Abstract
Cervical carcinoma is a major cause of morbidity and mortality among women worldwide. Histological subtype, lymphovascular space invasion and tumor grade could have a prognostic and predictive value for patients' outcome and the knowledge of these histologic characteristics may influence clinical decision making. However, studies evaluating the diagnostic value of various biopsy techniques regarding these parameters of cervical cancer are scarce. We reviewed 318 cases of cervical carcinoma with available pathology reports from preoperative core needle biopsy (CNB) assessment and from final postoperative evaluation of the hysterectomy specimen. Setting the postoperative comprehensive pathological evaluation as reference, we analysed CNB assessment of histological tumor characteristics. In addition, we performed multivariable logistic regression to identify factors influencing the accuracy in identifying LVSI and tumor grade. CNB was highly accurate in discriminating histological subtype. Sensitivity and specificity were 98.8% and 89% for squamous cell carcinoma, 92.9% and 96.6% for adenocarcinoma, 33.3% and 100% in adenosquamous carcinoma respectively. Neuroendocrine carcinoma was always recognized correctly. The accuracy of the prediction of LVSI was 61.9% and was positively influenced by tumor size in preoperative magnetic resonance imaging and negatively influenced by strong peritumoral inflammation. High tumor grade (G3) was diagnosed accurately in 73.9% of cases and was influenced by histological tumor type. In conclusion, CNB is an accurate sampling technique for histological classification of cervical cancer and represents a reasonable alternative to other biopsy techniques.
Highlights
Cervical carcinoma is a major cause of disability, morbidity, and mortality among women with an estimated number of worldwide deaths of 311,000 in 2018 [1].In patients diagnosed with cervical cancer the treatment strategy depends on locoregional and distant disease extent
This study aims to evaluate the performance of preoperative core needle biopsy (CNB) in cervical carcinoma
Histologic tumor type, lymphovascular space invasion (LVSI) and tumor grade were known in all 318 patients in both CNB and hysterectomy specimen
Summary
Cervical carcinoma is a major cause of disability, morbidity, and mortality among women with an estimated number of worldwide deaths of 311,000 in 2018 [1]. In patients diagnosed with cervical cancer the treatment strategy depends on locoregional and distant disease extent. Several pathological characteristics have been studied to predict advanced disease (e.g. lymph node metastasis), poor prognosis, or disease recurrence. The sharing of raw data is not supported by the ethical committee and not included in the written consent form of the study patients
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