<p>Histopathological Diagnosis of Cervical Biopsies: Reduction of Sampling Errors with the Evaluation of a Third Histologic Level</p>

Abstract

Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/rRIJg1MEv9k Aim: Cervical cancer (CC) is considered as a major public health problem; this disease affects mainly vulnerable women in poverty, causing a negative effect on a country's workforce. Objective: To determine the histopathological diagnosis variation after examining three more levels of cervical biopsy paraffin blocks from patients with HPVI, CIN and CC. Materials and Methods: A quantitative, retrospective correlational study was performed in a hospital with a second level of health care. We worked with 152 paraffin blocks of CIN (CIN, I, II and III) and cervical cancer samples. Currently, CIN I is considered as a set of low-grade injuries (low-grade squamous intraepithelial lesions, LSIL), while CIN II, CIN III and cancer in situ are considered as high-grade lesions (high-grade squamous intraepithelial lesions, HSIL). A slab was prepared with the 50micron block, which was subsequently cut into 5 microns; later, the same thing was done at two more levels to reevaluate the histopathological diagnosis and correlate it with the initial diagnosis issued by the institution. Results: During the examination of the additional block levels, a difference was observed from the initial diagnosis: of 32 cases of HPV diagnosis, there were 17 changes to CIN I; of 31 cases of CIN I, there were 4 changes to CIN II; of 30 cases of CIN II, there were 8 changes to CIN III and 1 change to invasive cancer; of 29 cases of CIN III, there were 9 changes to cancer in situ; and finally, of 14 cases of cancer in situ, there was 1 change to invasive cancer. After the statistical analysis, a value of p <0.05 was obtained, which indicated that the differences were statistically significant. Conclusion: By modifying the histopathological study technique, guidelines can be given to generate a more accurate diagnosis with a more solid base, and thus, a more appropriate and timely treatment can be offered to avoid the development of cervical cancer.

Promoter hypermethylation analysis of host genes in cervical intraepithelial neoplasia and cervical cancers on histological cervical specimens

“…The diagnostic reference standard is the WHO classification of tumors of female reproductive organs and the LAST project in 2012 proposed using the immunohistochemical staining of p16 (p16 IHC) [ 19 , 20 ]. The CIN diagnosis is based on H&E morphologic interpretation [ 21 , 22 ]. According to a two-tier system, CIN1 is a low-grade squamous intraepithelial lesion (LSIL), and CIN2 or 3 are high-grade squamous intraepithelial lesions (HSIL).…”

Comparison of Colposcopy and Histopathology in Abnormal Cervix

“…Cervical invasive cancer is considered a preventable condition because it has a lengthy pre-invasive stage, which makes it amenable to screening and treatment. Routine screening and HPV vaccination are recommended to reduce the future prevalence of cervical cancer [ 8 ]. In developing countries such as India, cytology-based screening programs have had very little success due to a lack of qualified personnel, laboratory space and equipment, high service costs, and inadequate follow-up.…”

Prognosis of high‐risk human papillomavirus‐related cervical lesions: A hidden Markov model analysis of a single‐center cohort in Japan

“…The diagnostic precision of histological examination has been shown to depend on the quality of specimen processing. 21 , 22 , 23 Furthermore, it is sometimes difficult to distinguish metaplastic epithelial cells from atypical epithelial cells in a cytological examination. 24 , 25 , 26 Second, cervical lesions are representative of a continuous disease spectrum rather than discrete states.…”

“…First, histological and cytological examinations may be subject to sampling errors. The diagnostic precision of histological examination has been shown to depend on the quality of specimen processing 21–23 . Furthermore, it is sometimes difficult to distinguish metaplastic epithelial cells from atypical epithelial cells in a cytological examination 24–26 .…”