Zhonghua fu chan ke za zhi · 2008
[Morphological observation of cone biopsy and hysterectomy specimens of high-grade cervical intraepithelial neoplasia].
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Chen Xiao-duan, Shi Hai-yan
Аннотация
OBJECTIVE: To study the histopathological features, growth pattern and distribution on the uterine cervix of high-grade cervical intraepithelial neoplasia (CIN).
METHODS: Cone biopsy and hysterectomy specimens of 592 women with high-grade CIN (CIN II or III) were reviewed morphologically. Of all cases, the gross appearance of the external os was recorded, and the frequency of cervical quadrants involved in high-grade CIN was assessed. Two hundred specimens were selected randomly to observe micrographical changes, including the extent, depth, growth pattern and cell types of high-grade CIN and the alteration of stroma surrounding CIN.
RESULTS: Of 592 specimens, external os showed smoothness in 46 cases (7.8%), mild erosion in 151 cases (25.5%), moderate or severe erosion in 395 cases (66.7%), hypertrophy in 48 cases (8.1%), and neoplasm in 4 cases (0.7%). High-grade CIN involvement was equally frequent on each quadrant of cervix (P>0.05). Of 200 cases of high-grade CIN reviewed micrographically, the depth of the deepest involved crypt was less than 3 mm in 188 specimens (94.0%), between 3 to 5 mm in 12 specimens (6.0%), and more than 5 mm in none. High-grade CIN with isolated endocervical crypt involvement was detected in 77 cases (38.5%), multiple crypt involvement in 143 cases (71.5%), and confluent crypt involvement in 73 cases (36.5%). High-grade CIN showed explanate in 81.0% (162/200) of cases, endophytic in 49.0% (98/200) of cases, and exophytic in 6. 5% (13/200) of cases. Abrupt transition between CIN and normal epithelia were found in 167 specimens (83.5%), whereas gradual transition in 66 specimens (33.0%). A variety of cell types, but basaloid type predominantly, were observed in high-grade CIN. In 28.5%-45.0% of cases, the stroma surroundin CIN displayed oedema, desmoplastic and lymphocytic responses.
CONCLUSIONS: Our data suggest that gross examination is of little importance for diagnoses of CIN. CIN trend to spread horizontally and along the endocervical crypts, and are mainly distributed to a depth less than 3 mm. These data also suggest that there are a variety of cell types of CIN, and stroma responses to CIN may exist in part of high-grade CIN.
METHODS: Cone biopsy and hysterectomy specimens of 592 women with high-grade CIN (CIN II or III) were reviewed morphologically. Of all cases, the gross appearance of the external os was recorded, and the frequency of cervical quadrants involved in high-grade CIN was assessed. Two hundred specimens were selected randomly to observe micrographical changes, including the extent, depth, growth pattern and cell types of high-grade CIN and the alteration of stroma surrounding CIN.
RESULTS: Of 592 specimens, external os showed smoothness in 46 cases (7.8%), mild erosion in 151 cases (25.5%), moderate or severe erosion in 395 cases (66.7%), hypertrophy in 48 cases (8.1%), and neoplasm in 4 cases (0.7%). High-grade CIN involvement was equally frequent on each quadrant of cervix (P>0.05). Of 200 cases of high-grade CIN reviewed micrographically, the depth of the deepest involved crypt was less than 3 mm in 188 specimens (94.0%), between 3 to 5 mm in 12 specimens (6.0%), and more than 5 mm in none. High-grade CIN with isolated endocervical crypt involvement was detected in 77 cases (38.5%), multiple crypt involvement in 143 cases (71.5%), and confluent crypt involvement in 73 cases (36.5%). High-grade CIN showed explanate in 81.0% (162/200) of cases, endophytic in 49.0% (98/200) of cases, and exophytic in 6. 5% (13/200) of cases. Abrupt transition between CIN and normal epithelia were found in 167 specimens (83.5%), whereas gradual transition in 66 specimens (33.0%). A variety of cell types, but basaloid type predominantly, were observed in high-grade CIN. In 28.5%-45.0% of cases, the stroma surroundin CIN displayed oedema, desmoplastic and lymphocytic responses.
CONCLUSIONS: Our data suggest that gross examination is of little importance for diagnoses of CIN. CIN trend to spread horizontally and along the endocervical crypts, and are mainly distributed to a depth less than 3 mm. These data also suggest that there are a variety of cell types of CIN, and stroma responses to CIN may exist in part of high-grade CIN.