Background: Cervical cancer remains one of the most common malignancies affecting women in developing countries, including India. Persistent infection with high-risk human papillomavirus (HPV) is now recognized as the most important etiological factor in cervical carcinogenesis. The present study was conducted to evaluate cervical cytology, histopathology, and HPV DNA status in women presenting with suspicious cervical lesions.

Methods: This observational cross-sectional study was conducted in the Department of Pathology, Government Medical College, Patiala, from January 2015 to June 2016. A total of 150 women with suspicious cervical lesions were included. Cervical smears, cervical brushings, cervical biopsies, and hysterectomy specimens were evaluated. Pap smears were reported according to The Bethesda System 2014, while histopathological lesions were classified according to WHO recommendations. HPV DNA testing was performed using the BD Onclarity HPV assay based on real-time polymerase chain reaction.

Results: Most patients belonged to the 31- 45 years age group (52.7%). Vaginal discharge was the most common presenting complaint (36%), followed by irregular bleeding (26%). Histopathological examination showed infection in 58.7%, dysplasia in 12.7%, benign lesions in 3.3%, and malignancy in 25.3% of cases. Squamous cell carcinoma was the most common malignant lesion (92.1%). HPV positivity was observed in 97.36% of malignant lesions and 57.89% of dysplastic lesions. HPV 16 was the most common genotype identified in malignant lesions (67.56%). Significant association was observed between increasing age, higher parity, HPV positivity, and cervical malignancy.

Conclusions: Infection with high-risk HPV, especially HPV 16, showed a strong association with cervical dysplasia and malignancy. Combined use of cervical cytology, histopathology, and HPV testing improves detection of premalignant and malignant cervical lesions.

KEYWORDS: Cervical Cancer, HPV DNA, Pap Smear, Histopathology, Cervical Cytology, HPV 16.