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Characterization of high- and low-grade cervical intraepithelial neoplasia
  1. M. I. Shafi*,
  2. J. A. Dunn,
  3. C. B. Finn*,
  4. S. Kehoe*,
  5. E. J. Buxton*,
  6. J. A. Jordan and
  7. D. M. Luesley*
  1. * Academic Department of Obstetrics and Gynaecology, Dudley Road Hospital, Birmingham;
  2. West Midland Cancer Research Campaign Clinical Trials Unit, Queen Elizabeth Hospital, Edgbaston, Birmingham; and
  3. Department of Obstetrics and gynaecology, Birmingham and Midland Hospital for Women, Sparkhill, Birmingham, UK.
  1. Address for correspondence: Dr Mahmood Shafi, Academic Department of Obstetrics and Gynaecology, Dudley Road Hospital, Birmingham B18 7QH, UK.

Abstract

A need exists to characterize the various grades of cervical intrapithelial neoplasia (CIN), and attempt to differentiate between high- and low-grade lesions, that may have different behavioral and progressive potentials. The identification of patients with high- or low-grade CIN is useful, as it may allow identification of those patients that have true cancer precursors. Fifty patients referred for colposcopy with abnormal cytology were studied. Univariate analysis identified three factors as important predictors of histologic grade; the colposcopic opinion, lesion surface area and the index cytology (P < 0.005). Colposcopic opinion was associated with the index cytology (P < 0.01) and the lesion surface area (P < 0.005). Only the colposcopic opinion and the index cytologic smear appeared in the final model using a stepwise logistic regression analysis, indicating their independent prognostic importance in prediction of grade of abnormality in cervical intraepithelial neoplasia. The study demonstrates the value of colposcopic training and experience being necessary prior to utilizing excisional treatment methods if overtreatment is to be avoided.

  • characterization
  • CIN
  • grade
  • lesion size.

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