"Cervical Intraepithelial Neoplasia"

Interobserver and Intraobserver Bias Exists in the Interpretation of Anal Dysplasia

“…Specifically, each pathologist was asked to apply the Richart grading system for cervical intraepithelial neoplasia to the anal pathology they were reviewing. 14,15 The level of agreement among the three raters in their interpretation of these three variables was then examined. In addition, original histologic diagnosis of dysplasia was compared with each of the participant's new evaluation of the slides.…”

Guía de práctica clínica sobre los tumores no definitorios de sida e infección por el virus de la inmunodeficiencia humana

“…Igualmente los resultados de las biopsias de la mucosa anal se clasifican como: normal; neoplasia intraepitelial anal de grado i o leve (AIN-I); de grado ii o moderado (AIN-II); de grado iii o grave (AIN-III), o carcinoma invasivo 28 . Recientemente se está empelando la nomenclatura de Bethesda para las lesiones anogenitales revisada en 2012, incluyendo la P16 para la definición de alto grado.…”

The Fallacy of the Concept of Invasion—Critique in Historical Perspective With Implications for Diagnosis of Early Malignant Neoplasms

“…4 They emphasized that ''grading of this type is devoid of long-term prognostic value'' and that ''it is not the severity of CIN that poses the greatest threat to a woman but the size of the lesion.'' 5 As the nomenclature came to be accepted and to be applied increasingly to other anatomic sites, the original intention of it was turned upside down. In the current textbooks of pathology, CIN and its analogues on other anatomic sites is said to be ''precancer'' rather than cancer, the grades of it reflecting different stages in the evolution of malignancy.…”

“…Accordingly, all studies that tried to establish differences between cells in ''dysplastic epithelium'' and carcinoma in situ failed; ''cells in even a mild dysplasia'' were found to ''show the same degree of chromosomal abnormality, in terms of aneuploidy, that characterise a carcinoma in situ.'' 5 Recognition ''that the evolution of an intraepithelial neoplasm is not a two-stage process and that the conditions known as ÔdysplasiaÕ and Ôcarcinoma in situÕ simply represent arbitrarily defined and artificially delineated stages in the evolution of a single continuous process'' eventually led to a new terminology, namely, ''cervical intraepithelial neoplasia,'' and analogous terms for lesions on other anatomic sites. 5 Despite the lofty aspiration to emphasize the continuity of a pathologic process, this was a setback, rather than an advance, for a variety of reasons.…”