ntese two major histologicd intities are recently ter.-
medcervical L’ltra-epithelial neoplasia (OIN) (Richard,
1967; Koss, 1978). The cervical intra-epithelial neoplasia
(OIE) are subdivided into C.I.N. I equivalent to
mild dysplasia , C.I.Ii. II to moderate dysplasia and
ali”III to severe dysplasia and carcinoma in situ (C.I.S).
nte lesions of (C.I.h) are pre-clinical that they can not
be recognized by traditional methods of clinical examination.
Themost importEnt two diEgnostic tools avliiJable
for the clinician for the diagnosis of these lesions, are
cervical exfoliative cytology and colposcopy. The incr_
easing accuracy achieved by exfoliative cytology over
the past two decades in predict1o&, epithelial neoplastic
changes in the uterine cervix is well recognised,’ since
the pioneer work ot l’apanicolaou and 1reut, 197,3.
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~e cervical sms,arbecomea WL1dav th:!:’ouehwhich thE; change
of epithelium from r.ormal to abnormal could be revelned.
~is change has it’s inception long before gross les10n
becomevisible.
~is study was done to evaluate the clinically suspicious
cervix from the cytological point of view, as a
starting point cefore the final histu-pethological diagnosis.
Pol’ this, the cyto-smears of 50 cases with clinically
suspicious cervices versus 20 cases with clinically
free cervices, as oontrol, were studied from the cases
attending the gynaecological out-patient clinic at
Zegazig University Hospital, in’ 1919-1980. All caees
attending the clinic were submitted to exarainetion by the
veginal speculum, before b1uenual e:xnUi..’1ationwas done and
no ll.i.hricants were emploYed.
~ose caseG with clinicelJyeuspic10us cervices
”clinically unhealthy looking cervices” inclUding; extensive
cervical erosion, ectropion with leceroted infectsd
cervices, hypertrophied cervices. cervices with polypi and
cervices that bleed on touch had beeh selected (SOc68es)
beside 20 caaee with clinically free cervices were also
selected BS control. J.. thorough history W&staken with
special emphasis on the factors knownto influence the
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prevalence r£to of cervical cercinoma. General physical
and gynaecological examinations were done with special
attention to the cervix.
The cervical screp smear ViSS Used by using the Ayre’s
spatula, the eneaz-was taken from squamo-colWll118jurnction
as well as any abnormal area, thaD spread rapidly
on a dry clean slide, fixed end stained by Papanicolaou
ste in. ~hen. the sLides were ready foZ’ microscopic
examination.
It was found that the max1wmincidence of suspicious
cervix in the group of age 3IJ-J9 yeers (20 cases: i. e. 40”’;;)
and the group of parity 4-6 (27 casea; ~.e. 54 %).
fhe total number of positive smears in suspicious group
was 11 smears out of 50 euear-a with two mld dYsplasia,
one moderate dysplasia, four severe dlrsplasia, one carcinoma
in situ and three malignant sweare while the control
were showing two positive slnears (10 %) with mild dy8Plasia
out of 20 smears of cases with clinically free cervices.
Regarding infection 32 smears were ehowi.lg nOll-specific
..
infection (64 %). and 8 smears were shov;~ trichomonas
vaginal1s (16 %) (15onll1e were bsdly a tcined by Papanico_
laou stain, eo no oommenton it v;::s dOJ13)out d: 50 swears of
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Cssee with suspicious cervices, while 8 smears were
showing trichomonas vaginalis (15 %) out at 20 smears
of cases with clinically free cervices.
~e high incidence of positive smears in this study wss
dtributed to tho fact that this work was done on a
selected group of suspicious cervices.
1’he prese.::lceof positive sneaz-a with the control
cases was a proof that not every clinically free cervi::
is innocent, as it mayundergo histo-pathological and
cytologic’ll changes which coqld not be rocognisad by
the traditional methods of clinical exauinatlon.
So, according to the previous conclusion we recommend
the following 1_
Each felU<.:ledurilg her reproductive ].Jeriod, must be
checked up by routine cerv!covaginal cytology every 6
months to detect any early leaiollS which could be easily
dealt with as early as possible end abort it before it
growSup_
Females 4lUstbe educated to conte for reout~ 9%f:c.l
l~Uve .~():l<2[{j,”4a”J...: exnminotion, especially if she
SUffers. from c~cesslve abnormal diechcrge or even mild
gynaecolog1ccl trouble.
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- !!.’hismethod of exfoliative cytology lDUstbe used
in every hospital end out-patient clinic as it is simple
cheap, time saving and can bo used for screening of
massive number and any physician can Usc it, also the
nursing steff should knew,howto take the smears_
- Ceses with suspicious smears lDUstbe submitted
for further investigations by colposcopy and histopathological
biopsies to diagnose the accurato stage
of dysplasia or of malignancy if it is present and put
an effective plan for treatment.