Cancer Management and Research (Jun 2020)
Histopathological Diagnosis of Cervical Biopsies: Reduction of Sampling Errors with the Evaluation of a Third Histologic Level
Abstract
Edgar Villegas-Hinojosa,1 Yolanda Terán-Figueroa,1 Veronica Gallegos-García,1 Dario Gaytán-Hernández,1 Sandra O Gutiérrez-Enríquez,1 Anahid E Campuzano-Barajas,2 Luz E Alcántara-Quintana3 1Facultad de Enfermería y Nutrición, Universidad Autónoma de San Luis, Potosí 78240, SLP, México; 2Hospital General de Soledad, Secretaría de Salud, Soledad de Graciano Sánchez 78435, SLP, México; 3Cátedra CONACYT, adscrito a Facultad de Enfermería y Nutrición, Universidad Autónoma de San Luis, Potosí 78240, SLP, MéxicoCorrespondence: Luz E Alcántara-QuintanaFacultad de Enfermeria y Nutrición, UASLP, Av. Niño Artillero 130 Zona Universitaria, SLP 78240, SLP Tel +52 444 826 23 00 ext 5032Email [email protected]: 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.Keywords: histopathological diagnosis, levels, cervical intraepithelial neoplasia, CIN, cervical cancer, low-grade squamous intraepithelial lesion, LSIL, high-grade squamous intraepithelial lesion, HSIL
