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Clin Exp Obstet Gynecol. 2001;28(2):78-80.

Morphological diagnosis of HPV lesions and cervical intraepithelial neoplasia (CIN) is highly reproducible.

Author information

1
Department of Gynecology UNICAMP, São Paulo, Brazil. ceciliaroteli@iname.com

Abstract

PURPOSE:

to assess the value of individual histological criteria in the diagnosis of cervical HPV lesions.

METHODS:

138 women referred for colposcopic evaluation (due to abnormal PAP smears) were subjected to cervical punch biopsy. The biopsies were classified as no HPV lesion, CIN 1, or CIN 2-3 by two observers independently. Kappa tests were used for interobserver agreement of the diagnosis. The presence of binucleation, multinucleation, abnormal mitosis. koilocytosis, spindle koilocytosis and dyskeratosis was similarly assessed.

RESULTS:

the Kappa statistic was 0.638 (CI 95% 0.533-0.743), showing substantial inter-observer agreement. Abnormal mitosis and multi-nucleation were the two most powerful discriminators between CIN 2-3 and CIN 1. Koilocytosis proved to be the single most powerful discriminator between CIN 1 lesions and non-HPV lesions.

CONCLUSION:

the results advocate the use of histology as the gold standard in diagnosing cervical precancerous lesions. The classical criteria can be also used to differentiate low-grade lesions, which has practical implications by avoiding the unnecessary treatment of minor abnormalities.

PMID:
11491378
[Indexed for MEDLINE]

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