Evaluation of colposcopically directed cervical biopsies yielding a histologic diagnosis of CIN 1,2.
OBJECTIVE
To determine the prognostic value of the diagnostic category CIN 1,2.


METHODS
Computerized pathology records of patients with CIN 1,2 at colposcopically directed biopsy followed by treatment with excision were examined, and we compared the diagnostic biopsy with the final tissue diagnosis. Two pathologists who were blinded to the final diagnosis reviewed the original biopsies independently. The ability of the referee pathologist to predict CIN 2 or 3 lesions and interobserver consistency are described.


RESULTS
Sixty-nine cases of biopsies with CIN 1,2 were reviewed. Nineteen of these patients were lost to follow-up. Of the 46 cases with either an excisional biopsy or hysterectomy, 12 cases (26.1%) demonstrated CIN 2 or greater. Pathologist A and B correctly predicted the high-grade lesions in 66.7% and 58.3% of cases reviewed. Pathologist A and B agreed with each other in 33 of the 46 cases (71.1%).


CONCLUSIONS
1) CIN 1,2 on a colposcopic biopsy is associated with a high-grade lesion in 26.1% of the cases. 2) Experienced gynecologic pathologists can identify these high-grade lesions on review in only two thirds of the cases. 3) CIN 1,2 is a useful diagnostic category to prevent undertreatment.
Molloy
Christine
C
Department of Obstetrics and Gynecology, Anatomy and Cell Biology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Dunton
Charles
C
Edmonds
Pamela
P
Cunnane
Mary F
MF
Jenkins
Thomas
T