A HISTOPATHOLOGICAL STUDY OF DISEASES OF THE CERVIX IN PORT HARCOURT A TEN YEAR RETROSPECTIVE REVIEW (1998-2007)

Abstract

OBJECTIVE: To ascertain the pattern and frequency of cervical lesions in Port Harcourt, and the findings compared with the records of other workers elsewhere.
DESIGN: A retrospective analysis of hysterectomy, trachelectomy and surgical biopsy materials.
SETTING: University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
SUBJECT: Six hundred and sixty-one histologically diagnosed samples from the uterine cervix, between January 1st 1998 and December 31st 2007.
METHOD: The departmental surgical registers from 1998 to 2007 were studied. The original request cards and case notes were retrieved and scrutinized for patient’s age, presentation, and initial clinical diagnosis. The biopsy slides were retrieved from the departmental files, and studied using light microscope. The cases were categorized into neoplastic and non neoplastic conditions. The neoplastic cases were grouped into benign and malignant conditions, and were further classified using 2004 World Health Organization (WHO) scheme. The data was processed using EPI-INFO version 2000 series.
RESULTS: A total of 7,529 surgical specimens were received by the department within the ten year study period. There were 671 samples from the cervix, 661 of which met the inclusion criteria for this study.
Three hundred and ninety-seven (60.1%) of the cases were non neoplastic, while 264 (39.9%) were neoplastic conditions. The commonest non neoplastic lesion was chronic non specific cervicitis. The commonest benign neoplastic condition was cervical polyp. The commonest malignant condition was squamous cell carcinoma.
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The age of patients whose specimens were received during the ten year study period ranged between 17 and 94 years. The mean age was 45.5 years.
The peak age group for the non neoplastic conditions was 40-49 years. The peak age group for the malignant conditions was also 4049 years.
CONCLUSION: There is high frequency and early onset of diseases of the cervix in our environment, in contrast to what is traditionally described in western countries. This underlies the importance of screening programmes and awareness campaign in our community.
An integrated approach, involving cytological diagnosis and cervical biopsy, in addition to aggressive and sustained health education of the population, may be the appropriate intervention to stem the tide of these conditions.
KEY WORDS: Diseases of the cervix, non neoplastic lesions, neoplastic lesions, cervical carcinoma.