Colposcopic, Histologic and Immunohistochemical Assessment in Cervical Intraepithelial Lesions

Abstract

It is widely accepted that HPV infection precedes the occurrence of neoplastic disease in a varying time frame, and HPV testing can detect 30-100% more cervical precancers than conventional cytology and 20-50% more precancers than liquid-based cytology. Low-grade squamous intraepithelial lesions include the categories of mild dysplasia, respectively cervical intraepithelial neoplasia grade 1, and complementary, various descriptors indicating the presence of Human papilloma virus, such as koilocytotic atypia or condilomatous dysplasia. High-grade squamous intraepithelial lesions cytologically consist of moderate and severe dysplasia, respectively cervical intraepithelial neoplasia grade 2, 3 and carcinoma in situ. The purpose of our paper is to analyze the cytological and colposcopic characteristics in low-grade squamous intraepithelial lesions and high-grade squamous intraepithelial lesions cervical lesions and to accomplish histological and immunohistochemical correlations in these cervical intraepithelial lesions. Systematic three-step colposcopic evaluation using successively, normal saline with or without green filter, acetic acid and Lugol staining provides enhanced efficiency to the colposcopic examination and allows a more individualized and targeted surgical, medical or expectant management. Special microscopic techniques are very important in diagnosing and grading cervical intraepithelial neoplasia.